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Year 4 > Conductive Hearing Loss > Flashcards

Conductive Hearing Loss Flashcards

1
Q

where does the eustachian tube enter the ear?

A

middle ear

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2
Q

what should be seen at tympanic membrane?

A

cone of light
handle of malleus
long process of incus
chorda tympani can sometimes be visible

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3
Q

how can you tell which ear drum youre looking at?

A

cone of light points forwards

handle of malleus points backwards

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4
Q

how can sensorineural hearing loss be further classified?

A

cochlear or retrocochlear (eg acoustic neuroma)

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5
Q

symbols in audiogram?

A 
triangles = bone conduction
circles = right air conduction
crosses = left air conduction
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6
Q

conductive hearing loss on audiogram?

A

large air bone gap
carharts notch (dip in bone conduction) indicates problem with ossicles
flat tympanogram

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7
Q

what can cause conductive hearing loss?

A 
abnormalities of ear canal 
otitis media with effusion
acute otitis media
perforation
cholesteatoma
ossicular chain abnormalities (congenital or after trauma)
otosclerosis
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8
Q

examples of abnormalities of ear canal which can cause conductive hearing loss?

A

congenital atresia
stenosis
otitis externa
compacted wax

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9
Q

what abnormality can cause otitis media with effusion?

A

eustachian tube dysfunction or obstruction

in adults - rhinosinusitis, nasopharyngeal carcinoma, nasopharyngeal lymphoma

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10
Q

how is otitis media with effusion managed?

A

hearing aids or grommets

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11
Q

what is a tympanogram?

A

measures how ear drum responds to pressure in ear canal
creates a seal in ear canal and bounces signal off tympanic membrane
how the signal bounces back gives info on tympanic membrane (flat in otitis media with effusion as packed with pus/fluid)

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12
Q

how can tympanic membrane appear in glue ear?

A 
changed position of cone of light
membrane sucked in, tight over ossicles
colour change (yellowish fluid seen behind membrane)
long process of incus more visible
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13
Q

what is a myryngotomy?

A

procedure cutting a hole in tympanic membrane
fluid sucked out and pressure equalised
grommet usually inserted to prevent recurrence

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14
Q

how long do grommets last?

A

usually fall out after around 1 year

usually resolved by then and dont need another one but some do

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15
Q

what is acute otitis media (without effusion) associated with?

A

still associated with blocked eustachian tube
URTI
commonly viral or can be bacterial

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16
Q

how is acute otitis media managed?

A

antibiotics not recommended unless symptoms last >3 days as its usually viral
generally self resolves or causes perforation which heals once infection settles

17
Q

what does acute otitis media look like?

A

skin injected and red

membrane bulging outwards (opposite to glue ear)

18
Q

complications of otitis media?

A

mastoiditis (infection spreads through air cell system into mastoid, bone breaks down and abscess forms)
- abscess causes ear to stick out and loss of sulcus behind the ear

19
Q

how can mastoiditis be managed?

A

make incision behind ear

20
Q

what is chronic suppurative otitis media?

A

chronic inflammation causing perforation and cholesteatoma

21
Q

what can be seen when ear drum perforated?

A

can cause scarring as it heals (tympanosclerosis) which shows as white area
promentary can be seen

22
Q

what is the prommentary?

A

basal turn of cochlea

23
Q

L shape in ear drum?

A

horizontal part = stapedius tendon

vertical part = long process of incus

24
Q

what is cholesteatoma?

A

presence of keratin within middle ear which grows and causing destruction of surrounding bone and infection

25
Q

theory of how cholesteatoma forms?

A

obstructed eustachian tube > reduced pressure in middle ear > retraction of tympanic membrane > pocket formation > collection of keratin in pocket > expansion, erosion and cholesteatoma established

26
Q

medial complications of otitis media and cholesteatoma?

A 
sensorineural hearing loss
tinnitus
vertigo
facial palsy
other cranial nerve palsies
27
Q

superior complications of otitis media and cholesteatoma?

A

brain abscess

meningitis

28
Q

posterior complications of otitis media and cholesteatoma?

A

venous sinus thrombosis

29
Q

what is otosclerosis?

A

gradual onset conductive hearing loss with normal examination appearances
due to fixation of stapes footplate on oval window
can be familial
progresses more rapidly in pregnancy

30
Q

who is otosclerosis more common in?

A

women

31
Q

how is otosclerosis managed?

A

hearing aids

stapedectomy

32
Q

features of otosclerosis on audiometry?

A

carharts notch

normal tympanogram

33
Q

how can trauma damage hearing?

A

can knock off ossicular chain or damage nerves
crack in temporal bone can progress track down and perforate tympanic membrane
can cause a haemotympanum (blood build up behind ear drum)

Year 4 (83 decks)

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