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[Diagnosis and therapy of infectious otitis externa. An overview for the non-ENT physician].

Knowledge of the different clinical manifestations of inflammation caused by specific infectious agents of the external ear canal and the auricle makes a successful empirical therapy possible. Initial therapy should always consist of local treatment modalities including repeated cleansing of the aural canal and insertion of a cotton wick carrying local medication. Major advancement of systemic therapy of bacterial external otitis has been obtained by the availability of the new Gyrase-inhibitors (Fluoroquinolones). These antibiotic drugs possess--given orally--strong activity against the entire spectrum of etiologic bacteria and are effective in the difficult to treat malignant external otitis. In systemic therapy of Zoster oticus the antiviral substance Aciclovir can improve otalgia and auricular eruptions. Early Aciclovir treatment is advised in cases of Ramsay Hunt Syndrome to minimize permanent nerve damage.

Anti-Bacterial Agents↗

Pathologic changes in otitis externa.

Otitic lesions must be evaluated in the context of the whole animal. Accurate historical and clinical assessments are important aids to the pathologist attempting to reach an accurate diagnosis. Primary lesions of the pinna, with or without involvement of the external ear canal, may be an extension of a more generalized dermatologic problem or may specifically involve the ear because of its unique gross and histologic characteristics.

Animals↗

[Atypical osteomyelitis of the base of the skull and malignant otitis externa].

Osteomyelitis of the skull base is a rare, but serious disease whose incidence is tending to increase. It affects the marrow of the temporal, occipital and sphenoid bones and is generally secondary to Pseudomonas aeruginosa infection of the external auditory meatus. Based on a clinical case, the authors recall the difficulty of establishing the positive diagnosis and the possible confusion with neoplastic disease, hence the fundamental role of biopsies. They also review the literature on this subject.

Aged↗

Evaluation of selected physiological and morphological characteristics of Pityrosporum pachydermatis isolated from clinical cases of otitis externa and dermatitis in dogs and cats.

Physiological properties and proportion of typical features of Pityrosporum pachydermatis were determined on 385 strains from clinical cases of O.E and dermatitis in dogs. Carbohydrates and nitrogen assimilation were determined auxanographically. Urease production and enzyme release were assessed on Christensen's medium and API-ZYM respectively. All strains oxidised carbohydrates in the OF test. 90% assimilation of glucose and production of urease are typical of Pityrosporum, contrary to 100% positive reactions in literature data. Production of acid and alkaline phosphatases, phosphohydrolase, leucin arylamidase, and beta-glucosidase dominated, while lipase C14, esterase-lipase C8, esterase C14 and alpha-galactosidase were variable.

Animals↗

[Idiopathic Frey's syndrome under the appearance of a recurrent otitis externa].

Frey syndrome has been observed especially in patients who have undergone a parotidectomy operation, but also in zoster herpes, in parotiditis, condilea fractures, obstetric traumatisms with forceps and in surgery of the meningioma of the cerebellopontine angle. It also appears without previous surgery, like in our case. In these circumstances it is believed that a clinical neuritis, primary or secondary to a neighbouring inflammation may cause the start of this disorder. Several treatments have been suggested which highlights the difficulty of them. The most effective one is the intradermic injection of botulinum toxin type A. Its use in Frey's syndrome was initiated by Drobik and Laskawi in 1995. Since then the references to its use are numerous. Nevertheless, it is a treatment which has been introduced very few times in our country.

Aged↗

[Bacteriological and clinical notes on otitis externa in saturation. Double-blind study on the efficacy of prophylactic and therapeutic preparations].

Microbiological analysis of the variation in the bacterial flora of the external auditory canal was carried out during 39 immersion in saturated solutions. A double blind test on the usefulness of prophylactic and therapeutic preparations was also carried out. Prophylactics. - 5% Al acetate in H2O (P1), Boric alcohol (P2), lactic acid in H2O (P3, Domeboro (P4), no prophylactic (P0). After the immersions, a significant increase in Pseudomonas Aeruginosa and Candida Albicans (p less than 0,01) was noted in the auricular bacterial flora. Gram positive bacteria in general were considerably reduced (p less than 0,01). Gram negative bacteria other than pseudomonas. A (p less than 0,3) and coagulase negative straphylococci (p less than 0,03) did not vary significantly. Prophylactic preparations P1 and P2 were shown to be significantly more effective than P3, P4 and P0 in preventing the symptomatology (p less than 0,01). The most effective therapeutic preparation was found to be a locally applied gentamycinpolymixin association.

Adult↗