Otology

Ear problems are among the most common concerns seen by family physicians. This edition of FP Essentials addresses several key diagnoses in the field of otology. Section One covers hearing loss, which is increasingly common. I was interested to learn that more than 60% of people older than 70 years have significant hearing loss and that 10% to 20% of hearing loss can be attributed to noise exposure. Section Two gives helpful tips on diagnosing and categorizing the various types of vertigo so that appropriate management can be selected. Section Three covers ear infections: otitis media, otitis media with effusion, and otitis externa. Section Four focuses on management of cerumen impactions and aural foreign bodies.

I hope you find this edition of FP Essentials helpful for your practice. When you have finished studying it and are ready to submit your posttest answers, please tell us what was most useful and what we can do to improve. We look forward to hearing your ideas for topics you would like covered in future editions.

Karl T. Rew, MD, Associate Medical Editor
Clinical Associate Professor
Departments of Family Medicine and Urology
University of Michigan Medical School, Ann Arbor

John Malaty, MD, FAAFP, is a professor in the Department of Community Health and Family Medicine at the University of Florida (UF) College of Medicine (COM), Gainesville. He is also medical director of the UF Health Family Medicine—Main clinic, associate program director of the UF Family Medicine Residency Program, and director of the Resident as Teacher Program at UF. He completed 3 years of otolaryngology residency before completing family medicine residency. His interests include otolaryngology in primary care, practice management, and quality improvement. He has had numerous publications and presentations that have focused on otolaryngology in family medicine.

Frank A. Orlando, MD, FAAFP, is an associate professor in the Department of Community Health and Family Medicine at the UF COM and medical director of the UF Health Family Medicine—Springhill clinic. He completed 2 years of general surgery residency followed by a 2-year surgical oncology fellowship. He serves as an associate editor of Family Medicine and Primary Care, a specialty section of Frontiers in Medicine.

Michael Tudeen, MD, is an assistant professor in the Department of Community Health and Family Medicine at the UF COM. His clinical and research interests include outpatient procedures, women’s health, health disparities, and graduate medical education.

Maribeth Porter Williams, MD, MSCR, FAAFP, is an associate professor in the Department of Community Health and Family Medicine at the UF COM, where she serves as program director for the Family Medicine Residency Program. She completed an academic generalist fellowship. Her clinical and research interests include global and underserved health, quality improvement and health services research, tobacco research, and graduate medical education. She is actively involved in the Florida Academy of Family Physicians (FAFP) and serves on the Board of Directors.

Disclosure: It is the policy of the AAFP that all individuals in a position to control CME content disclose any relationships with ineligible companies upon nomination/invitation of participation. Disclosure documents are reviewed for potential relevant financial relationships. If relevant financial relationships are identified, mitigation strategies are agreed to prior to confirmation of participation. Only those participants who had no relevant financial relationships or who agreed to an identified mitigation process prior to their participation were involved in this CME activity. All individuals in a position to control content for this activity have indicated they have no relevant financial relationships to disclose.

• Summarize the types and etiologies of hearing loss and discuss appropriate management.
• Discuss the beneficial effect of hearing aids on hearing-specific health-related quality of life for patients with mild to moderate hearing loss.
• Differentiate the types of vertigo by triggers and timing.
• Discuss the worrisome red flag signs, symptoms, and findings that could indicate urgent or emergent causes of vertigo.
• Recommend observation for most children 6 months or older with nonsevere, unilateral acute otitis media.
• Summarize the indications for tympanostomy tube placement and advise patients.
• Discuss management for cerumen impactions and aural foreign bodies.