Martin Porter Consultant ENT Worcester Take home messages Do not refer Glue Ear to ENT Do not give antibiotics to otitis externa Otitis mediaGlue ear Classification Diagnosis Management ID: 481533
Download Presentation The PPT/PDF document "Glue Ear and Otitis Externa" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Glue Ear and Otitis Externa
Martin Porter
Consultant ENT
WorcesterSlide2
Take home messages
Do not refer Glue Ear to ENT
Do not give antibiotics to otitis externaSlide3
Otitis media/Glue ear
Classification
Diagnosis
Management
Indications for surgery
Follow up arrangements
FAQsSlide4
Classification
Acute otitis media
Otitis
Otitis media with effusion (OME)
Serous otitis media (SOM)
Glue ear
Catarrhal otitis mediaSlide5
Diagnosis
History
Deafness
Pain
Discharge
Behaviour
SpeechSlide6
Diagnosis
History
ExaminationSlide7Slide8Slide9Slide10
Management
Watchful waiting
Video
Leaflets
Internet
Reassess
Smoking
Make allowancesSlide11
Grommet operations
1994-5
43K
2008-9
25KSlide12
Grommet protocol
Subjective problem
parents or teachers
Objective
otoscopy or tympanometry
Quantify
25 dB loss
Persistent
three months minimum
ExceptionsSlide13
Grommet follow up
Audiology lead follow up!
Six weeks
discharge to GP
Exceptions
multiple handicap
Structural changesSlide14Slide15
FAQ’s
What are the alternatives?
Further watchful waiting
Antibiotics
Diet
Otovent
Osteopathy
Hearing aidSlide16
FAQ’s
Role of adenoidectomy
Role of tonsillectomy
Chances of recurrence
Swimming after operation
Complications
Infection
PerforationSlide17
Summary
Glue ear is common
Most
cases
are self limiting
Watchful waiting for the majority
Education
Making allowances
Grommets for a select minority
Audiological follow upSlide18
Otitis Externa
Definition
Predisposing factors
Pathology
Differential diagnosis
Prevention
Treatment
FAQsSlide19
Otitis externa-definitionSlide20
Otitis externa –predisposing factors
Skin conditions
Trauma
Wet
Diabetes
Middle ear disease
Antibiotics!Slide21
Otitis externa -pathology
Inflammation of skin
Infection of skin
Bacterial
Pseudomonas
Staph
Coliforms
Fungal
Aspergillus
Yeast
Candida
Viral
HerpesSlide22Slide23Slide24Slide25
Otitis-differential diagnosis
Otitis externa
Adult
Painful itch
Thin discharge
Trauma/water
Narrow ear canal
Otitis media
Child/Adult
Painful/painless
Mucoid discharge
Preceding URTI
Normal ear canalSlide26
Otitis Externa- prevention
Remove wax
Softener
Syringe
Microsuction
Treat Itch
Earcalm
Steroid drops
Avoid water
Ear plugs/cotton wool/bandsSlide27
Otitis externa - Treatment
Anti-irritant
Ear calm
Aluminium acetate
Anti inflammatory
Betnosol ear drops
Betnovate scalp application
Toilet
Mop
Microsuction
Remove foreign body
Antibiotic
Topical +/-wick
SystemicSlide28Slide29
Otitis Externa- FAQs
Perforations
Syringing Slide30
Summary
Prevention is better than cure
Avoid antibiotics unless absolutely necessarySlide31Slide32