Ear Flashcards
The _______ is a cartilaginous structure cover by skin that functions to gather sound waves.
Auricle or pinna
The external auditory canal secretes a waxy substance called
Cerumen.
The __________ seperates the external ear and the middle ear.
Tympanic membrane.
The ossicles include
Malleus, stapes, and incus
The tympanic membrane transmits sound waves to what?
mallus (hammer), incus (anvil) and stapes (stirrups) to the inner ear via the oval window. Into the perilymph of the cochela through the vestibular membrane to the basilar membrane of the organ of corti.
The ________ connects the middle ear to the nasopharynx to equalize pressure.
Eustachian tube
Middle ear infection is also called
Otitis media
The organ of hearing is the
Organ of corti
The bony labyrinth is formed by the _____ and is filled with perilymph flud.
Temporal bone
The spiral shaped part of the ear is
The cochlea
Each of the semicircular canals contains an enlarged space called the
Ampulla
The _______ is located in the ampulla and is responsible for equilibrium of the body in motion
Crista ampullaris.
Nerve transmission occurs form the ______ membrane to the _____ nerve.
Basilar membrane to the cochlear nerve.
Microscopic examination of the ear is performed with a ______mm lens and an ear speculum.
250
A ________ is used to test bone conduction and sensorineural hearing function of the cochlea. This called the Rinne and Weber test.
Tuning fork.
A ________ tests for nystagmus.
Electronystagmography
The ___________ test is used to test for benign paroxysmal positional vertigo.
head positioning test
The _________ test stance, git, and balance for signs of vertigo.
Balance test
The _________ tests for bertigo and nystagmus. Warm or cool water is instilled into the external ear to determine wheter those conditions are elicited.
caloric testing.
The ________ can be conducted by a audiologist or neurologist. It measures the response of the brainstem to electrical stimulus as it reaches the ear.
Auditor brainstem response.
An otology endoscope is available in _____mm or _____mm.
2.7 or 4
This type of dressing is applied after complex ear procedures. It consits of several fluffed gauze sponges to cover the ear and incision as well as rolled gauze (Kling or Kerlix), which is wrapped around the head.
Mastoid
This type of dressing is used after simple ear procedures and come prepackaged. It is composed of gauze sponges with Velcro strips to secure the dressing in place.
Glasscock.
What is used in most ear surgeries to control bleeding by vasoconstricition?
Lidocaine with epinephrine.
The two primary hemostatic agents used in ear procedures are
Gelfoam and Helistat.
Gelfoam is soaked in what for ear procedures?
epinephrine
A surgical opening made in the TM to release fluid from the middle ear is called
Myringotomy
Fluid in the middle ear is called
Effusion
A _________ is performed to close a small nonhealing hole in the TM.
Myringoplasty
Otology power drills used with small cutting or diamond burrs vary in size from ____ to _____mm.
0.5 to 7mm
A _____ to _____ml syringe fitted with a _____-gauge _______ catheter is used for irrigation during otology surgery.
3 to 5mL syringe on 18 guage angiography catheter.
Operating microscopes are used during all procedures of the ________ and ________ ear.
Inner and middle ear
When performing a myringoplasty, a _________ or ________ can be used to repair the hole.
Paper patch or fat graft.
A myringoplasty is performed in what area of the ear?
The external portion of the ear. The middle ear is not entered.
Causes of perforation of the Tm may include what 3 things.
- Persistent opening after removal of a tympanostomy tube
- A blast injury
- Penetrating foreign body in the ear
When a fat graft is utilized, it should be kept moist in what solution?
Saline - a small amount
A tympanoplasty is surgical removal of
Cholesteatoma and mastoid bone.
A benign tumor of the middle ear caused by the shedding of keratin is called
Cholesteatoma
Two methods are commonly used to perform a tympanoplasty. method one is when the Tm is lifted away and the middle ear is filled with Gelfoam to support a graft on the undersurface of the Tm perforation. This is used for a small visible perforation with minimal signs of infection. This is called ________.
Method 2 is used for large perforation, for a severely damaged Tm, or for extensive infection. The TM remnants and bony canal skin are removed. The bony canal is enlarged with a drill, and the TM is recreated with a fascia and skin graft. This is called _______.
Method 1 is the underlay technique. Method 2 is the overlay technique.
What may cause infection, otorrhea, bone destruction, hearing loss, and paralysis of the facial nerve.
Cholesteatoma.
What type of incision is used for a tympanoplasty?
Postauricluar
A mastoidectomy is also called
Tympanomastoidectomy
A simple mastoidectomy is removal of
Diseased bone, the mastoid air cells, and the soft tissue lining the air cells of the mastoid.
Inadequate flow of air through the sinuses can lead to _______ and ____________.
Infection and erosion of the surrounding bone.
___________, __________, ___________, or___________ of the middle ear may block airflow to the mastoid and cause chronic mastoiditis.
Cholesteatoma, eustachian tube dysfunction, neoplasm, or congenital malformation.
The incision for a mastoidectomy is
Postauricle.
A _______ needle is often used as a pick during ear surgery.
Rosen.
A ______ is an instrument used as a pick during ear surgery.
Gimmick
Two examples of double edged razor blades are
Gillette or Watson
A _________ is the reconstruction of the ossicles to restore conduction to the oval window.
Stapedectomy
A stapedectomy is also called
Ossicular reconstruction.
