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Otitis Externa

Rob Orman, MD and Clayton Finley MD
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05:08
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Nurses Edition Commentary

Lisa Chavez, RN and Kathy Garvin, RN
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01:37

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EM:RAP January 2018 Written Summary 933 KB - PDF

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Brian T. -

What drops (if any) are safe when the TM is perforated or cannot be assessed due to swelling? I have heard mixed answers to this. Some say no drops, some say no steroids, some say it doesn't matter...

Christine A. -

What is the safety of quinolone drops in children?

Joseph P. -

He mentions using eye drops in the ear. I have had a pharmacist request a change to tobramycin drops. I was concerned about ototoxicity if there is a perforation. Thoughts?

Clayton F. -

Quinolone drops are safe in children because the effect is mainly topical, and they're safe with perfs/tubes (as are steroids). Besides canal swelling, another shout-out for steroid drops is in patients with bloody otorrhea (which almost always represents granulation tissue that will melt away with the steroids). We didn't mention it, but the steroid eyedrop I usually use is prednisolone (aka Pred Forte). As to the issue of using an aminoglycoside-containing drop (or any other ototoxic component) in a patient that has (or might have) a perf/tube: imagine yourself explaining to the jury why you used a medicine referred to as "ear-toxic" in the ear... enough said.
Cortisporin has not one but TWO ototoxic components: polymyxin B and neomycin.

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The Collector Full episode audio for MD edition 263:02 min - 367 MB - M4AEM:RAP 2018 January German Edition Deutsche 96:14 min - 132 MB - MP3EM:RAP 2018 January Canadian Edition Canadian 18:24 min - 25 MB - MP3EM:RAP 2018 January Spanish Edition Español 94:31 min - 130 MB - MP3EM:RAP 2018 January French Edition Français 21:02 min - 29 MB - MP3EM:RAP 2018 January Individual MP3 340 MB - ZIPEM:RAP 2018 January Individual Written 964 KB - ZIPEM:RAP 2018 January Spanish Written 1,019 KB - PDFEMRAP Board Review Answers 2018 01 Jan Vol.18 01 95 KB - PDFEMRAP Board Review Questions 2018 01 Jan Vol.18 01 161 KB - PDFEM:RAP January 2018 Written Summary 933 KB - PDF

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