Conditions of the Ear

Description

Cerumen impaction occurs when earwax (cerumen) accumulates in the ear canal to a degree that may cause symptoms such as pain, hearing loss, or dizziness.

Signs and Symptoms

• Hearing loss
• Earache or fullness
• Tinnitus (ringing in the ear)
• Dizziness
• Cough (due to ear canal stimulation)

Treatment

Supportive

• Manual Removal: Performed by a healthcare professional using specialized
• Ear Irrigation: Flushing the ear canal with warm water, performed by a healthcare
• Avoid: Inserting objects like cotton swabs into the ear, which can push wax further

Pharmacological

• Cerumenolytics: Substances that soften earwax, making it easier to
• Saline Solution: Can be used to irrigate and soften the
• Wax Softeners: Docusate Sodium: Softens and breaks down
• Dosage: Instill 5 ml to 1 ml into the affected ear and leave for 15-30 minutes. Repeat if necessary.

When to Seek Professional Help

• If home treatments are
• If you experience severe pain, discharge, or signs of

Preventive Measures

• Regular cleaning of the outer ear with a
• Avoid inserting objects into the ear
• Use ear drops periodically if prone to wax build-

Description

Otitis externa is the inflammation or infection of the external auditory canal (EAC), the auricle, or both. This condition can be found in all age groups. Types of Otitis Externa:

• Acute diffuse OE: Most common form of OE, typically seen in
• Acute localized OE (furunculosis): Associated with infection of a hair
• Chronic OE: Same as acute diffuse OE but is of longer duration (>6 weeks).
• Eczematous OE: Encompasses various dermatologic conditions that may infect the EAC and cause
• Otomycosis: Infection of the ear canal from a fungal species (e.g., Candida, Aspergillus).

Signs and Symptoms

• Painful ear
• Ear fullness
• Hearing loss
• Occasionally discharging ear (weeping ear)
• Severe cases present with lymph node swelling around the ear and fever

Treatment

Supportive

• Keep the ear dry at all
• Plug with a cotton ball smeared with petroleum jelly when taking a
• Avoid inserting anything into the ear (including ear buds).

Pharmacological

Pain Management:

• Paracetamol (Acetaminophen):
  • Adults: 500 mg to 1 g every 6-8
  • Children 6-12 years: 250-500 mg every 6-8
  • Children 1-5 years: 120-250 mg every 6-8
• Ibuprofen:
  • Adults: 200-400 mg every 8
  • Children 4-7 years: 150 mg every 8 hours (maximum 5-10 mg/kg daily).
  • Children 7-12 years: 200 mg every 8 hours (maximum 5-10 mg/kg daily).
• Diclofenac:
  • Adults: 50-100 mg every 12
• Topical Medications:
  • Betamethasone Sodium Phosphate 0.1% Eye/Ear/Nose Drops: Indicated for inflammation in otitis externa with eczema Instil 2-3 drops in the ear every 2-4 hours, reduce frequency when relief is obtained.
  • Dexamethasone Sodium Phosphate 0.1%: Indicated for inflammation in otitis externa with eczema present. Instil 2-3 drops every 2-3 hours, reduce frequency when relief is Caution: Use under expert supervision, avoid prolonged use.
  • Ciprofloxacin 3% Ear Drops: Indicated for acute localized OE and chronic OE.
    • Children 1–17 years: Apply 0.25 mL twice daily for 7
    • Adults: Apply 0.25 mL twice daily for 7
  • Otic Clotrimazole 1% Solution: Indicated for
    • Children and Adults: Apply 2-3 drops 2-3 times a day, continue for at least 14 days after disappearance of infection.
  • Systemic Antibiotics: For severe otitis
    • Amoxicillin: 25 mg/kg three times daily for 5-7

If penicillin-hypersensitive:

• Erythromycin: 10-20 mg/kg orally twice
• Cephalexin: 25 mg/kg orally every 6 hours.
• Ciprofloxacin: 10mg/kg orally every 12 hours

• Avoidance of Contributing Factors

Description

Acute otitis media is an infection behind the eardrum of an infective origin. It is extremely common in children.

Signs and Symptoms

• Fever
• Ear pain
• Rubbing the ear by infants and toddlers
• Pus drainage from the ear in some cases

Treatment

Pharmacological

Pain Management:

• Paracetamol (Acetaminophen):

• Adults: 500 mg to 1 g every 6-8
• Children 6-12 years: 250-500 mg every 6-8
• Children 1-5 years: 120-250 mg every 6-8

• Ibuprofen:

• Adults: 200-400 mg every 8
• Children 4-7 years: 150 mg every 8 hours (maximum 5-10 mg/kg daily).
• Children 7-12 years: 200 mg every 8 hours (maximum 5-10 mg/kg daily).

• Diclofenac:

o     Adults: 50-100 mg every 12 hours.

Antibiotics:

• Amoxicillin: 80-100 mg/kg/day.

• Children < 2 years: 10-14
• Children > 2 years: 7
• Adults: 5

• If penicillin-hypersensitive:

• Erythromycin: 10-20 mg/kg orally twice
• Cephalexin: 6.25 mg/kg orally every 6