Diseases Of External Ear

Question 1

Congenital abnormalities of pinna

Answer 1

Anotia
Microtia
Macrotia
Bat earcup / Lop ear
Cryptotia
Coloboma
Ear lobule deformity
Pre auricle tags / appendages
Pre auricular pits / Sinus

Question 2

Minor deformities of pinna

Answer 2

Darwin’s tubercle
Stahl’s ear
Satyr ear

Question 3

Trauma to the pinna (auricle)

Answer 3

Haematoma
Lacerations
Avulsion
Frostbite
Keloid

Question 4

Inflammatory disorders of the pinna

Answer 4

Erysipelas
Cellulitis
Perichondritis
Relapsing polychondritis

Chondrodermatitis nodularis chronica helicis

Tumors

Question 5

Galium 67 used in malignant otitis externa

Answer 5

Detect soft tissue infection

Taken up by monocytes + reticuloendothelial cells

Question 6

Technitium 99 used in diagnosis

Answer 6

Bone infection in malignant otitis externa

Results positive for 1 yr

Question 7

Arnold’s nerve

Answer 7

Auricular branch of vagus nerve(X)

Question 8

Swimmer’s ear

Answer 8

Otitis externa

Question 9

Otitis externa /swimmer’s ear causes

Answer 9

Bacterial (pseudomonas, E coli,S. Aureus)

Fungal (candida, aspergillus)

Dermatological (alllergic contact dernatitis, psoriasis, atopic dermatitis

Diabetes

Question 10

Signs of swimmer’s ear/ititis externa

Answer 10

Pinna traction
Otorrea (yellow discharge)

Swelling purulent debris (canal obstruction)(conductive hearing loss)

Post. Auricular lymphadenopathy
External ear canal pruritis

Question 11

Complicated otitis externa signs

Answer 11

Periauricular soft tissue erythema

Swelling

Question 12

Hearing test in otitis externa/swimmer’s ear

Answer 12

Weber test (sound lateralized to affected ear)
Rinne test (BC > AC)

Question 13

Signs of otitis externa /swimmer’s ear

Answer 13

Ear pain(otalgia)
Discharge/debris (yellow ,white,gray)
Pruritis
Tinnitus
Hearing loss
Lymphadenopathy
Fever
External auditory canal occluded (erythematous+edematous)

Question 14

Types of otitis externa (eitiological)

Answer 14

Infective

Reactive

Question 15

Infective type of Otitis Externa include

Answer 15

Bacterial 
  Furuncle/localized OE
  Diffuse OE
  Malignant OE
Viral
  Herpes zoster oticus
  OE haemorrhagica
Fungal
  Otomycosis

Question 16

Reactive type of otitis externa include

Answer 16

Eczematous OE
Seborrhoeic OE
Neurodermatitis

Question 17

Herpes zoster oticus

Answer 17

Vesicles on tympanic membrane
Meatal skin
Concha
Postauricular groove
7th + 8th nerve involved

Question 18

Otitis externa haemorrhagica

Answer 18

Haemorhhagic bullae on tympanic membrane
Deep meatus
Severe pain
Blood stained discharge(bullae rupture)

Question 19

Furuncle /Localized Acute OE

Answer 19

Staph. infection of hair follicle
Furucle only in meatus
Single/multiple
Severe pain
Tenderness
Painful pinna movement
Painful jaw movement
Edema over mastoid (post meatal wall)

Question 20

Treatment of Furuncle OE

Answer 20

10% Ichthammol glycerine

Provide splintage and reduces pain

Question 21

Diffuse OE

Answer 21

Diffused inflammation of meatal skin

Pinna + epidermal layer of tympanic membrane

Excessive sweating changes pH of meatal skin (alkaline)

Leads trauma + invasion of pathogens

Question 22

Phases of Diffuse OE

Answer 22

Acute

Chronic

Question 23

Acute phase Diffuse OE

Answer 23

Hot burning sensation
Pain (jaw movement)
thin serous discharge (thick+purulent)
Meatal lining (inflammed+swollen)
Conductive hearing loss(oclusion)
Lymph nodes swell +tender(cellulitis)

Question 24

Chronic phase of diffuse OE

Answer 24

Irritation
Itching
Discharge scanty (dry crusts)
Meatal skin (thick + swollen + scalling + fissuring)
Chronic stenotic OE(hypermetropic meatal skin)

Question 25

Malignant /necrotizing OE

Answer 25

``` Pseudomonas infection Elderly diabetics / immunosuppressive Excruciating pain Granulation in ear canal FACIAL PARALYSIS SPREAD Skull+jugular foramen(nerve palsies) Ant. Temporomandibular fossa Post. Mastoid Medially middle ear+petrous bone Severe otalgia ```

Question 26

Fungal OE /otomycosis

Answer 26

``` Aspergillus niger, fumigatus, candida Tropical and subtropical Intense itching Pain Watery discharge (musty odour) Ear blockage Fungal mass (white/brown/black) Meatal skin red + edematous ``` Antifungals (nystatin,clotrimazole,povidone iodine) Keratolytic (2% salicylic acid)

Question 27

Eczematous OE

Answer 27

``` Hypersenstivity to organisms/ear drops(neomycin) Allergic reaction(hearing aids) Intense irritation Vesicle formation Canal crusting+oozing ```

Question 28

Seborrhoeic OE

Answer 28

Seborrhoeic dermatitis of scalp Itching Greasy yellow scales (canal+lobule+postauricular sulcus)

Question 29

Neurodermatitis

Answer 29

Compulsive scratching (psychological) Intense itching Bacterial infection may follow

Question 30

Area of collection in canal/blind pocket

Answer 30

Anteroinferior meatal recess

Question 31

Ear toilet

Answer 31

Blind spot specially Dry mopping Suction clearance Irrigation (warm sterile normal saline)

Question 32

Medicated wicks

Answer 32

Gauze wick Soaked in antibiotic steroid 2-3 times a day Local steroid drops releive edema, erythema and prevent itching Aluminium acetate 8% ,silver nitrate 3% mild astringents (dry up oozing meatus)

Question 33

Antibiotics for treatment of malignant/necrotizing OE

Answer 33

Gentamicin+ticarcillin IV (Ototoxic+nephrotoxic) Cephalosporins(ceftriaxone/ceftazidime) Quinolones+rifampin

Question 34

Primary cholesteatoma of EAC

Answer 34

``` Squamous epithelium invades bone Abnormality conductive for epithelium Post traumatic /post surgical Starts from posteroinferior part of ear canal Purulent otorrhoea Pain Granulation(sequestrated bone) ```