Complete Solutions
Acute Otitis Media w/ Perforation Drainage
otitis media Myringotomy tubes
-recurrent: 3-4 episodes in 6mo, or 4 episodes in 12 months with
one of the episodes being in the previous 6 mo
-Middle ear effusion lasting 3 mo or more
-speech or learning delays are also indications for tubes.
-correction of middle ear drainage problems secondary to
horizontal eustachian tubes.
,- topical antibiotics in children with tubes rather than systemic
antibiotics
Complications of acute otitis media
-perforation of tympanic membrane
-tympanosclerosis -> hearing loss and mastoiditis. These
patients present with fever, ear pain and a protruding auricle
-meningitis
-Although this can still occur, it used to result in deaths, but now
,with antibiotics usually mastoiditis can be treated
-untreated otitis media can also cause meningitis.
-increasing antibiotic resistance and especially Strep
pneumoniae these complications may resurge.
Otitis Externa definition & causes
-inflammation or infection of the external auditory canal, the
auricle or both.
-all age groups.
-bacterial or fungal.
-Most common bacterial is pseudomonas, next is staph, and then
strep.
-fungal causative aspergillus (most common) and then candida
albicans.
, Otitis Externa Classification
-Acute diffuse (most common): swimmers
-acute localized: infected hair follicle
-Chronic: same as acute diffuse lasting greater than 6 weeks
-Eczematous: dermatologic conditions that affects the exterior
auditory canal leading to otitis externa.
-Necrotizing malignant: infection that extends into the deeper
tissues, immunocompromised adults (referral otolaryngologist)
-Otomycosis is infection of the exterior auditory canal by a
fungal species.
Otitis Externa pharm
-(If cellulitis or necrotizing malignant absent) antibiotic drops
-ciprofloxacin + Hydrocortisone (copra HC otic) (>1 yr) 3 drops
BID, 7 days
-ciprofloxacin 0.3% + dexamethasone 0.1% (ciprodex otic)
(>6mo) 4 drop BID, 7 days
-cortisporin otic (2+yr) 3-4 drops TID or QID, 7 days (max 10
days)
-Tobradex (2+yr) 1-2 drops q4-6hrs
-gentamycin opthlamic (1mo +) 1-2 drops q4hr
Vertigo definition
-complaints of dizziness, disequilibrium, syncope,
lightheadedness, ataxia, vertigo.
-True vertigo (illusion of motion), primarily associated with the
balance organs of the inner ear; peripheral vestibular disorders
peripheral vertigo causes