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ENT > 1: Conditions of the pinna and external auditory canal > Flashcards

1: Conditions of the pinna and external auditory canal Flashcards

1
Q

What is chrondrodermatitis nodular helices

A

Catilaginous lump on helix or anti-helix

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2
Q

What are two risk factors for chondrodermatitis nodular helices

A
  • Usually affects the ear the person sleeps on

- Working outside

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3
Q

What is a pinna haematoma

A

Blunt trauma to the ear

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4
Q

What is auditory exostosis also known as

A

Surfer’s ear

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5
Q

What is auditory exostosis

A

Hypertrophy of multiple bony canals bilaterally

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6
Q

What causes auditory exostosis

A

Cold exposure

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7
Q

How may cerumen impaction present clinically

A

Aural fullness
Conductive hearing loss
Tinnitus

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8
Q

What counts as the outer ear

A

Auricle, external auditory meatus, tympanic membrane

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9
Q

What is basal cell carcinoma

A

Malignant proliferation of basal cells

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10
Q

What is the most common malignant skin cancer

A

BCC

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11
Q

In which population does BCC occur more

A

Males

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12
Q

What are 3 risk factors for BCC

A
  • Skin types 1 and 2
  • Sun exposure
  • Gorlin syndrome
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13
Q

Explain growth of BCC

A

Grows over weeks-months

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14
Q

How do BCC present clinically

A
  • Pearly nodule, with rolled borders
  • Ulcerated centre
  • Telangectasia
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15
Q

How is BCC investigated

A

Exciscional biopsy

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16
Q

How is BCC managed

A

Surgical excision

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17
Q

Explain the prognosis of BCC and why

A

Good prognosis as it is only locally invasive - with a low risk of metastases

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18
Q

what is squamous cell carcinoma

A

malignant proliferation of keratinocytes in stratum spinosum

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19
Q

what is the most common site for SCC to develop

A

ear

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20
Q

what is the second most common skin cancer

A

SCC

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21
Q

in which gender is SCC more common

A

males

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22
Q

how does the incidence of SCC change with age

A

increases with age

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23
Q

what are 4 risk factors for SCC

A
  • Sun exposure
  • Previous skin cancer
  • Chemical exposure
  • Xeroderma pigmentosum
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24
Q

explain presentation of SCC

A
  • Growths weeks - months
  • Presents as a non-healing, bleeding ulcer with everted edges
  • Surrounding skin appears inflamed
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25
what is bowen's disease
Squamous cell-carcinoma in situ
26
How is SCC diagnosed
Punch biopsy Or, excision biopsy = diagnosis and treatment
27
How is SCC managed
Excision biopsy
28
If the lesion is less than 20mm, what margins should be used
4mm
29
What % of SCC metastasise
2%
30
When is a foreign body in the ear more common
Children
31
How may foreign body present clinically
- Pain - Conductive hearing loss - Discharge - Bleeding
32
How are insects removed
Olive Oil
33
When is syringing used to remove an object
If sure there is no damage to tympanic membrane
34
How are soft foreign bodies removed
Tilley's or crocodile forceps
35
How are solid foreign bodies removed
Jobson-Horne Probe
36
When should a child be referred to a senior for GA removal of an object
- Un-cooperative - Failed attempt - Suspect TM rupture
37
Define otitis externa
Inflammation of external ear
38
In which patients does otitis externa tend to occur
Young female
39
What is the most common causative organism of otitis externa
Pseudomonas aeurginosa
40
What is a risk factor for otitis externa
Moisture of the ear
41
What are risk factors for otitis externa
Moisture: - Swimming - Frequent hair washing - Humid environment Trauma: - Cotton buds - Eczema/Psoriasis Immunocompromised Ear polyp or foreign body
42
Explain relationship between diabetes and otitis externa
Diabetes increases risk of otitis externa and complications of otitis externa
43
How wil otitis externa present
Erythematous canal Progressive ear pain Purulent discharge
44
If bacteria otitis externa, what colour is the discharge
White-Yellow
45
If fungal otitis externa, what colour is the discharge
Thick Grey
46
What are two signs of otitis externa
Erythematous | Tragus is tender to palpation
47
What is mild otitis externa
- Erythematous
48
What is moderate otitis externa
- Painful - Discharge - Narrowed external auditory meatus
49
How does severe otitis externa present
- Completely occluded EAM
50
What are 3 differentials of otitis externa
- Furuncle - Otitis media with effusion - Ramsay Hunt
51
What is a furuncle
Painful ear canal due abscess formation from infection of hair follicle
52
How is otitis externa usually diagnosed
Otoscopy
53
What is used to grade the severity of otitis externa on otoscopy
Brighton-Grading System
54
What is grade I on Brighton grading system
- Erythema - Mild pain - No hearing loss - TM visible
55
What is grade 2 on Brighton grading system
- Erythema - Pain - Canal slightly obstructed by debris - TM obscured
56
What is grade 3 on Brighton grading system
- Erythema - Canal closed - TM not visible
57
What is grade 4 on Brighton grading system
- Systemic complications - Cellulitus - Perichondritis
58
When are swabs sent in otitis externa
Suspect fungal infection - thick grey discharge
59
Why may a random plasma glucose be ordered in otitis externa
Check for diabetes
60
When is high-resolution CT ordered in otitis externa
Suspect complications
61
What is the management of mild otitis externa
Cleaning
62
What are three methods of cleaning the ear canal
1. Syringing 2. Micro-suction 3. Dry mopping
63
What is indicated for moderate otitis externa
Topical antibiotics and topical corticosteroids
64
What is indicated for severe otitis externa
Aluminimum acetate wick inserted for several days. Then removed (when canal widened) and micro-suctioned
65
What is a criteria for ear syringing
TM must be intact
66
What may resistant to otitis externa treatment indicate
SCC
67
How should treatment-resistant otitis externa be investigated and why
Punch-out biopsy - due to risk of SCC
68
What is major complication of otitis externa
Malignant otitis externa
69
What is malignant otitis externa
Extension of otitis externa into mastoid air cells in temporal bone
70
What is a risk factor for malignant otitis externa
Diabetic and elderly
71
How may malignant OE present
Severe Headache | CN7 Involvement
72
How is malignant OE managed
Urgent IV antibiotics and debridement
73
What are 3 complications of malignant OE
Mastoiditis Osteomyelitis Intra-cranial spread

ENT (16 decks)

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