Hearing Pathology Otalgia Otitis Externa: Natural barriers to infection overcome → infection of the skin of the ear canal Symptoms: Initial discharge & itch Pain Hearing loss as the ear canal closes off May have some swelling of the pre-auricular or post-auricular lymph nodes Causative Organisms: Pseudomonas species Staphylococcal species Examinations: Debris in the canal Tympanic membrane usually normal In severe cases, canal may be swollen & view of tympanic membrane impossible Treatment & Management: Foreign body removal 1st line: Topical combo antibiotics + steroid drops (e.g., gentamicin 0.3%, hydrocortisone 1%) 2nd line: Ciprofloxacin 0.3% Ofloxacin 0.3% Neomycin sulfate 0.5% Polymyxin B sulfate 0.1% Hydrocortisone 1% Similar MOA to gentamicin: Amikacin Bactericidal, aminoglycoside **Otitis Media** * Most commonly affects children under 10 * Infection of the middle ear seeded from the URT through Eustachian tube * Common causative pathogens - most commonly URTI * RSV * Influenza * H. influenzae * Moraxella catarrhalis **Pathophysiology:** * Eustachian tube dysfunction → inflammatory exudate of middle ear space * Inflammation of the middle ear mucosa **If doesn't resolve:** * Tympanic membrane perforation & discharge * **Complications:** Rare * Mastoiditis or intracranial infection as infection spreads through air cells & sinuses **Physical Examination Findings:** * Ear canal with erythema * Bulging tympanic membrane * Otalgia * Hearing disturbance