3. Traumatic Disorders of the Auricle
• Hematoma
- Direct trauma to the anterior
auricle
- cartilaginous necrosis
Tx.
- drain, antibiotics, bulky ear
dressing close follow up
- Use posterior auricular
block for anesthesia
5. Otitis Externa
• Infection and inflammation
caused by bacteria
(pseudomonas, staph), and fungi
Tx.
• removal of debris from the
external auditory canal
• administration of topical
medications to control edema
and infection
- ex. with antibiotic-steroid drops
6. Foreign Bodies in Ear Canal
• Usually put in by patient,
some bugs fly in
TX.
• kill bugs with mineral oil, or
lidocaine
• remove with forceps, suction
or tissue adhesive
7. Tympanic Membrane Perforation
• Hard to see – Hx of drainage
• Usually from middle ear pressure
secondary to fluid
• Sometimes from external trauma
TX.
• most heal uneventfully but all need
otology follow-up
• treat with antibiotics
• drops controversial but indicated for
purulent discharge
• (avoid gentamycin drops because
ototoxicity)
8. Middle Ear
• Serous Otitis Media - Eustachian tube
dysfunction
• Otitis Media - infection of middle ear
effusion - viral and bacteria
Tx.
treat with decongestants &
amoxicillin as the first-line
antimicrobial agent of choice
11. Nasal Fracture
Tx:
* apply ice to the nose and
elevate the head to aid in
reduction of any swelling
present.
* Nasal decongestants to reduce
swelling and mucosal
congestion.
Refer if:
Obvious deformity
(5-7 days) Septal Haematoma
(URGENT)
15. Foreign Body in Nose
Rx : one attempt at removal
only.
Do not use forceps for round
objects
Urgent ENT referral
16. Orbital Cellulitis
Rx : Systemic antibiotics
Decongestants
Analgesia
URGENT ENT referral
URGENT EYE referral
URGENT CT sinuses
17. 7th Nerve Palsy
Rx : Prednisolone 30mg
Acyclovir 200mg 5x/day
Hypermellose eye drop
Red bulging ear drum =
URGENT ENT review
If not, Non urgent ENT review
If poor eye closure =
Ophthalmology review
18. Facial Infections
Sinusitis
• Signs and symptoms
- facial pain in sinus
distribution
- purulent yellow-green
rhinorrhea
- fever
- CT more sensitive
* Causative Organisms
- gram positives and H. flu
(acute)
- anaerobes, gram neg (chronic)
20. Facial Cellulitis
• Most common strept and
staph,
• Rarely H.Flu
• Can progress rapidly
Tx.
• Antibiotic regimens are
effective in more than
90% of patients