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Insect in the External Auditory Meatus

Insect in Ext Auditory Meatus


Presentation

  • The Fourth Edition of this best-selling book is packed full of information to help the reader move from a presenting problem to an accurate diagnosis.[books.google.com]
  • Patients with delayed presentation and complications have a guarded prognosis.[cambridge.org]
  • Syringing of the external auditory canal by the referring practitioner had frequently occurred prior to presentation to our departments.[ispub.com]
  • Background Foreign bodies (FB) in the external auditory canal in children are a common presentation to ED. It is more common in children less than 7 years or in older children with intellectual impairment.[kidshealthwa.com]
  • The removal of foreign bodies from the ear is a common procedure in the emergency department. [1] Children older than 9 months often present with foreign bodies in the ear ; at this age, the pincer grasp is fully developed, which enables children to maneuver[emedicine.medscape.com]
Gangrene
  • EpididymitisOrchitis 364 Epidural Abscess 366 Epidural Hematoma 368 Epiglottitis Adult 370 Epiphyseal Injuries 374 Epistaxis 376 Erythema Infectiosum 380 Esophageal Trauma 386 Failure to Thrive 396 Fatigue 398 Fever Adult 406 Flail Chest 414 500 426 Fournier Gangrene[books.google.com]
HELLP Syndrome
  • Syndrome 488 Hypoglycemia 574 Hypothermia 584 Immunizations 590 Influenza 600 Intracerebral Hemorrhage 602 Lightning Injuries 604 Marine Envenomation 610 Irritable Infant 612 Jaundice 620[books.google.com]
Hyperthermia
  • GuillainBarre Syndrome 468 Hand Infection 472 Head Trauma Blunt 476 Extremity Trauma Penetrating 478 Headache 480 Fatigue 484 Hemoptysis 494 Hemorrhagic Fevers 496 1054 498 Hepatic Injury 508 High Altitude Illness 512 Herpes Genital 516 Hiccups 522 Hyperthermia[books.google.com]
Irritable Infant
Pseudotumor
  • Infections 824 Neonatal Jaundice 830 Peripheral Neuropathy 836 Rectal Prolapse 840 Pertussis 844 Bartholin Abscess 134 Pharyngitis 850 Diverticulosis 858 Pneumothorax 876 286 888 Pregnancy Trauma 898 Foreign Body Esophageal 902 Procedural Sedation 904 Pseudotumor[books.google.com]
Hemoptysis
  • Flail Chest 414 500 426 Fournier Gangrene 428 Frostbite 434 Giant Cell Arteritis 452 Giardiasis 454 Gonococcal Disease 462 GuillainBarre Syndrome 468 Hand Infection 472 Head Trauma Blunt 476 Extremity Trauma Penetrating 478 Headache 480 Fatigue 484 Hemoptysis[books.google.com]
Failure to Thrive
  • […] to Thrive 396 Fatigue 398 Fever Adult 406 Flail Chest 414 500 426 Fournier Gangrene 428 Frostbite 434 Giant Cell Arteritis 452 Giardiasis 454 Gonococcal Disease 462 GuillainBarre Syndrome 468 Hand Infection 472 Head Trauma Blunt 476 Extremity Trauma[books.google.com]
Neonatal Jaundice
  • Jaundice 830 Peripheral Neuropathy 836 Rectal Prolapse 840 Pertussis 844 Bartholin Abscess 134 Pharyngitis 850 Diverticulosis 858 Pneumothorax 876 286 888 Pregnancy Trauma 898 Foreign Body Esophageal 902 Procedural Sedation 904 Pseudotumor Cerebri 910[books.google.com]
Ear Fullness
  • […] may rupture Canal erythema, swelling & foul smelling discharge may be late occurrences History Asymptomatic or incidental examination finding Pain in affected ear Noise or “drumming” in ear associated with insect foreign body Hearing loss Sensation of ear[fprmed.com]
  • Pressure against the ear canal skin due to a blockage commonly causes outer ear pain as well as other symptoms, including itchiness, ear fullness and possibly hearing loss, dizziness, and/or ringing in or drainage from the ear.[livestrong.com]
Renal Injury
  • Injury 956 Reperfusion Therapy Cerebral 960 Pneumothorax 962 Poisoning Gastric Decontamination 968 Dysfunctional Uterine Bleeding 336 Retropharyngeal Abscess 970 Polycythemia 974 Rib Fracture 978 Pregnancy Trauma 984 Procedural Sedation 990 Pseudotumor[books.google.com]
Encephalopathy
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
Spinal Cord Syndrome
  • Cord Syndromes 1042 Coccyx 1048 Splenic Injury 1054 Subarachnoid Hemorrhage 1076 Vomiting Pediatric 1220 1082 Pleural Effusion 866 1096 Fibrocystic Breast Disease 410 TemporalMandibular Joint InjurySyndrome 1102 Reiter Disease 950 1116 Gonococcal Disease[books.google.com]

