Clase Oido Unfv 2015

7/23/2019 Clase Oido Unfv 2015

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OTITIS EXTERNA Y MEDIAOTITIS EXTERNA Y MEDIA

DIAGNOSTICO YDIAGNOSTICO Y

TRATAMIENTOTRATAMIENTO

DR. MARIO YVAN SALERNO CORDERO

SERVICIO DE OTORRINOLARINGOLOGIA

HOSPITAL NACIONAL ARZOBISPO LOAYZA


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Cerumen

Agua 10.0 %

Minerales 43.3 % (Na, K, Mg, Ca, P, Cu)

Lpidos 3.4 % (grasas neu!ras, "os"#!idos)

Pro!enas 3.0 %

Pigmen!os 0.$ %

"e&!o "ungis!#!i&o ' a&!erios!#!i&o


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LAA*+ * +*+-


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+- /NA*NC+N2

n"lama&in del odo e!erno '5o paelln

auri&ular.

+L+6A2

-!rep!o&o&os ' -!a"ilo&o&os aureus.

Aspergillus ' C#ndida ali&ans.


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+- /NA

An!e&eden!es de impor!an&ia2

Na!a&in

Manipula&in &on 7isopos

n!rodu&&in de &uerpo e!ra8o

Apli&a&in de go!as !i&as


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+- /NA

Cuadro &lni&o2

+!odinia

Pruri!o

uda&in

*isminu&in de agude9a audi!i:a-ignos del !rago ' paelln posi!i:os

Adenopa!a


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+- /NA

CC;N-CA


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C


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++MC+--


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+- /NA

ra!amien!o2

La:ados

6o!as de &or!i&oide &on an!ii!i&o

Amoi&ilina

*i&loa&ilinaCe"alosporinas de primera genera&in

An!i">ngi&o !pi&o


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MM=ANA MPANCA


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+- M*A

*NC+N2

NLAMAC+N *L +*+ M*+,

?; NCL;@ N+ -+L+ -A

CA*A* -N+ AM=N +MPA *

;-A?;+ @ MA-+*-.


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+- M*A

CLA-CAC+N CLNCA2

1. MN6-

. +- M*A -;P;AA A6;*A

3. +- M*A -C+A

4. +- M*A -;P;AAC+NCA


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MN6-

NLAMAC+N * MM=ANA

MPANCA -+LA + C+M=NA*A

C+N +- /NA + C+N +-M*A


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MN6-


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+- M*A -;P;AA

A6;*A

+.M.P;;LNA A.5+.M.A.

NCC+N *L +*+ M*+

*NCA=L P+ M*+-

CLNC+-, * NC+ -;=+ @*;AC+N =.


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+- M*A -C+A

+.M.C. C+N *AM5 +.M. N+

-;P;AA5 +. CAAAL5

+.M.-+-A5 -+MPAN+5+.M.M;C+*5 M;C+MPAN+

L?;*+ + *AM N +. M*+

C+N M.. NACA, -N -N+MA- N-6N+- A6;*+-.


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+- M*A -C+A


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+- M*A -C+A


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+- M*A -;P;AA

C+NCA

+.M.C.

-CC+N C+NCA *L +. M*+

A A- * P+AC+N * M..

-;P;AA AC NCA A

NCC+N CLNCA ACA.


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+- M*A C+NCA


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PA+6NA

AC+-2

1. NCC+N AL + =ACANA

. *-;NC+N MCANCA +

;NC+NAL * ..

3. AL6A

4. =A+A;MA

B. C+M=NAC+N * -+- AC+-.


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1. NCC+N AL +

=ACANA

NCC+N -PA+A ALA.

;- N B A 10% +M.+MA =ACANA *-P;- * A

AL.

;- *-;@N MCAN-M+M;C+CLA * .. @ +.M*+.


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1. NCC+N AL +

=ACANA

A AL ACLA NCC+N

=ACANA *-* NA-+AN6ACA .. @ +.M*+.

=ACA-2 -.PN;M+NA,

.NL;N


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. *-;NC+N ;=AA

+=-. MCANCA + ;NC+NAL

P++CA A=-+C+N * 6A- ,

P-+N () @ L?;*+ N +. M*+.MCANCA2 . NA-+AN6+, .

A*N+*A-, PALA*A N**+.

;NC+NAL2 +LA+, ;NC+NCLA AN+MAL, -. KAA6N.


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3. AL6A

*MA @ C+N6-+N * N-

AL6CA P;*N *-MNA-

ACA .. @ +. M*+.


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4. =A+A;MA

=;C+, ;L+, AAMN+ C+N

+/6N+ P=AC+.AL A-CN* P. AM=NAL

*-MN;@ @ A N +. M*+ -

/PAN* @ -AL P+ . .


