Otitis externa

Question 1

what is otitis externa ?

Answer 1

inflammation of the external auditory canal

Question 2

what are the risk factors associated with otitis externa ?

Answer 2

swimming
warm and humid climates
underlying skin conditions like eczema
immunosuppression
trauma
hearing aids

Question 3

what are the causative oganisms
of otitis externa ?

Answer 3

mostly bacteria : pseudomonas aeruginosa and Staph Aureus
can also be fungal after prolonged antibiotic use

Question 4

what aree the symptoms associated with otitis externa ?

Answer 4

otalgia - especially on movement of the pinna or the jaw
itching
discharge
hearing loss

Question 5

what is the first symptom associated with each of :
bacterial otitis externa
fungal otitis externa ?

Answer 5

bacterial otitis : first complaint is pain
fungal otitis: first complaint is itching

Question 6

what are the signs associated with otitis exteerna ?

Answer 6

tenderness on the tragus or pulling of the auricle
swelling of the external auditory meatus
eryhtema
purulent discharge

Question 7

what investigations should be done for otitis externa ?

Answer 7

swab from thee EAC for culture and sensitivity

Question 8

whatt is the treatment for otitis externa ?

Answer 8

aural toilet by suction
topical antibiotic
or topical anti-fungal
ear packing in case of severe oedema ( feteel el othon)

Question 9

what is malignant otitis externa ?

Answer 9

severely painful progressive otitis externa
not responsive to medical treatment
for more than 2 weeks
history of diabetes or uncompromised 3amatan

Question 10

what is the etiology associated with malignant otitis externa ?

Answer 10

osteomyelitis of the lateral skull base

Question 11

what is the main complication associated with Malignant otitis exteerna ?

Answer 11

multiple lower cranial nerve palsies ( lower facial nerve palsy)

Question 12

what are the signs associated with malignant otitis externa ?

Answer 12

deep seated pain that worsens at night
swelling of the EAC
erythema
purulent discharge
granulation seen at the floor of the EAC

Question 13

what are the investigations required for malignant otitis externa ?

Answer 13

swab for sensitivity and culture
blood glucose and ESR
CT scan is required
biopsy from granulationn to exclude malignancy

Question 14

what is the treeattment of malignant otitis externa ?

Answer 14

hospitilization first
control of blood sugar
IV Ab
regular aural toilet
surgical debridement may be required

Question 15

what is ramsay hunt syndrome characterized by ?

Answer 15

Herpes Zoster Oticus
characterized by severly painful vesicular exanthem
7th and 8th cranial nerve may bee affected

Question 16

what are the diagnostic features of ramsay hunt ?

Answer 16

facial paralysis
SNHL
vesicular exanthem

Question 17

what is otomycosis ?

Answer 17

fungal ear infection

Question 18

if on examination of a suspected otitis externa patient a perforated TM is found what is this likely an indication of ?

Answer 18

chronic suppurative otitis media and the otitis externa happened as a secondary complication

Question 19

otalgia that increases at night is indicative of ?

Answer 19

malignant otitis externa

Question 20

what is the causative organism in Ramsay Hunt syndrome ?

Answer 20

varicella zoster virus

Question 21

what are the complications of ramsay hunt syndrome ?

Answer 21

affection of the 7th and 8th cranial nerve
facial nerve paralysis
SNHL
post herpetic neuralgia

Question 22

what is thee treatment for Ramsay Hunt syndrome ?

Answer 22

systemic steroids
systemic antivirals
analgesics