1. ( Ear II ) Diseases of External Ear & Otitis media
Dr. Farid Alzhrani Assistant professor
Consultant of Otolaryngology, head and neck surgery
King Abdulaziz University Hospital

2. Objectives Congenital anomalies of auricle
Traumatic injury and it’s complications
Perichondritis
Otitis externa ,classifications ,presentation and treatment
Acute otitis media
Recurrent otitis media

3. DISEASES OF THE EXTERNAL EAR

4. EXTERNAL EAR
Auricle
External Canal

5. THE AURICLE

6. 1. Congenital Malformations
Anotia & microtia
Accessory auricle
Preauricular sinus
Protruding ear

8. 2. Trauma To The Auricle
Lacerations
Hematoma auris

9. Complication
Cauliflower ear

10. 3. Perichondritis Of The Pinna
Usually follow trauma (hematoma auris, surgical, frostbite, burn) or otitis externa
Commonly caused by Pseudomonas
Fever, pain, redness and swelling
Treatment is by antibiotics

11. OTITIS EXTERNA

12. Definition
An acute or chronic infection of the whole or a part of the skin of the external ear canal.

13. CAUSES OF OTITIS EXTERNA
INFECTIVE
REACTIVE
Bacterial
Fungal
Viral
Staph. arues
Pseudomonos
Others
Aspirigillus Niger
Candida Albicans
Herpes zoster
Eczematous
Seborrheic

14. Clinical Features Of Otitis Externa
Itching
Pain
Tenderness and swelling
Otorrhea
Deafness
Changes in the lumen and skin of EAM

15. Clinical Types Of Otitis Externa
1. Localize O.E (furuncle)

16. Clinical Types Of Otitis Externa
2. Diffuse infective O.E.

17. Clinical Types Of Otitis Externa
3. Otomycosis

18. Clinical Types Of Otitis Externa
4. Bullous myringitis

19. Clinical Types Of Otitis Externa
5. Herpetic O.E.

20. Clinical Types Of Otitis Externa
6. Eczematous and seborrheic O.E.

21. Clinical Types Of Otitis Externa
Localize O.E ( furuncle)
Diffuse infective O.E.
Otomycosis
Bullous myringitis
Herpetic O.E
Eczematous and seborrheic O.E.
“Malignant” otitis externa

22. Managment Of Otitis Externa
Swab for culture and sensitivity
Ear toilet
Keep the ear dry
Local medications
Systemic medications
Surgery may be required in chronic cases

23. ACUTE OTITIS MEDIA

24. Definition
Acute infection of the mucous membrane lining of the middle ear cleft.

25. Predisposing Factors Age Bottle feeding Climate
Crowded living conditions
Associated conditions: cleft palate, immunodeficiency, ciliary dyskinesia, Down syndrome, and cystic fibrosis

26. Route Of Infection
Eustachian tube
External auditory canal
Blood borne

27. Bacteriology Streptococcus pneumonia Haemophilus influenzae
Moraxella catarrhalis
Streptococcus pyogens
Staphylococcus aureus

28. Pathogenesis Tubal occlusion Exudative inflammation
Suppurative inflammation
Tympanic membrane rupture
Resolution

29. Clinical Picture Tubal occlusion Exudative inflammation
Discomfort, autophony, retracted drum
Exudative inflammation
Fever, earache, deafness, congested drum
Suppurative inflammation
Fever, sever earache, deafness, bulging drum
Tympanic membrane rupture
Otorrhea... temp. & earache subside
Resolution

31. Treatment Symptomatic Antimicrobials Decongestant Myringotomy
Ear toilet and local antibiotics

32. RECURRENT ACUTE OTITIS MEDIA

33. Definition
Three or more attacks of acute otitis media over a 6-months period.

34. Treatment
Ventilation tube insertion

36. THANK YOU