Answers:
A 25 y/o M presents with symptoms of a right sided CHL. He endorses a sensation of fullness in that ear. On exam a mass of keratinized epithelium is noted which appears to be blocking the EAC. After removing the debris the underlying skin appears shiny, atrophic and erythematous however his CHL appears to improve. What is the most likely diagnosis?
A) Keratosis Obturans
B) Cerumen Impaction
C) Otitis Externa
D) Surfer's Ear
E) Otomycosis
Keratosis obturans is characterized by a buildup of keratinizing squamous epithelium that can obstruct the EAC. Often seen in young/middle age patients, its etiology is unknown. After removing the mass of epithelium shiny, atrophic and erythematous skin is often appreciated underneath. Treat with frequent debridements to avoid large buildups that are difficult to remove.
What is the treatment of otitis externa?
Cleaning the canal, topical abx and acetic acid (to restore acidic environment of EAC). A gauze wick can be used to allow abx to reach further medially if severe obstruction present.
MC Questions:
A 70 yo F w/ ho diabetes presents with painful and discharge from her L ear. On exam purulent otorrhea is appreciated, pinna is tender to palpation and granulation tissue is appreciated inside the EAC. What is the most concerning diagnosis?
A) Malignant Otitis Externa
B) Otitis Externa
C) Otitis Interna
D)Perichondritis of Auricle
E) Otomycosis
A) Keratosis Obturans
B) Cerumen Impaction
C) Otitis Externa
D) Surfer's Ear
E) Otomycosis
Keratosis obturans is characterized by a buildup of keratinizing squamous epithelium that can obstruct the EAC. Often seen in young/middle age patients, its etiology is unknown. After removing the mass of epithelium shiny, atrophic and erythematous skin is often appreciated underneath. Treat with frequent debridements to avoid large buildups that are difficult to remove.
What is the treatment of otitis externa?
Cleaning the canal, topical abx and acetic acid (to restore acidic environment of EAC). A gauze wick can be used to allow abx to reach further medially if severe obstruction present.
A 70 yo F w/ ho diabetes presents with painful and discharge from her L ear. On exam purulent otorrhea is appreciated, pinna is tender to palpation and granulation tissue is appreciated inside the EAC. What is the most concerning diagnosis?
A) Malignant Otitis Externa
B) Otitis Externa
C) Otitis Interna
D)Perichondritis of Auricle
E) Otomycosis
Free Response Question:
A pt presents with pruritus, pain and otorrhea from the right ear. Pt had been using ear drops (pt cannot remember the name) every day, twice daily for the past 6 months. How would you treat this patient?
Quick Facts:
Microtia
-Due to malformation of 1st/2nd branchial arches
-Can be bilateral or unilateral.
-Reconstruction is typically staged and involves harvesting costal cartilage.
-Results are often quite good.
-Due to malformation of 1st/2nd branchial arches
-Can be bilateral or unilateral.
-Reconstruction is typically staged and involves harvesting costal cartilage.
-Results are often quite good.
No comments:
Post a Comment