Answers:
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
Malignant Otitis Externa is a potentially life threatening condition more commonly found in immunosuppressed patients including elderly diabetics. It can progress to osteomyelitis of bony canal or skull base. Classic findings includes granulation tissue at the junction of the bony and cartilaginous portions of EAC. Diagnose w/ bone scans and possible CT (to define extent of disease). Treat w/ long term VI abx. Gallium scan can be used to track disease. For diabetics, tight blood sugar control can aid in treatment of illness.
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?
This patient likely has otomycosis. Prolonged use of ototopic drops is a risk factor for this condition. The offending drops should be stopped and pt should be treated with acetic acid, nystatin powder. Frequent cleanings and clotrimazole can also be useful.
MC Questions:
All of the following are true regarding Aural Atresia except:
A) Due to failure of second branchial groove to form properly
B) 15% of patients have + family hx
C) Often unilateral
D) Affects M>F
E) Causes CHL
A) Malignant Otitis Externa
B) Otitis Externa
C) Otitis Interna
D)Perichondritis of Auricle
E) Otomycosis
Malignant Otitis Externa is a potentially life threatening condition more commonly found in immunosuppressed patients including elderly diabetics. It can progress to osteomyelitis of bony canal or skull base. Classic findings includes granulation tissue at the junction of the bony and cartilaginous portions of EAC. Diagnose w/ bone scans and possible CT (to define extent of disease). Treat w/ long term VI abx. Gallium scan can be used to track disease. For diabetics, tight blood sugar control can aid in treatment of illness.
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?
This patient likely has otomycosis. Prolonged use of ototopic drops is a risk factor for this condition. The offending drops should be stopped and pt should be treated with acetic acid, nystatin powder. Frequent cleanings and clotrimazole can also be useful.
All of the following are true regarding Aural Atresia except:
A) Due to failure of second branchial groove to form properly
B) 15% of patients have + family hx
C) Often unilateral
D) Affects M>F
E) Causes CHL
Free Response Question:
Microtia is due to abnormal development of what embryonic structure(s)?
Quick Facts:
Keloids:
-Abnormal reaction to trauma.
-Due to excessive deposition of collagen/extracellular matrix.
-Most commonly occurs after ear piercing.
-Keloids extend from original site of trauma unlike hypertrophic scars which do not.
-Most common in African Americans age 16-20.
-Can treat w/ steroid injection or excision (although risk of reformation)
-Abnormal reaction to trauma.
-Due to excessive deposition of collagen/extracellular matrix.
-Most commonly occurs after ear piercing.
-Keloids extend from original site of trauma unlike hypertrophic scars which do not.
-Most common in African Americans age 16-20.
-Can treat w/ steroid injection or excision (although risk of reformation)
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