Ear Pathologies

Question 1

Auricular physical trauma
-risk factors, pathophysiology
Hematoma, laceration management

Answer 1

Rugby, boxers

• auricular cartilage receives blood from perichondral vessels
• damage to these vessels => avascular cartilaginous necrosis
• infection risk

Hematoma - shearing force
-aspirate, ABx, dressing

Lacerations -
-posterior auricular block, single layer closure

Question 2

Auricular infection - perichondritis

• presentation
• pathophysiology
• risk factors
• management

Answer 2

Red, painful, swollen
Fever
Pus accummulates between cartilage and perichondrium => cuts off blood supply

Diabetics, IC, GPA

EMERGENCY ENT REFERRAL
ABx, drain abscess
Supportive

Question 3

Foreign body in ear canal

• cause
• management

Answer 3

Inserted by patient
Bugs fly in

Kills bugs with mineral oil/lidocaine

Refer to ENT if you cannot remove it

Question 4

Tympanic membrane perforation

• presentation
• causes
• management
• when to refer

Answer 4

Sudden hearing loss, tinnitus
Earache
Itching
Fluid discharge
Fever

Otitis media
Physical trauma, barotrauma, phonotrauma

Conservative normally enough
ABx used if evidence of infection

All need ENT follow up
Refer urgently if vertigo/VII involved

Question 5

Acute mastoiditis

• common cause
• presentation
• management

Answer 5

Infection of mastoid bone secondary to acute OM

• pain, red, swelling over mastoid
• fever

URGENT ENT REFERRAL
-potential to spread to skull bones, blood, brain