A stapedectomy is performed to treat
Profound hearing loss related to sclerosis of the stapes.
What is the most common cause of ossicle immboility of the stapes?
Otosclerosis
Otosclerosis generally begins at what age?
30 and progresses with age.
The most common cause of a break in the ossicle chain is
Cholesteatoma.
The size ratio between the _______ and the _______ provides most of the amplification.
Tm and oval window.
What type of laser is used to remove the stapes superstructure?
CO2 laser
What type of incision is made during a stapedectomy?
Endaural.
What size Frazier suctions tips are commonly used during otology surgery?
5 and 7Fr.
A cochlear implant is used to transmit …
External sound directly to the eighth cranial nerve.
A cochlear implant is used to treat _____.
Sensorineural hearing loss.
Hearing impairment arising from the cochlea, auditory nerve, or central nervous system with functional outer and middle ear structures is called
Sensorineural Hearing loss
The cochlear implant has two primary components. What are they?
An electronic processor: implanted outside the ear over the temporal bone, captures sound and sends it in digital form to an internal transmitter.
Transmitter: conveys signals to electrodes , which are implanted into the cochlea. Takes over function of the cochlear cilia.
Sensorineural deafness can be congenital or acquired. There are seven different causes including:
- Viral or bacterial infection causing damage to the cilia
- Acoustic trauma (loud noise) permanent injury to cilia.
- Tumor of the ocular nerve
- Drugs such as certain antibiotics
- Autoimmune disease
- stroke
- brain tumor.
Congenital deafness in the child can be treated with a cochlear implant, but surgery is delayed until what age?
2 years old.
What incision is made for a cochlear implant?
Postauricular and mastoid
What is used to protect the facial nerve during ear suregery?
Facial nerve monitoring.
Implants are packaged individually and must be opened in a manner that limits or prevents the discharge of static electricity created during opening. Why?
Static charge can interfere with the function of the implant electrode.
How should the scrub open the inner package of a cochlear implant?
The inner pack is submerged in a basin of normal saline and opened below the surface .
When is the cochlear implant activiated?
Several weeks after surgery, it is activated slowly to allow the patient to adjust to the hearing world.
Sensorineural hearing loss is also called
Perceptive hearing loss
A benign tumor of the vestibular portion of Cranial Nerve VIII is called
Acoustic neuroma.
What is used for measurement of hearing loss?
Diagnostic audiogram.
What type of anesthesia is used especially during microsurgery to create a bloodless field?
Hypotensive anesthesia using vasodilator drugs.
For skin prep, hair is removed how far around the incision site/
1 1/2 inches around the incision.
Ototome with small burrs are frequently used which requires continuous irrigation to do what?
Remove bone dust, prevent clogging of burrs, and keep tissue cool.
Autogenous tissue grafts are commonly taken from?
Temporalis fascia.
When a temporalis fascia graft is taken, what is used to flatten and stiffen the graft?
Fascia press
After ear surgery, the ear canal is kept dry for how long?
10 days to 2 weeks.
After ear surgery, the patient should avoid what activities?
Blowing the nose and coughing, mouth should be kept open if they sneeze.
Otic drops given after myringotomy contain:
Antibiotics and steroids
A modified radial mastoidectomy is
Incision into the mastoid process and drilled with small burrs plus removal of the posterior wall of the ear canal to facilitate drainage.
A Radical mastoidectomy is removal of
Mastoid cells, malleus, incus, and tympanic membrane. This opens the mastoid antrum and middle ear to create one cavity.
Use of an autogenous graft to patch the ear drum, with the graft supported by gelfilm during healing (myringoplasty) is Type ___- Tympanoplasty.
1
Use of an autogenous graft to repair the perforated eardrum for erosion and replacement of the malleus is type ___ typmanoplasty.
II
Replacemtn of the typmanic membrane, malleus, and incus with a homograft or implant Partial ossicular replacement prosthesis is Type __ tympanoplasty.
III
Homograft transplantation of the tympanic membrane and ossicles (the footplate of the stapes may be intact); may also implant PORP or TORP (total ossicular replacement prosthesis) is Type ____ tympanoplasty.
IV
Use of a homograft to seal off the middle ear and provide sound protection for the round window when otosclerosis has resulted in fixation of the stapedial footplate is Type ____ tympanoplasty.
V
What should not be given as an anesthetic after a graft or prosthesis has been placed? Why?
Nitrous oxide. It causes bubbles to form in the middle ear, displacing the graft or prosthetic device.
Stapes mobilization involves what?
Freeing the footplate of the stapes from an adhered postion.
Stapes mobilization is performed to treat?
Otosclerosis.
Labyrinthectomy is removal of
The vestibular labyrinth.
A labyrinthectomy is performed to correct
Incapacitating vertigo
Through a mastoidectomy approach, the endolymphatic sac behind the semicircular canal is opened, the inner ear is drained into the mastoid or subarachoid space, and a tube is inserted. This procedure is called
Endolymphatic sac shunt.
An Endolymphatic sac shunt is used to treat
Meniere’s disease.
Meniere’s disease
Vertigo, ringing in the ears (tinnitus) and sensorineural hearing loss.
Microtia
SMall ears
Macrotia
Large ears
Otoplasty
Cosmetic procedure of the external ear to correct microtia and macrotia.
