Disorders of the middle ear

Question 1

What is otitis media? What is it caused by?

Answer 1

Inflammation or infection of the middle ear

Undefined etiology but associated with Eustachian tube dysfunction

Question 2

Inflammation of the middle ear may be due to …

Answer 2

Allergies
Infection
Manual blockage (swollen adenoids or tonsils)

Question 3

What is otitis media with effusion?

Answer 3

Middle ear infection with fluid

Question 4

What is serous otitis media?

Answer 4

Early stages of the fluid

Thin, clear, watery fluid without infection

Question 5

What is secretory otitis media?

Answer 5

Thicker fluid that may contain infection

Question 6

What is suppurative or purulent otitis media?

Answer 6

Thick, infected and looks like glue

Question 7

What is acute otitis media?

Answer 7

Less than 3 weeks

Question 8

What is recurrent otitis media?

Answer 8

3 or more separate episodes in 6 months or 4 or more in a year

Question 9

What is chronic otitis media?

Answer 9

One episode that is persistent for more than 30 days

Question 10

Otitis media begins with ___ in stage I

Answer 10

Hyperemia: looks red due to presence of large blood supply that is trying to clear the infection

Question 11

Hyperemia is followed by ____ which involves

Presents with ….

Answer 11

Exudation, gradual increase of liquid in the middle ear space, start to see bubbles
TM thickened, red bulging, pain, fever, hearing loss

Question 12

Exudation is followed by ___ which involves ..

Presents with ….

Answer 12

Suppuration, rupture of the TM and drainage of the infected liquid through the perforation
Release from fever and pain

Question 13

Suppuration is followed by ….

This involves and presents with ….

Answer 13

Resolution of the infection

TM perforation usually heals spontaneously and hyperemia diminishes `

Question 14

When can antibiotics be used for treatment of otitis media?

Answer 14

Infectious stage of only bacterial infection

Prescribe antibiotics for a few weeks then reevaluate, may start second round if no improvement

Question 15

If antibiotics do not work, otitis media can also be treated with ..

Answer 15

PE tubes

Question 16

What is a cholesteatoma?

Answer 16

Pocket of tissue created after the TM becomes sucked in that becomes infected and continues to grow
Can be deadly and treated with mastoidectomy (removal of the mastoid)

Question 17

What is ossicular discontnuity?

Answer 17

Ossicular chain becomes separated leading to hypermobility

Causes CHL and type Ad tymps

Question 18

What is otosclerosis?

Answer 18

Disorder of the otic capsule and ossicular chain
Leads to fusion of the stapes footplate to the oval window
Starts in one ear then becomes bilateral

Question 19

What is the diagnostic sign of otosclerosis with otoscopy?

Answer 19

Schwartze sign: red hue in the region of the promontory

Question 20

Otosclerosis results in …. (tymps)

Answer 20

Type As tymp

Normal peak pressure but low peak acoustic admittance

Question 21

Otosclerosis results in ….. (acoustic reflexes)

Answer 21

Typically absent because CHL wipes them out

Question 22

Signs of otosclerosis on the audiogram …

Answer 22

Hearing loss will be CHL bilaterally
Rising low frequency hearing loss
Carhart’s notch - elevated bone conduction threshold at around 2000 Hz

Question 23

What is carhart’s notch?

Answer 23

Elevated bone conduction thresholds at around 2000 Hz indicating otosclerosis

Question 24

What causes otoscleriosis?

Answer 24

Unknown

Theories: genetics, viral involvement, immune disorder

Question 25

Otosclerosis can be treated with a ….

Answer 25

Stapedectomy