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CMSD5260 Hearing Disorders > Disorders of the External Ear > Flashcards

Disorders of the External Ear Flashcards

1
Q

What does Congenital mean?

A

Present at birth

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2
Q

What does Acquired mean?

A

not present at birth

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3
Q

What is the relation between the branchial arches and the structures in embryology?

A

Each branchial arches develop into a specific structure (muscle, skeletal, nerve and artery). If there is a problem during development, it can cause congenital disorders like otosclerosis.

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4
Q

Which part of the outer ear develops at week 4-6-8 of gestation?

A

4: EAC
6: Hillocks of His distinct
8: Pinna structures identifiable

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5
Q

Which part of the outer ear develops at week 18-20-28 of gestation?

A

18: Auricle adult form
20: EAC plug disintegrates
28: EAC fully open

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6
Q

What are the sensory innervation of the External ear?

A

Sensory innervation: CN V, VII, IX, X, and great auricular nerve (C2, C3)

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7
Q

What are the arteries that supply blood to the OE? (2)

A

superficial temporal and posterior auricular arteries

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8
Q

What can we say about the OE and lymphatic system?

A

OE contains Lymphatic parotid and cervical nodes (immune system)
Infections and inflammatory conditions of the EAC (& ear) can present with enlarged lymph nodes

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9
Q

What is Darwin’s tubercule?

A

Unique congenital prominence that may be found on the posterior helix of the ear

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10
Q

What are prominent ears?

A

Ears that stick out more than 2 cm from the side of the head are considered to be prominent or protruding

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11
Q

What is Cryptotia?

A

Ear cartilage framework that is partially buried beneath the skin on the side of the head.

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12
Q

What is Cup/Lop ear?

A

Ear deformity where the rim of the ear can be folded forward slightly, giving the appearance of a cup, or more severely, with the entire outer ear appearing as a roll

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13
Q

What is Stahl Ear?

A

consists of an extra cartilage fold in the scapha portion of the ear.

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14
Q

What is Microtia?

A

Absent or underdeveloped external ear.

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15
Q

What are preauricular pits?

A

little dimple in front of the ear

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16
Q

What is a preauricular skin tag?

A

Bump of skin next to ear

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17
Q

What is auricular hematoma?

A

Mass of blood in the OE

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18
Q

What can Auricular hematoma cause?

A

Can have CHL

EAC swelling
Hemotympanum (blood in middle ear)
Ossicular injury/discontinuity

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19
Q

How do you treat auricular hematoma?

A

incision and drainage

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20
Q

What causes cauliflower ear?

A
  • Occurs secondary to hematoma
  • Auricular trauma - auricular hematoma - cauliflower ear (if hematoma left untreated)
  • Hematoma disrupts blood supply to auricular cartilage which leads to cartilage necrosis (death) and neocartilage formation
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21
Q

What is Cellulitis?

A

Cellulitis = inflammation/infection of skin

Pain (on touch)
Warmth
Erythema (redness)
Edema (swelling)
Pruritus (itching)
Weeping & crusting

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22
Q

What is Chondritis?

A

Chondritis = inflammation/infection of cartilage
(lobule is sparred)

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23
Q

What is perichondritis?

A

Inflammation of skin over the cartilage (perichondrium)

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24
Q

What can cause Cellulitis, Perichondritis, and Chondritis? (4)

A

Trauma (usually penetrating)
Piercings
Ear surgery (iatrogenic)
Underlying conditions (eg diabetes, immunosuppression)

