Otitis Externa Flashcards
What is otitis externa?
It is defined as condition in which there is inflammation of the external ear canal
What are the two classifications of otitis externa?
Acute Otitis Externa
Chronic Otitis Externa
What is acute otitis externa?
It is defined as inflammation of the external ear canal which persists for a period less than three weeks
What is chronic otitis externa?
It is defined as inflammation of the external ear canal which persists for a period greater than three weeks
What are the seven risk factors asscoiated with otitis externa?
Bacterial Infection
Fungal Infection
Seborrhoeic Dermatitis
Contact Dermatitis
Psoriasis
Acne Vulgaris
Swimming
What two bacterial infections are associated with otitis externa?
Psuedomonas Aeruginosa
Staphylococcus Aureus
What two fungal infections are associated with otitis externa?
Candida Albicans
Aspergillus Niger
What are the six clinical features associated with otitis externa?
Ear Pain
Watery Ear Discharge
Ear Itch
Ear Erythema
Conductive Hearing Loss
Auricular Lymphadenopathy
Describe the ear pain associated with otitis externa
The pain stimulated on palpation of the tragus
What two investigations are used to diagnose otitis externa?
Hearing Tests
Ear Swab Microbiology
What two hearing test results indicate otitis externa?
Negative Rinne’s Test, BC > AC
Weber’s Test Lateralises To Affected Ear
When is ear swab microbiology used to investigate otitis externa?
When pharmacological management is deemed ineffective following a maximum 14 day course
What are the two conservative management options of otitis externa?
Strict Water Precautions
Avoid Cotton Bud Use
What are the two pharmacological management options of otitis externa?
Topical Antibiotics ± Topical Steroids
Oral Antibiotics
When are topical antibiotics ± topical steroids used to manage otitis externa?
They are the first line management option
Name a topical antibiotic + topical steroid used to manage otitis externa
Otomise Spray (Neomycin + Dexamethasone)
What course length of topical antibiotics ± topical steroids is used to manage otitis externa?
7 - 14 days
What topical antibiotic class should be avoided in cases where the tympanic membrane is perforated? Why? What anitbiotic should be instead administered?
Aminoglycosides
This is due to the risk of ototoxicity
Quinolone
When are oral antibitoics used to manage otitis externa?
They are the second line management option of otitis externa, in cases where infection extends beyond the external ear canal
Name an oral anitbiotic used to manage otitis externa
Flucloxacillin
In which patient group, are oral antibiotics recommended as the first line management option? Why? Which antibitoic is administered?
Diabetics
This is due to the fact that in diabetic patients pseudomonas auergonisa is a common causative organism
Oral ciprofloxacin
When should otitis externa be urgently referred to ENT? Why?
When pharmacological management is deemed ineffective following a maximum 14 day course with worsening pain
This indicates malignant otitis externa
What complication is associated with otitis externa?
Malignant Otitis Externa
What is another term for malignant otitis externa?
Necrotising otitis externa
