My last Seminar

1. ENT Emergencies Otological Emergencies Sariu Ali didi

2. Anatomy of the Ear

3. Ear emergencies include Sudden Sensory neural Hearing loss Middle Ear Trauma to TM AOM Acute mastoiditis Pinna: Perichondritis Auricular Hematoma EAC: Foreign body Malignant OtitisExterna

4. Auricular Hematoma Collection of blood between the cartilage and its perichondrium. The haematoma prevents proper oxygenation of the cartilage, resulting in necrosis and a cauliflower ear. Complications: Infection Cauliflower ear Rx : aspiration with an 18-gauge needle or incision and drainage compressive dressing for a week to allow the cartilage to readhere to the perichondrium. Coverage with an antistaphylococcal antibiotic is recommended.

5. Perichondritis Ifection secondary to hematomas, laceration or surgical incision. Organism: pseudomonas and mixed Sx : Red, hot, painful pinna Abcess can form btwnprichondrium and cartliage leading to necrosis of cartilage. Rx : systemic antibiotics local application of 4%alluminium acetate compression.

8. PE :On otoscopy, the external ear canal will typically have granulation tissue at the bony-cartilaginous junction

9. Ix : RBS, ESR, CT or MRI evidence of otitisexterna with possible bone erosion and infiltration into infratemporal soft tissues

10. Rx : - high dose IV Antibiotic treatment (antipseudomonalcoverage (for six to eight weeks); quinolone is the drug of choice. - Surgical debridement of devitalized tissue.

12. Syringing

13. Suction

14. Microscopic removal with specific instruments

15. small children - may put objects such as pips, beads and paper clips in their ears. Adults may get foreign bodies like toothpicks. Foreign bodies in ears are more often seen in the mentally disturbed

16. Isects should be killed first( olive oil) Then try syringing with warm water Unskilled attempts at removal of FB may lacerate the meatal lining , damage tympanic membrane or the ossicles.

17. Acute Mastoditis

19. When infection spreads beyond the mucosa – involving mastoid air cells and the bony mastoid cortexAetilogy: accompanying / following ASOM Organism: B hemolytic streptococcus.

21. Labyrinthitis

22. Facial paralysis

23. Petrositis

24. Extradural abscess

25. Subdural abscess

26. Meningitis

27. Brain abscess

28. Lat sinus thrombosis

30. Surgery

31. Myringotomy

32. Simple I&D

35. trauma (e.g.head injury)

36. immunological (e.g.Cogan's syndrome)

37. toxins

38. ototoxic drugs

39. multiple sclerosis

40. Ménière's disease4 theoretical pathways Labyrinthine viral infection Labyrinthine vascular compromise Intracochlear membrane ruptures Immune-mediated inner ear disease.

41. Evaluation Rule out others conditions Normal tm Audiometry test (pta, abr) Hrct, mri (tumor, multiple sclerosis) Vestibular test (prognosis) Blood ix. - esr, coagulation profiles, blood sugar, serologic test - syphilis, ana etc.

44. REFERANCES Diseases of ear nose and throat PL Dhingra http://www.gpnotebook.co.uk http://www.ispub.com/journal/the_internet_journal_of_otorhinolaryngology/volume_4_number_1_37 http://www.ncbi.nlm.nih.gov/pmc/articles