Treatment

  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]
  • Learn more about ear treatment with expert advice from Sharecare. Recently Answered 1 Answer A Treatment options depend on if the ear injury is external or internal. Severity will determine if you need to seek medical treatment.[sharecare.com]
  • Consider seeking specialist advice if: Symptoms have not improved despite treatment and treatment failure is unexplained. Treatment with a quinolone is indicated. Consider referral to secondary care if there is: Extensive cellulitis.[patient.info]
  • The rather large syringe of old-fashioned appearance has changed little in the past 100 years, and remains a simple and effective treatment for wax impaction.[mussenhealth.us]
  • If the granulations do not resolve with treatment, 64.[slideshare.net]

Prognosis

  • […] instructions should include: Anticipatory Guidance Analgesics as necessary PMD follow up in 2-3 days to asses for healing Activity No swimming or getting water into canal until ear is healed Signs and Symptoms to return Ear drainage Worsening ear pain PROGNOSIS[urgentcarepeds.org]
  • Patients with delayed presentation and complications have a guarded prognosis.[cambridge.org]
  • […] care provider or otolaryngologist may be appropriate if extraction complicated by Canal laceration Tympanic membrane perforation Canal wall hematoma, or Otitis externa Otitis externa and tympanic membrane perforation should be treated appropriately Prognosis[fprmed.com]
  • Prognosis Most cases of otitis externa resolve within a few days of starting treatment. The condition will tend to recur unless underlying causative factors are addressed.[patient.info]

Etiology

  • Pathophysiology and Etiology Impacted cerumen is more common among people who have excessive thick or dry cerumen.[sites.google.com]
  • Internal auditory canal osteoma: Case report and review of the literature June 5, 2015 Sharon Ovnat Tamir, MD; Francoise Cyna-Gorse, MD; Olivier Sterkers, MD Abstract We report a case of internal auditory canal osteoma and discuss this entity's etiology[entjournal.com]
  • Discussion The exact etiology of external auditory canal cholesteatoma is unclear. (7) The basic pathogenesis involves canal occlusion. (4) Most cases occur spontaneously or after surgery (tympanoplasty, middle ear surgery, or mastoid surgery) and/or[thefreelibrary.com]
  • […] object such as insect, organic, or inorganic matter in external auditory canal Synopsis Relatively common foreign body complaint in primary care office, urgent care, and emergency room settings May be asymptomatic or an incidental finding Pathophysiology Etiology[fprmed.com]
  • Its exact etiology is unknown, but it is thought to result from abnormal epithelial kinetics and loss of the lateral migration pattern of the squamous epithelium.[entokey.com]

Epidemiology

  • References Epidemiological profile of hearing impairments: the scale and nature of the problem with special reference to the elderly.fckLRDavis ACfckLRActa Otolaryngol Suppl. 1990;476:23.[physio-pedia.com]
  • Epidemiology  1 in 10,000 to 15,000 births  Up to 50% of the time associated with some craniofacial syndrome  Unilateral : Bilateral, about 3:1  30% are bilateral  Atresia : Microtia, 7:1  Slightly more common on the right  Male : Female, 2:1 7[slideshare.net]
  • Epidemiology Otitis externa is a common presenting complaint in UK general practice, with studies suggesting that it accounts for around just over 1% of all GP consultations.[patient.info]
  • Aetiology and epidemiology Patients presenting with foreign bodies in the nose or ear are predominantly children in the 2 to 8 age group. 2 Foreign bodies in the nose are less common than those in the ear and occur almost exclusively in children.[emj.bmj.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology and Etiology Impacted cerumen is more common among people who have excessive thick or dry cerumen.[sites.google.com]
  • Definition Foreign object such as insect, organic, or inorganic matter in external auditory canal Synopsis Relatively common foreign body complaint in primary care office, urgent care, and emergency room settings May be asymptomatic or an incidental finding Pathophysiology[fprmed.com]
  • […] when there is obstruction of the canal, desquamation of the epithelium continues and the collection of impacted squamous debris may ultimately modify the canal lining and lead to cholesteatoma formation. (9) Several classification systems based on the pathophysiologic[thefreelibrary.com]
  • However, their exact pathophysiology is not completely understood. 9, 10 Van Gilse 11 proposed that exposure to cold water for long periods of time produces erythema of the canal and a periosteal reaction that induces exostosis formation.[entokey.com]

Prevention

  • Prep for success: Prevent addition damage Before extracting the insect, you must kill it or otherwise immobilize it to prevent ongoing intra-aural damage by the insect. Many providers drown the insect in viscous lidocaine.[aliem.com]
  • The small hairs project outwards and the ceruminous glands producing earwax or cerumen help prevent the entry of insects into the ear.[bodterms.weebly.com]
  • Anesthesia/Sedation: Lidocaine or phenylephrine spray can be used to prevent swelling and pain, but should be rarely used due to the risk of causing sneezing and associated aspiration or ingestion of the object.[emdocs.net]
  • Nursing Management The nurse instructs the client to carry out the medical treatment and provides health teaching to prevent recurrence. For example, he or she advises swimmers to wear soft plastic ear plugs to prevent trapping water in the ear.[sites.google.com]
  • Prevention Prevention of otitis externa relies upon minimising the underlying causative factors.[patient.info]

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