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Glue Ear and Otitis Externa Glue Ear and Otitis Externa

Glue Ear and Otitis Externa - PowerPoint Presentation

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Uploaded On 2016-10-28

Glue Ear and Otitis Externa - PPT Presentation

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

ear otitis glue externa otitis ear externa glue diagnosis media follow antibiotics grommet waiting faqs discharge prevention skin infection

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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

ExaminationSlide7
Slide8
Slide9
Slide10

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 changesSlide14
Slide15

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

HerpesSlide22
Slide23
Slide24
Slide25

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

SystemicSlide28
Slide29

Otitis Externa- FAQs

Perforations

Syringing Slide30

Summary

Prevention is better than cure

Avoid antibiotics unless absolutely necessarySlide31
Slide32