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25
How do we treat Cellulitis, Perichondritis, and Chondritis? (2)
Antibiotic treatment Incision and drainage for abscess
26
Can Cellulitis, Perichondritis, and Chondritis cause hearing loss?
CHL possible but rare
27
What can cause weather-related injuries?
Frostbite Sunburn
28
What are the susceptible factors of weather-related injuries? (4)
Malnutrition Dehydration Prolonged exposure Poor hygiene
29
What can frostbite cause?
Superficial ->Deep Erythema (light skin) or gray color (dark skin) Tingling, stinging sensation Numb, yellow, waxy/shiny, gray color Feels cold, stiff, woody Blisters Black necrosis (tissue death)
30
What can cause sunburn?
Winter -> Summer Fair skin, light hair (red hair) Exposed skin areas Snow can reflect sunlight UV light Major risk factor for skin cancer
31
What is 1st degree sunburn?
Superficial: red, tender, slightly swollen
32
What is 2nd degree sunburn?
Superficial: very red, swollen
33
What is 3rd degree sunburn?
Mid-level: severe blisters, peeling skin, nerve damage (no pain)
34
What is 4th degree sunburn?
Deep: death of soft tissue, muscle, cartilage, bone
35
How do you treat sunburn on ears?
1st degree burn-no referral needed (heals in 1 wk) Other burns requires urgent treatment
36
Do frostbite and sunburn cause hearing loss?
Very rare, it must swell or obstruct the canal to some degree - Ear canal swells - Secondary infection - Physical damage to pinna - Tympanic membrane involvement
37
What are Dermatological Conditions?
Skin conditions that can affect the auricle and/or ear canal
38
What Seborrheic Dermatitis?
Dermatological Conditions where there is an inflammatory skin * Eczema like condition * Scaly, flaky, itchy, and red skin * Affects sebaceous gland rich areas * May affect postauricular regions and EAC
39
What is Actinic Keratosis?
Dermatological Conditions, Pre-malignant lesion caused by sun exposure * Thick, crusty patches of skin * Can progress to SCC * Early removal is recommended (surgery, laser, liquid nitrogen)
40
What is Cutaneous Horn?
Dermatological Conditions, Conical projection above skin surface Resembles a “horn” Composed of compacted keratin Base may be malignant Requires surgical excision
41
What is Staphylococcal Dermatitis?
Bacterial skin infection caused by staph aureus Can be associated with hearing aid molds and poor hygiene
42
What can cause skin cancer?
Sun exposure (UV light) Skin type Immunosuppression Chronic inflammation Genetic predisposition
43
What is the most common human skin cancer?
Basal Cell Carcinoma 20% of all cancers in men 10-15% of all cancers in women
44
85% of all BCC occur in _______ & _______
85% of all BCC occur in head & neck
44
85% of all BCC occur in _______ & _______
85% of all BCC occur in head & neck
45
What is squamous cell carcinoma?
* More aggressive than BCC * Higher incidence of metastasis * Often a progression from sun-damaged areas (eg actinic keratosis * Erythematous, crusting, ulcerated lesion with friable base
46
What is the most aggressive type of skin cancer?
Melanoma - 75% of deaths caused by skin cancers - Derived from melanocytes (produce melanin)
47
What are the features of melanoma? (ABCDE)
* Asymmetry * Borders (irregular) * Colour (variegated) * Diameter * Evolving over time
48
What are features of the EAC?
Outer 40% is cartilaginous Inner 60% is bony Skin overlying bony canal Skin, hair, and sebaceous glands overlying cartilaginous canal Sebaceous glands produce wax for protection Narrowest point at bony-cartilaginous junction (isthmus
49
How do you remove excessive cerumen?
* Small amount and not obscuring view-leave alone * Irrigation/flushing (TM must be intact) * Ear drops (oils, acetic acid, cerumenex; TM must be intact)
50
What is Aural Atresia and stenosis?
Atresia-complete absence of EAC (no connection to middle ear) Stenosis-narrowing of EAC Congenital cause of CHL
51
What is Otomycosis?
* Fungal infection of the EAC * Fungal elements visible * Aspergillus fumigatus, Aspergillus niger, Candida albicans are most common forms
52
What is Otitis Externa?
Inflammation/infection of the EAC Bacteria induced Most common condition that affect the EAC Acute and chronic types
53
What is Otitis Externa?
Inflammation/infection of the EAC Bacteria induced Most common condition that affect the EAC Acute and chronic types
54
What can cause Otitis Externa?
* Ear canal skin is injured by trauma/humidity exposure * Normal protective wax layer is disrupted * Bacteria
55
What is Acute otitis Externa?
* Acute Infection of the EAC by Pseudomonas auriginosa (most commonly) * Causes Spontaneous/idiopathic Local trauma Frequent swimming Chronic OE
55
What is Acute otitis Externa?
* Acute Infection of the EAC by Pseudomonas auriginosa (most commonly) * Causes Spontaneous/idiopathic Local trauma Frequent swimming Chronic OE
56
What can Otitis Externa cause? (3)
Otalgia (severe) with ear movement Otorrhea Pruritis EAC swelling and collection of debris/discharge CHL
57
How can you treat Acute Otitis Externa?
Analgesics Antibiotic/anti-inflammatory drops Aural toilet (refer to ENT) Counseling for prevention
58
What is Necrotizing Externa Otitis?
* Aka malignant external otitis * Infection of the temporal bone - Osteomyelitis * Mostly affects elderly with diabetes - Immunosuppressed * Often preceded by EAC trauma or OE
59
What are features of Necrotizing Externa Otitis? (3)
Severe otalgia Otorrhea Graulation tissue Cranial nerve weakness - Facial palsy Intracranial complications May be lethal
60
What foreign bodies are common with children in the External ear canal?
Toys and Bugs
61
What is Exostosis?
Bony growths in the EAC (multiple) Frequently bilateral Arises near the annulus/TM Associated with prolonged cold water exposure May cause CHL
61
What is Exostosis?
Bony growths in the EAC (multiple) Location Frequently bilateral Arises near the annulus/TM Radiographic appearance Broad base Solid Associated with prolonged cold water exposure May cause CHL
62
What is Osteoma?
Bony growths in the EAC (solitary) Unilateral Lateral EAC Radiographic appearance Not solid Pedunculated (on a stalk) No association with cold water exposure Typically no CHL
62
What is Osteoma?
Bony growths in the EAC (solitary) Location Unilateral Lateral EAC Radiographic appearance Not solid Pedunculated (on a stalk) No association with cold water exposure Typically no CHL

CMSD5260 Hearing Disorders (12 decks)

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