Ear

Question 1

otitis externa

Question 2

mastoiditis

Question 3

pinna haematoma

Answer 3

shearing forces applied the auricle, most commonly seen amongst rugby players and boxers.

Following initial trauma, the perichondrial blood vessels tear, resulting in haematoma forming between the auricular cartilage and the overlying perichondrium. Consequently, the blood supply to the underlying cartilage can become impaired.

Question 4

pinna haematoma untreated

Answer 4

avascular necrosis of pinna
subsequent fibrocartilage overgrowth can lead to structural deformity
can lead to infection

Question 5

management pinna haematoma

Answer 5

drainage within 24 hrs - inside of the helical rim (the point where most fluctuant and least aesthetic compromise) is made
apply gauze padding after and tight headband

Question 6

ddx pinna haematoma

Answer 6

auricular pseudocyst

Question 7

pinna laceration

Answer 7

wound cleaning
cutaneous coverage

Question 8

temporal bone fracture first line investigation

Answer 8

CT head

Question 9

types of temporal bone fractures

Answer 9

longitudinal - more common type - lateral blow to head, conductive hearing loss
transverse - fronto-occipital head trauma, sensorineural hearing loss, facial nerve injury

Question 10

tympanic membrane perforation

Question 10

signs of temporal bone fractures

Answer 10

Post-auricular ecchymosis (termed Battle’s sign”), usually resulting from rupture of the posterior auricular artery secondary to the basal skull fracture
Haemotymanum, or other otoscopy signs, including an irregular step in the canal, canal laceration, or tympanic membrane perforation
CSF otorrhoea or rhinnorhoea
Hearing loss, either conductive or sensori-neural

Question 11

acute otitis media

Question 12

otitis media with effusion all - associations, mx, other sx

Answer 12

eustachian tube disfunction - adenoidal enlargement

otitis media with effusion - nasal obstruction, snoring, constant symptoms, asscoaited asthma
tx with adenoidectomy or gromeet