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4. =A+A;MA

AL *-CN* A;MNA P.AM=NAL, A * +. M*+ @ .. -

C+MPMN @ - 6A*N *

P-+N- - /C-+ LA .. -C+LAP-A. - N+ - 6;ALA P-+N,

- P+*;CA *AM P--N

N +. M*+, C+N M+A6A +

A-;*AC+N * -;+.


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PA+6NA

AC+- CA;-AL- * +M-M;LAN -CC+N *M*A*+- NLAMA++-(-AMNA, P+-A6LAN*NA-,

L;C+N+-, CNNA-,P+A-A- @ N


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L?;*+- N +*+ M*+

P;;LN+- 2 +MP

-+-+- 2 +M-

M;C+*- 2 +MM

N LA CLNCA - C+M;N LA

C+M=NAC+N * -+- L?;*+-.


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+- M*A A6;*A

*A6N+-C+2

++*NA, =, A=L*A*,

-+MN+LNCA, - A + +CA LPA=LL+N A;C;LA.

M MA+-A, L;6+ -

+PACCA, APAC LLNA @P+MNN, - - +MP A@

*AM P;;LN+.


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+- M*A A6;*A


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+- M*A A6;*A


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+MA 2 AAMN+

AN=+C+2

AM+/CLNA2 D0 mg5Kg5d !id

AM+/CLNACLA;NALA+2 D0510

mg5Kg5d !id5id

CACL+2 40 mg5Kg5d id

A/L C;+/MA 2 30 mg5Kg5d id

A


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*;AC+N 10 *A-.N 4D A $ +A- ME+A.

- +L;C+NA MAL A 4 +A-

AL;A C+MPLCAC+N

/AMP+AL 5 MNN6-

- P-- *AM2

MPAN+CN-- (6AM, C;L+)

AN-AMNC+-5*-C+N6-+NAN- 2 FF

+MA 2 AAMN+


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+M 2 *A6N+-C+

PLN;* A;AL, P+AC;-A,

A*+ N A*?;-C+N *L

A=LA @ L LN6;AE.M +PACA, CM+-A +

AMALLNA, A=+M=A*A.

+M- 2 M AM=A + PAE


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+M 2 *A6N+-C+

=;=;EA- + NL *+A+.

ALAC+N * M+L*A* * M.

MPAN+MA2 C;A = PLANA

C+N A;-NCA * LE+

-AP*AL.

A;*+MA2 P+AC;-A

C+N*;CA L A M+*A*A.


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+- M*A -+-A


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+M 2 *A6N+-C+ +MM 2

M +PACA, N6+-A*A, C+L+ AM=A

ACC+N L A M+*A*A

A;MN+ * A-C;LA*A*, P;* - A


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+- M*A M;C+*


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+M 2 AAMN+

AN=+C+ (G +MA).

6LANCA 3 A 4 -MANA-.

AN-AMNC+- @*-C+N6-+NAN-.

C+C+*- (+M NAA=L)

AAMN+ * AL6A NM;N


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+M 2 AAMN+

MN6++MA N-C+N *

;=+ * NLAC+N.

A*N+*C+MA C5-AM6*ALC+MA.

MA-+*C+MA.

*NAE -N;-AL.


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+M 2 AAMN+

;=+ * NLAC+N2

LMNA L *AM P--N,

P+P+C+NA NLAC+N @ *NAEAL +. M*+.

A ACC+N * M @ +-+N *

;-CLL+-.

N;MP MP+ALMN

-C;NCA * +MA A +MC.


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;=+ * NLAC+N


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+MC 2 *A6N+-C+

ANC*N- +MA C;N,

++A *A, P+AC;-A, NN;-,

6+, ++*NA.P+AC+N M C5- ++A,

MPAN+-CL+--, M;C+-A

NLAMA*A + P+LP+*, M

ALCA-CA, =+L-A * ACC+N,C+L-A+MA.


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+- M*A C+NCA

-;P;AA


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+- M*A C+NCA

-;P;AA


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C+L-A+MA


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MPAN+-CL+--


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+MC 2 *A6N+-C+

+M+6AA C+MP;A


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+MC 2 AAMN+

A-PAC+N @ LMP


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+MC 2 AAMN+

MPAN+-+MA /PL+A*+A,

+-C;L+PLA-A, MPAN+PLA-A,

MA-+*C+MA.C+N+L * P+C-+ PA+L+6C+

-;=@ACN, C+M+ C+L-A+MA, @

AA * -A;A L MCAN-M+

A;*+.


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GRACIASGRACIAS

Clase Oido Unfv 2015

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