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diseases of the external ear

Terms in this set (35)

Acute otitis externa is said to last less than...
3 weeks
Chronic otitis externa is said to last longer than...
3 months
What is malignant otitis externa?
It is the spread of otitis externa into the bone surrounding the ear canal- the mastoid and temporal bones
Name three characteristic symptoms of otitis externa.
Ear pain, itch, discharge, hearing loss
Describe the appearance of the external ear canal in otitis externa
swollen, red, eczematous
Name three complications of otitis externa
abscess, inflammation of the tympanic membrane, malignant otitis externa
Name two risk factors for the development of malignant otitis
diabetes, radiotherapy to head and neck, older age
What is the most common cause of otitis externa? Name two causative agents.
Bacterial infection: pseudomonas or staph aureus
Name five causes of chronic otitis externa.
allergic contact dermatitis, irritant contact dermatitis, seborrhoeic dermatitis, fungal infection, bacterial infection
Name three signs of chronic otitis externa.
lack of earwax in the external ear canal, dry hypertrophic skin, pain on manipulation of external ear canal
What is the recommended initial management of otitis externa?
Topical antibiotic or topical abx combined with steroid
What features may suggest severe inflammation?
red, oedematous ear canal narrowed and obstructed by debris,
conductive hearing loss,
discharge,
regional lymphadenpathy,
fever
What is the treatment of otitis externa?
clean the external auditory canal
topical otic neosporin-polymyxin B
Name can be used in the prevention of recurrent otitis externa?
ethyl alcohol drops or acetic acid drops after swimming or bathing
What is perichondritis and how does it present?
inflammation of the covering of the cartilage --> pain, warmth of the pinna which is uniformly enlarged and thickened
What is the most common cause of perichondritis?
pseudomonas aeruginosa
What is the management of perichondritis?
broad spectrum abx e.g. ciprofloxacin, fluroquinolone
betadine or boric acid wet dressings
What distinguishes otitis externa from perichondritis?
the lobule is spared in perichondritis
What is otomycosis?
fungal infection of the external auditory canal
How does otomycosis present?
inflammation, pruritus, scaling and severe discomfort
What is the characteristic feature of otomycosis?
long, white, filamentous hyphae growing from the skin surface
Name two risk factors for otomycosis?
surfing
scuba diving
What is myringitis?
inflammation of the tympanic membrane
What is the significance of haematoma of the auricle?
The auricle is a well vascularised area. Shearing forces can cause separation of the perichondrium from underlying cartilage, this can cause tearing of blood vessels and subsequent haematoma, which if not drained can lead to avascular necrosis and asymmetrical cartilage growth --> cauliflower ear
Name three precancerous or malignant lesions that may affect the external ear.
1. acitinic keratosis
2. squamous cell carcinoma
3. basal cell carcinoma
How does acitinic keratosis present?
Flat, scaling lesion on sun- exposed area
What can acitinic keratosis progress to?
Squamous cell carcinoma
Name four risk factors for acitinic keratosis?
1. skin type I or II
2. immunosuppression following organ transplantation
3.increasing age
4. cumulative sun exposure
Name three features of solar damage
telangiectasis
elastosis
pigmented lentigines
What is used in the treatment of acitinic keratosis?
5- fluoro uracil
Name four clinical features of acitinic keratoses.
- flat or thickened papule or plaque
- white, yellow, skin coloured or red
-scaly, warty
Keloids are more common in who?
people of afro- caribbean origin
Name four common sites of keloid formation.
1. sternum
2. earlobe
3. shoulder
4. cheek
What type of texture do keloids have?
rubbery
What is the mainstay of treatment of keloids?
Intralesional steroid injections, with triamcinolone
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