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What are the characteristics of Auricular hematoma?
External ear becomes shapeless, with reddish-purple mass of blood collecting between perichondrium and cartilage.
What is the primary TX for Auricular hematoma?
Aspiration or incision and drainage.
What is a complication of Auricular hematoma.
Avascular Necrosis
What has happened when a Tympanic membrane has a suppurative perforation.
Pus in the middle ear, caused by otitis media has ruptured through the TM.
A loss of hearing and tinnitus are characteristics of what HENT disorder.
Tympanic Membrane perforation
What does vertigo associated with TM perforation suggest?
An associated injury to inner ear.
If a pt with a TM perforation get water in to ear what can happen and how long could it take.
Person may get a purulent otorrhea wich may begin in 24 - 48hrs
What is the antibiotic of choice for a TM perforation to prevent infection?
Pen V 250mg q6h x 7 days
When might Tympanoplasty be indicated?
When a TM perforation has not resolved within 2 months.
In Tinnitus where should the focus of Tx be directed toward?
The underlying disease.
What are the most important things to avoid in the Tx of Tinnitus?
Exposure to excessive noise
Ototoxic agerates
Factors that may cause Cochlear damage
What is a complication associated with pulsatile tinnitus?
Arterial obstruction, Anyeurism, and vascular neoplasms
What is the db level of noise that can cause hearling loss?
Noise induced hearing loss occurs at what khz first, and then does what with further exposure?
Starts a 4khz and gradually moves into the lower frequencies with further exposure.
What is the most common epistaxis encountered?
Bleeding from Kiesslebachs Plexus
Define auricular hematoma and its etiology.
Bleeding between the auricular cartilage and the perichondrium frequently follows contusions or other injuries to the auricle.
What is the primary treatment for auricular hematoma?
Aspiration or I&D
Pus in the middle ear caused by OM ruptures through the TM is called?
Suppurative perforation
This suggests an injury to the inner ear.
Following a TM perf. what should be given to prevent infection?
PCN V 250mg q6h x 7 days
This type of med can be used if the ear becomes infected, but is not used prophylactically.
Acetic Acid 2%
What's the sig for acetic acid use on TM perf's.?
5 gtts tid
After how long should a patient be referred to ENT if the TM has not healed?
2 months
The perception of abnormal ear or head noise is called what?
Persistent tinnitus usually indicates the presence of?
Sensory hearing loss
If the tinnitus is pulsatile, it is what?
Synchronous with the heart
Which ototoxic medications may cause tinnitus?
Salicylates, quinine, CO, Heavy metals, aminoglycosides, diuretics, alcohol
What is the #1 and #2 most common cause of sensory hearing loss?
#2-Noise Trauma
At what decibel is noise considered damaging?
>85 db's
Where is the most common type of epistaxis encountered?
Kiesselbach's Plexus
Most cases of ant. epistaxis are usually treated by?
Direct Pressure
If a posterior pack is utilized, what should you administer immediately?
Ampicillin 250 mg PO q6h
Who is usually affected with impacted foreign bodies?
Children or mentally incompetent PT's
Pt's with a nasal foreign body present with what Sx's?
May be asymptomatic or may present with nasal d/c, nasal discharge/obstruction or sinusitis
What is the cardinal symptom of a nasal obstruction?
Unilateral purulent nasal discharge
What is the principal DDX for a nasal foreign body?
What is the most frequently fractured bone in the body?
Nasal pyramid
These may occur and become infected 2ndary to nasal fracture?
Septal hematomas
What is the primary tx for a septal hematoma?
What meds should be RX to a pt after it has been I&D' for a septal hematoma?
Ampicillin or Emycin 500 mg PO TID/QID
This is caused by a disorder characterized by recurrent prostrating vertigo, sensory hearing loss, and tinnitus, associated with generalized dilation of the membranous labyrinth?
Meniere's Disease
This is caused by symptom complex including hay fever, perennial allergic rhinits, characterized by by seasonal or perennial sneezing, rhinorrhea, nasal congestion pruritis, and often conjuctivitis and pharyngitis?
Allergic Rhinitis
Trismus and hot potato voice are sx of what?
Peritonsillar abscess
This is inflammation of the laryngeal mucosa due to bacteria, virus or trauma?
Acute laryngitis
Symptomatic relief of vertigo may be obtained with anticholinergic agents is tx of what?
Meniere"s Disease
What rx is for Pos. Hemorrhage?
Ampicillin 250mg po q6h
If the TM becomes infected what topical med can be used?
2% acetic acid 5ggts tid
What antibiotic is given to prevent an infection in a TM perforation?
Pen V 250mg q6h x 7 days
What antibiotic ointment can be applied for auricular hematoma?
What is the antibiotic of choice for otitis media and what is the med if the person is allergic?
Amoxicillin 20-40mg/kg/d
Erythromycin 50mg/kg/d
Sulfonamide 150mg/kg/d
What is the TX for Ludwigs Angina?
Aqueous PCN G 300,000 u/kg/d
or if sensitivity
Clindamycin 30mg/kg/d
What is the antibiotic of choic for Sterp Pharyngitis?
PCN V potassium 250 qid x10 days
What is the tx for Viral URI?
Pseudoephedrine 30mg q4h or 120mg BID
What is an alternattive med for Sinusitis?
Cephalexin 250mg po bid
What is the first choice antibiotic for sinusitis?
Amoxicillin 250mg po tid x 10 days
What is the antibiotic of choice for mastoiditis?
PCN G 1 mill unit IV q6h
What antibiotic is given to someone with a septal hematoma?
Ampicillin or Erythromycin 500mg po tid or qid
If cellulitis is present and extends beyond the ear canal what antibiotic is indicated?
PCN G 250mg q6 x 7 days
External otitis media also responds to altering the canal ph with what?
2% Acetic acid 5ggts tid x 7 days
In pt. c otitis media alternative useful in resistant cases are what?
Cefaclor 20-40mg/kg/d

Amoxicillin clavulanate 20-40mg/kg/d

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