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Ear Flashcards

1
Q

What is another name for otitis media with effusion?

A

Glue ear

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2
Q

What is Glue ear?

A

Fluid in the middle ear

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3
Q

What is glue ear due to?

A

Blockage of the eustachian tube

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4
Q

What is the commonest cause of conductive hearing loss in childhood?

A

otitis media with effusion (glue ear)

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5
Q

What age group does glue ear normally affect?

A

2 year olds

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6
Q

How does glue ear normally present?

A

Hearing loss
Speech delay
Behavioural problems

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7
Q

What are the 2 main risk factors of glue ear?

A

Downs syndrome

Cleft palate

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8
Q

What would you see on otoscopy of glue ear?

A

Dull tympanic membrane
Visible fluid level
Air bubbles

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9
Q

What is used to show the extent of the glue ear?

A

Auroscope

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10
Q

What is the main management of glue ear?

A

Nothing

Should resolve within 3 months

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11
Q

What would you do if the glue ear didn’t resolve?

A

Grommets

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12
Q

What is acute otitis media?

A

An infection of the middle ear

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13
Q

What does acute otitis media usually follow?

A

An URTI

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14
Q

What is the main cause of acute otitis media?

A

Streptococus pneumonia

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15
Q

What other 2 organisms can cause acute otitis media?

A

Moraxella catarrhalis

Haemophilus influenza

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16
Q

What are the main presentations of acute otitis media?

A

Otalgia and ear tugging
Hearing loss
Discharge
Coryzal symptoms- Fever

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17
Q

Why might you get discharge in acute otitis media?

A

Tympanic membrane perforates

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18
Q

What is the main investigation of acute otitis media?

A

Otoscopy

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19
Q

What might you see on an otoscopy of acute otitis media?

A

Bulging red tympanic membrane
Loss of light reflex
Opacification of tympanic membrane

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20
Q

What is the main management of acute otitis media?

A

Analgesia for the pain

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21
Q

What would you give if acute otitis media didn’t resolve in 3 days?

A

Amoxicillin

Erythromycin or clarithromycin

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22
Q

What are other possible reasons to give antibiotics for acute otitis media?

A

Bilateral acute otitis media and younger than 2
Immunocompromised
Perforation of the tympanic membrane
Symptoms lasting more than 4 days and not improving
Patient systemically unwell

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23
Q

What are the complications of acute otitis media?

A

Otitis media with effusion
Permanent hearing loss
Perforated ear drum
Mastoiditis

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24
Q

What is chronic otitis media?

A

Chronic inflammation of the tympanic membrane

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25
Q

What is the main presentation of chronic otitis media?

A

Hearing loss despite grommets

Recurrent perforation of the tympanic membrane

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26
Q

What is the main management of chronic otitis media?

A

Mastoiditis

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27
Q

What is otitis externa?

A

Inflammation of the skin of the external auditory meatus

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28
Q

What is the main cause of otitis externa?

A

Pseudomonas aeruginosa

(staph aureus is the other common cause)

29
Q

What is the main presentation of otitis externa?

A

Minimal discharge, itch and pain due to acute inflammation of the skin of the external auditory meatus.

30
Q

What can malignant otitis externa progress to?

A

Temporal bone osteomyelitis

31
Q

How is malignant otitis externa diagnosed?

32
Q

What is the immediate management of malignant otitis externa?

A

Admission to hospital and urgent referral to ENT

33
Q

What is the medical management of malignant otitis externa?

A

IV antibiotics for pseudomonas aeruginosa

34
Q

What additional symptoms can you get with malignant otitis externa?

A

Dysphasia
Hoarseness
Facial nerve dysfunction

35
Q

What is otosclerosis?

A

Commonest cause of conductive hearing loss in young people

36
Q

What type of condition is otosclerosis?

A

Autosomal dominant condition

37
Q

What age group does otosclerosis usually affect?

A

20-40 year olds

38
Q

What is the common presentation of otosclerosis?

A

Conductive hearing loss
Tinnitus
Normal tympanic membrane

39
Q

What is the initial management of otosclerosis?

A

Hearing aid

40
Q

What is the medical management of otosclerosis?

A

Stapedectomy

41
Q

What is tympanosclerosis?

A

Chronic inflammation and scarring of the tympanic membrane leading to subsequent calcification of the tympanic membrane and associated structures

42
Q

How does tympanosclerosis present?

A

Hearing loss

White patches on tympanic membrane

43
Q

What is the management of tympanosclerosis?

A

Hearing aid

44
Q

What is the surgical management of tympanosclerosis?

A

Excision of sclerotic patches

45
Q

What is a cholesteatoma?

A

Non-cancerous growth of squamous epithelium

46
Q

What does a cholesteatoma do?

A

It is trapped within the skull base causing local destruction

47
Q

What age group is commonly affected by a cholesteatoma?

A

10-20 year olds

48
Q

What is the main RF of a cholesteatoma?

A

Cleft palate

49
Q

How does a cholesteatoma present?

A

Foul-smelling, non-resolving discharge
Hearing loss
Vertigo
Facial nerve palsy

50
Q

How does a cholesteatoma cause vertigo?

A

Local invasion of CN 8

51
Q

How does a cholesteatoma cause facial nerve palsy?

A

Local invasion of CN 7

52
Q

How is a cholesteatoma diagnosed?

53
Q

What is seen otoscopy of a cholesteatoma?

A

‘attic crust’

54
Q

What is the management of a cholesteatoma?

A

Referral to ENT for surgical removal

55
Q

What is a common trigger for otitis externa?

56
Q

What are the main features of otitis externa?

A

ear pain, itch, discharge

57
Q

What would you find on otoscopy of someone with otitis externa?

A

red, swollen, or eczematous canal

58
Q

What is the medical management of otitis externa?

A

Topical antibiotic or a combined topical antibiotic with a steroid

59
Q

What medication would you not use in someone with otitis externa and a perforated ear drum?

A

Aminoglycosides

60
Q

What are the other possible causes of otitis externa?

A

seborrhoeic dermatitis
contact dermatitis (allergic and irritan)

61
Q

What can be used in the management of otitis externa?

A

Neomycin and dexamethasone

62
Q

What is otosclerosis due to?

A

Normal bone is replaced with vascular spongy bone

63
Q

What is malignant otitis externa?

A

Uncommon, potentially life threatening type of otitis externa that is found in immunocompromised individuals

64
Q

Who does malignant otitis externa usually affect?

A

Diabetes
Immunosuppressant medications (e.g., chemotherapy)
HIV

65
Q

How can malignant otitis externa present?

A
  • severe, unrelenting, deep-seated otalgia
  • temporal headaches
  • purulent otorrhea
  • possibly dysphagia, hoarseness and/or facial nerve dysfunction
66
Q

Wat would be the management of non-resolving otitis externa with worsening pain?

A

Refer urgently to ENT
IV antibiotics that cover pseudomonal infections

67
Q

What is tympanosclerosis?

A

Calcification of tympanic memebrane

68
Q

What is tympanosclerosis due to?

A

Chronic inflammation and scarring of the tympanic membrane

69
Q

What is tympanosclerosis due to?

A

Chronic inflammation and scarring of the tympanic membrane

ENT (29 decks)

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