Outer Ear Disorder

Question 1

Where is hematoma of pinna

Answer 1

B/w perichondrium and cartilage

Question 2

Hematoma of Pinna : Tx

Answer 2

I + D *early
Drain clot if needed
Pressure dressing w/ 2-day follow-up
Prophylactic ABX 3-5 days

Question 3

Cerumen impaction : presentation

Answer 3

Pain
Pressure
vertigo
Hearing loss

Question 4

Cerumen impaction : Tx

Answer 4

Irrigation

Ear wax softener (Debrox, Cerumenex, Docusate)*no if TM perf

Question 5

Cerumen impaction: irrigate w/ TM perf?

Answer 5

NO

Question 6

Curette usage …

Answer 6

With caution

Question 7

How can patients ear irrigate at home?

Answer 7

Bulb syringe

Question 8

Bug in ear : kill with

Answer 8

Lidocaine jelly
Alcohol
Mineral oil

Question 9

Foreign body in ear : presentation

Answer 9

Children ( <8 yrs)
Otalgia
Otorrhea (blood/smell) - long time
Hearing loss, N/V
NO FEVER, URI

Question 10

Otic Foreign body : removal

Answer 10

*Atraumatically*
Irrigation
Suction
Forceps
Balloon catheter

Question 11

Do NOT irrigate ear if

Answer 11

TM perf
Foreign matter absorbs water
Battery

Question 12

How to dissolve styrofoam in ear?

Answer 12

Acetone

Question 13

Otic Foreign body aftercare

Answer 13

ABX drops

Question 14

Otitis externa bug

Answer 14

Pseudomonas

Warm, wet

Question 15

OE : cause

Answer 15

Canal trauma
Bacterial
Fungi/yeast

Question 16

OE : s/s

Answer 16

Fever
Hearing change
Otorrhea
Canal swelling/full

Question 17

OE : physical exam

Answer 17

Tragal tenderness
Periauricular adenitis
SPECULUM: Erythema, epithelial edema, moist debris
TM: mobile

Question 18

Acute OE

Answer 18

Swimmers ear

Question 19

Chronic OE

Answer 19

> 6 weeks

FB, hearing aid

Question 20

Eczematous OE

Answer 20

Psoriasis, eczema

Question 21

Necrotizing/malignant OE

Answer 21

Into deeper tissues

DM/immunocompromised

Question 22

OE : dx

Answer 22

None

If mastoiditis: temporal CT

Question 23

OE : Tx

Answer 23

Topical drops
Analgesic
Pope/ear wick
MAYBE oral ABX, admit (necrotizing)

Question 24

OE : antibiotic drops

Answer 24

Acetic acid
Cortisporin otic (neomycin, polymixin B, hydrocort)
Ofloxacin, Ciprodex
Clotrimazole
ECZEMA - acetic acid/aluminum acetate
FUNGAL - tinactin/micatin

Question 25

Middle Ear Trauma : damage to

Answer 25

TM perf Ossicles Middle ear hematoma

Question 26

ABX for TM perf?

Answer 26

Otitis media - YES Trauma - YES (prophylactic) Auditory - NO

Question 27

TM perf physical abuse red flag

Answer 27

Bilateral for no good reason

Question 28

TM perf : cause

Answer 28

Abuse, FB, Irrigation/cleaning, OM, Barotrauma

Question 29

TM perf : s/s

Answer 29

Otorrhea Hearing changes/tinnitus Pain

Question 30

TM perf : signs

Answer 30

Traumatic - lack discharge | Weber - lateralize to perf side

Question 31

TM perf : management

Answer 31

Dry Refer Audiology/ENT INFXN: Cortisporin Otic , Ciprofloxacin Opthalmic (ciloxan) TRAUMA: no abx

Question 32

Barotrauma : s/s

Answer 32

``` Abrupt pain onset Ear fullness Conductive H.L. Dizziness/vertigo/N/V Tinnitus Facial paralysis ```

Question 33

Barotrauma: from

Answer 33

AIR TRAVELERS Scuba Hyperbaric O2 chamber Blast injury

Question 34

Barotrauma : Tx

Answer 34

Open eustachian tube Rx: antihistimine, decongestants, ABX prevent infxn SEVERE: surgery

Question 35

Middle Ear Hematoma : cause

Answer 35

Basilar scull fracture(??)

Question 36

Middle Ear Hematoma : Tx

Answer 36

``` Watch No ABX (unless infxn) Refer audiometry/EMT ```

Question 37

Middle Ear Hematoma: prognosis

Answer 37

Hearing back in 6 -8 weeks | If no ossicle fracture