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Similaire à Ear disease presentation (manchester g ps)
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Ear disease presentation (manchester g ps)
- 1. Ear Disease Simon Lloyd Consultant ENT Surgeon Manchester Royal Infirmary
- 2. Anatomy
- 3. Tympanic Membrane Left ear Long process of incus Pars flaccida Handle of malleus Pars tensa Light reflex
- 4. Middle Ear
- 5. Inner Ear Consists of: Semi-circular canals Vestibule Cochlea Function: Balance Hearing
- 7. Symptoms 5 symptoms Otalgia Otorrohoea Hearing impairment Tinnitus Vertigo
- 10. Familiar Sounds
- 11. External Ear
- 12. Otitis externa Inflammation of ear canal skin Aetiology: Bacterial – Staph. aureus, Pseudomonas, Proteus Fungal – Aspergillus niger, Candida albicans Viral – Herpes simplex,Herpes zoster Reactive – Eczema, Psoriasis Predisposing factors: Bathing, humidity Trauma Canal stenosis Eczema
- 13. Symptoms & Signs - Bacterial Otalgia - severe Purulent otorrhoea Deafness Inflammation of ear canal +/- pinna
- 14. Treatment Swab for sensitivities Aural toilet Splinting of ear canal (Pope wick) Topical antibiotics eg. Sofradex, Gentasone Keep dry
- 15. Malignant OtitisExterna Osteomylitis of temporal bone Immunocompromised patients eg. Diabetes Usually pseudomonas Extremely painful May be associated with cranial nerve palsy Have a high index of suspicion Treat aggressively with IV antibiotics for at least 6 weeks
- 16. Symptoms & Signs - Fungal Itching Mild otalgia Fullness Greyish white debris +/- fungal spores
- 17. Treatment Aural toilet Topical antifungal agents eg. Canestan
- 18. Furunculosis Staph. infection of hair follicle causing abscess formation Severe otalgia Requires I&D
- 19. Ramsey Hunt Syndrome Herpes zoster Geniculate ganglion of facial nerve Vesicular rash of pinna and ear canal (+/- mouth and tongue) Facial nerve palsy Painful Vertigo Treatment Analgesia Antiviralseg. Acyclovir Protect the eye
- 20. Perichondritis Inflammation of perichondrium Aetiology: Ear piercing Laceration Surgery CT disease Treatment: Antibiotics I & D (if abscess) Sequelae: Cauliflower ear
- 21. Foreign body in ear
- 22. Hyperostosis Exostosis Multiple bony swellings in deep canal Cold water Asymptomatic No treatmentunless large Osteoma Single benign bony tumour outer bony meatus No treatment unless large
- 23. Embryology
- 24. First Branchial Cleft Anomalies Pre-auricular sinus
- 25. First Branchial Cleft AnomaliesAccessory Auricle
- 26. Benign Skin Pathology SeborrhoeicKeratosis Gouty Tophi Solar keratosis
- 27. Benign Skin Pathology Chondrodermatitishelicisnodularischronica Keloid Scarring Darwin’s tubercle
- 28. Malignant Skin Pathology of The Pinna Basal Cell Carcinoma Squamous Cell Carcinoma
Notes de l'éditeur
- Solar keratosis – Sundamagedskin,painless, scaly, cream, ‘cutaneous horn’, not malignant, no treatment/cryotherapy/excisionSeborrhoeickeratosis – Round, dark, wart like, not malignant, ‘liver spots’, sun damage, no treatment/cryotherapy/excisionTophi – Painless, smooth, uric acid crystals subcutaneously, resolve slowly with treatment of gout
- CDHNC – pressure induced, painful, round raised, central crust, helix or antihelix, cryotherapy/excisionKeloid – Follows piercing, dark skin, hypertrophy of fibrous tissue, excise/inject steroid/clasp ear ringDarwins tubercle – Inherited, thickening of cartilage of helix