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ENT > Diseases of the Middle Ear > Flashcards

Diseases of the Middle Ear Flashcards

1
Q

Typically precipitated by URI causing eustachian tube obstruction

Allergic rhinitis, environment (passive smoke) other reasons

Bacterial infection of the mucosally lined air-containing spaces of the temporal bone

Most common in childhood with peak incidence first two years of life

A

Acute Otitis Media

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2
Q

AOM is the most common in childhood with peak incidence at what age?

A

first two years of life

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3
Q

What is the most common pathogen in acute otitis media?

A

S. pneumonia

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4
Q

The majority of acute otitis media cases are viral or bacterial?

A

viral

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5
Q

List some common pathogens in acute otitis media

A

S. pneumonia (up to 40%) – most common pathogen
H. influenza (25-30%)
Moraxella catarrhalis (10-20%)
Group A strep (2%)
S. Aureus (1%)

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6
Q

A workup for what is required on any neonate (< 1 month) with an acute otitis media?

A

sepsis

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7
Q

List some differential diagnoses to consider with a bulging red TM

A

Acute otitis media
Otitis externa
Referred otalgia
Serous otitis media
Aerotitis (barotrauma)
Bullous myringitis

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8
Q

What is the DOC in acute otitis media?

A

Amoxicillin/Augmentin

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9
Q

List some complications of AOM

A

Chronic/recurrent OM
Mastoiditis
Petrositis/petrous apicitis
Otogenic skull base osteomyelitis
Facial nerve paralysis
Sigmoid sinus thrombosis
CNS infections
Speech issues

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10
Q

What is the management of recurrent otitis media?

A

Long term antibiotic prophylaxis (3-6 months Amoxicillin)

ENT referral (Failure of the above may indicate need for ventilation tubes)

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11
Q

What are the common pathogens seen in chronic otitis media?

A

P. aeruginosa
S. aureus
Mixed anaerobic infections

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12
Q

What is the most frequent serious complication of middle ear infection?

A

Mastoiditis

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13
Q

Extension of infection into mastoid air cells – the common intratemporal complication of AOM

Presents several weeks of inadequately treated acute otitis media

Typically refers to the coalescent type that is associated with mastoid
bone destruction

A

Mastoiditis

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14
Q

What are the common pathogens seen in mastoiditis?

A

Group A strep
Pneumococcus
Staph
H. flu

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15
Q

What are some complications of mastoiditis?

A

Intracranial extension
Abscess
Sigmoid sinus thrombosis
Facial nerve paralysis

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16
Q

What is the most worrisome/greatest concern complication of mastoiditis?

A

Intracranial extension

17
Q

What is the study of choice in diagnosing mastoiditis?

18
Q

Mastoidectomy indicated in mastoiditis if no improvement after 24 hours or any of these factors are present

A

Symptoms of otogenic intracranial complications

Symptoms of subperiosteal collection

Facial paralysis

Worsening of condition

19
Q

What are some differential diagnoses to consider when evaluating for mastoiditis?

A

Pseudomastoiditis in otitis externa (secondary cellulitis)

Parotitis

Cervical lymphadenitis

20
Q

Complication of chronic otitis media

Chronic negative middle ear pressure retraction of the pars flaccida
into the middle ear

Keratin debris accumulates in cholesteatoma sac and may become
chronically infected

Erode bone penetrating mastoid and destructing ossicular chain

A

Cholesteatoma

21
Q

What are some complications of a cholesteatoma?

A

Intracranial extension

Facial nerve paralysis

osteomyelitis

22
Q

Infection involving layers of the TM - Can occur with any AOM pathogen

Presentation and Treatment same as AOM

A

Bullous Myringitis

23
Q

What are the most common infectious agents in bullous myringitis?

A

Mycoplasma

H. influenzae

24
Q

Slowly progressive conductive hearing loss unless impingement on cochlea causing permanent sensory hearing loss

Usually bilateral an asymmetric – patients may report improved hearing with background noise

Process in which staples lose mobility by excessive bone growth at the oval window

Familial tendency - hereditary

A

Otosclerosis

25
Q

What is the pathogenesis of otosclerosis?

A

Abnormal removal of mature bone
Abnormal remodeling
Lesion at footplate of the stapes

26
Q

What is a common population/demographic of otosclerosis?

A

pregnant young females

27
Q

Complaints of what symptom is common in patients with otosclerosis?

28
Q

Traumatic perforation secondary to impact or explosive acoustic trauma

Hemotympanum can result also (blood behind TM)

Spontaneous healing usually occurs

Ossicular chain disruption

A

Trauma to Middle Ear

ENT (13 decks)

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