sinusitis

Objective: To provide family physicians and general otolaryngologists with a practical, evidence-based, and comprehensive approach to the management of patients presenting with suspected referred otalgia.

Sources of information: The approach described is a review based on the authors' clinical practices along with research and clinical review articles published between 2000 and 2020. MEDLINE and PubMed were searched using the terms otalgia, referred otalgia, and secondary otalgia. Current guidelines for the management of referred otalgia were also reviewed.

Main message: Otalgia is defined as pain localized to the ear. It is one of the most common head and neck presentations in primary care, otolaryngology, and emergency medicine. Secondary otalgia arises from nonotologic pathology and represents nearly 50% of otalgia cases. Otalgia in the absence of other otologic symptoms is highly indicative of a secondary cause. A thorough assessment of patients presenting with referred otalgia requires an understanding of the possible causes of this condition, including dental and oral mucosal pathologies, temporomandibular joint disorders, cervical spine pathology, sinusitis, upper airway infection, and reflux, as well as head and neck malignancy. This paper aims to highlight the most common causes of referred otalgia, their presentations, and initial options for assessment and management.

Conclusion: The prevalence of referred otalgia makes this an important condition for family physicians to be able to assess, manage, and triage based on patient presentation and examination. Understanding the common causes of referred otalgia will help reduce wait times for specialist assessment and allow ease and speed of access to management options for patients in community clinics.

Author/s:

Fatemeh Ramazani, Charmaine Szalay-Anderson, Arthur Volpato Batista, Phillip Park, Euna Hwang, Justin Chau, Justin Lui

FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions

Jeffrey Wilson — Mon, 10 Dec 2018 14:18:59 +0000

Date Added:

December 10, 2018

Journal/Publication:

FDA News Release

Publisher:

U.S. Food and Drug Administration

Publication Date:

July 10, 2018

URL:

FDA updates warnings for fluoroquinolone antibiotics on risks of mental health and low blood sugar adverse reactions

Type:

Notifications and Opportunities

Format:

Web Page

Keywords

MeSH

The more we learn about the potential adverse effects of fluoroquinolones, the more we should try to avoid their use, particularly for self-limited conditions like sinusitis and bronchitis.

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The U.S. Food and Drug Administration today is requiring safety labeling changes for a class of antibiotics called fluoroquinolones to strengthen the warnings about the risks of mental health side effects and serious blood sugar disturbances, and make these warnings more consistent across the labeling for all fluoroquinolones taken by mouth or given by injection.