上海交通大学耳鼻咽喉科学英文版课件 disease of the external ear.ppt

* Disease of the External Ear Otitis Externa Bacterial infection of external auditory canal Categorized by time course Acute Subacute Chronic Acute Otitis Externa (AOE) “Swimmer’s ear” Preinflammatory stage Acute inflammatory stage Mild Moderate Severe Preinflammatory Stage Symptoms: pruritus and sense of fullness Signs: mild edema Acute Otitis Externa (AOE) Progressive infection Symptoms Pain Increased pruritus Signs Erythema Increasing edema Canal debris, discharge Acute Otitis Externa (AOE) Severe pain, worse with ear movement Signs Lumen obliteration Purulent otorrhea Involvement of periauricular soft tissue Acute Otitis Externa (AOE) Treatment Most common pathogens P. aeruginosa （绿脓杆菌） S. aureus(金黄色葡萄球菌) Four principles Frequent canal cleaning Topical antibiotics Pain control Instructions for prevention Acute Otitis Externa (AOE) Chronic Otitis Externa (COE) Chronic inflammatory process Persistent symptoms ( 2 months) Bacterial, fungal, dermatological etiologies Symptoms Unrelenting pruritus Mild discomfort Dryness of canal skin Chronic Otitis Externa (COE) Signs Asteatosis（皮脂腺分泌减少） Dry, flaky skin Hypertrophied skin Mucopurulent otorrhea (occasional) Chronic Otitis Externa (COE) Treatment Similar to that of AOE Topical antibiotics, frequent cleanings Topical Steroids Surgical intervention Failure of medical treatment Goal is to enlarge and resurface the EAC Chronic Otitis Externa (COE) Furunculosis Acute localized infection Lateral 1/3 of posterosuperior canal Obstructed ear canal Pathogen: S. aureus (金黄色葡萄球菌) Symptoms Localized pain Pruritus Hearing loss (if lesion occludes canal) Furunculosis Signs Edema Erythema Tenderness Occasional fluctuance Furunculosis Treatment Local heat Analgesics Oral anti-staphylococcal antibiotics Incision and drainage reserved for localized abscess IV antibiotics for soft tissue extension Furunculosis Thanks！