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    Disease of External Canal

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    miemednote
    1) The document discusses various diseases of the external ear canal including congenital atresia, trauma such as lacerations and foreign bodies, and various types of inflammation including infectious causes like diffuse otitis externa and malignant otitis externa. 2) Malignant otitis externa is caused by Pseudomonas aeruginosa bacteria, often affects diabetics, and can aggressively spread to the skull and cause osteomyelitis if not properly treated with long-term high dose antibiotics and control of diabetes. 3) Treatment of conditions discussed include antibiotics, analgesics, aural toilet, and sometimes surgery.

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    Disease of External Canal

    Uploaded by

    miemednote
    383 views6 pages
    1) The document discusses various diseases of the external ear canal including congenital atresia, trauma such as lacerations and foreign bodies, and various types of inflammation including infectious causes like diffuse otitis externa and malignant otitis externa. 2) Malignant otitis externa is caused by Pseudomonas aeruginosa bacteria, often affects diabetics, and can aggressively spread to the skull and cause osteomyelitis if not properly treated with long-term high dose antibiotics and control of diabetes. 3) Treatment of conditions discussed include antibiotics, analgesics, aural toilet, and sometimes surgery.

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    4th year medical school, zagazig university, ENT

    Original Title

    Disease of External Canal (1)

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    1) The document discusses various diseases of the external ear canal including congenital atresia, trauma such as lacerations and foreign bodies, and various types of inflammation including infectious causes like diffuse otitis externa and malignant otitis externa. 2) Malignant otitis externa is caused by Pseudomonas aeruginosa bacteria, often affects diabetics, and can aggressively spread to the skull and cause osteomyelitis if not properly treated with long-term high dose antibiotics and control of diabetes. 3) Treatment of conditions discussed include antibiotics, analgesics, aural toilet, and sometimes surgery.

    Copyright:

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    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    383 views6 pages

    Disease of External Canal

    Uploaded by

    miemednote
    1) The document discusses various diseases of the external ear canal including congenital atresia, trauma such as lacerations and foreign bodies, and various types of inflammation including infectious causes like diffuse otitis externa and malignant otitis externa. 2) Malignant otitis externa is caused by Pseudomonas aeruginosa bacteria, often affects diabetics, and can aggressively spread to the skull and cause osteomyelitis if not properly treated with long-term high dose antibiotics and control of diabetes. 3) Treatment of conditions discussed include antibiotics, analgesics, aural toilet, and sometimes surgery.

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    of 6

    DISEASE OF EXTERNAL CANAL

    I) CONGENITAL
    CONGENITAL ATRESIA Failure of canalization of ext ear unilateral/bilateral usually congenital in ext ear associated with congenital in auricle and mid ear. INVESTIGATION CT scan : evaluate degree of atresia Audiologcal : TTT Unilateral cases Bilateral cases plastic surgery after puberty hearing aid after few month To help speech development Reconstruction surgery 6 yrs 1 ear,other After puberty Bilateral dead ear lip reading,cosmetic Surgery. B)LONGITUDINAL FRACTURE TEMPORAL BONE

    II) TRAUMA
    A) LACERATION Causes Sign self inflicted, unskilled ear wash mild bloody otorrhea,laceration otitis externa

    Complication ttt

    Antibiotic+steroid ear drop

    C)FOREIGN BODY Common in child


    Animate

    mosquito,fleas discomfort, Should be kill by oil then ear Wash

    Inanimate

    vegetable(seed,beans) Use hook to remove it,dont Wash coz it will swell non-vege(paper) use ear Wash, asymptomatic May coz conductive deafness

    Impacted dd

    postauricular incision under Anesth. (ttt)

    Complication

    Skin&tympanic memb. Injury Impaction Otitis interna

    D) Traumatic rupture Drum Tortuous direction protect the tympanic memb. Etiology Indirect : hand slap,otitic barotrauma Explosion

    Direct : F.B , self inflicted, Unskill ear wash,

    Sign

    Blood in ext meatus

    Perforation characterized by - central in pars tensa - small size - irregular hyperaemic sharp edge. In self inflicted perforation - perforation small - in post sup part tymp. Memb.

    Conductive hearing loss

    III) INFLAMMATION OF EXTERNAL EAR


    (OTITIS EXTERNA) A) INFECTIVE
    Diffuse otitis externa Localized otitis externa(Furuncle) Malignant otitis externa

    Bacterial

    Otomycosis

    Fungal
    Bullous myringitis Herpes zoster oticus

    Viral

    B) NON INFECTIVE (REACTIVE)

    Eczematous otitis externa

    Seborrhaeic otitis Externa

    Item

    FURUNCLE

    DIFFUSE OTITIS EXTERNA

    Def.

    Localized supp. Infection oh hair follicle in skin lining of ext canal.

    Diffuse inflamm. Of skin lining of ext canal.

    Causative organism

    Staph. aureus

    Staph. Aureus, pseudomonas

    Predispose scratch canal skin by contaminated bud Factor Debiliating disease(D.M)

    self inflicted scratch canal skin by contaminated ear bud unskilled ear wash Local Earache : severe, On mastication

    Symptoms

    General absent coz area supp. is small. Local Earache : severe throbbing(coz skin Tightly attach to perichondrium) and On moving jaw( mastication)

    Hearing Loss( when edema Occlude ext canal Hearing Loss( when furuncle is large And occludes ext canal Sign localized red tender swelling(outer cartilaginous 1/3 ext canal) Otorrhea(scanty,purulent when it rupture) tenderness pre&post auricular lymphadenitis diffuse redness, edema, tenderness skin of ext canal otorrhea tenderness pre & post auricular lymphadenitis

    Treatment

    Systemic

    Antibiotics

    Systemic

    Antibiotics

    Analgesic Local Aural toilet: repeat remove ear Discharge by suction Packing canal with gauze strip Soaked with antibiotic/steroid ear drop Local ear

    Analgesic Aural toilet: repeat remove Discharge by suction Packing canal with gauze strip Soaked with antibiotic/steroid ear drop

    ITEM

    MALIGNANT OTITIS EXTERNA

    Causative org : pseudomonas aeruginosa occur in immunocompromised patient & usually effect old diabetics angiopathy diabetics role in aggressive spread to skull(osteomyelitis)

    Pathology

    Facial n. Paralysis& jugular Foramen syndrome(9,10,11 n)

    To big vessel of neck

    Intracranial spread Start as otitis externa(severe pain) & doesnt respone to ttt

    Clinical Picture

    Granulation tissues at junction of bony,cartilaginous part

    Scanty ,sanguineous, purulent discharge

    Facial & other cranial nerve palsies

    INVESTIGATION

    CT scan of temporal bone, skull base & MRI Biopsy Culture& sensitivity for discharge Blood & urine test for sugar

    TREATMENT

    1) 2) 3) 4) 5)

    CONTROL DIABETES MASSIVE ANTIBIOTIC THERAPHY ( QUINOLONES,CEPHALOSPORINE) ANALGESIC AURAL TOILET&ANTIBIOTIC EAR DROP SURGICAL

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