Ear Flashcards
What is tinnitus?
ringing in the ears
What is presbyscusis?
age related sensorineural loss of hearing
What questions do you ask a patient with hearing problems?
- How long?
- Gradual or sudden onset?
- Are some sounds harder to hear?
- One ear or both?
- Previous head injury, ear infections, allergies?
- Occupation and hobbies with loud noises?
- Vertigo, dizziness?
What is otitis externa?
- inflam. of external ear canal skin
- any skin diseases can cause this
- exacerbated by water, sweating, trauma
• FROM: Infective, Seborrhoeic, Allergic
- pruritus, pain (canal, nodes) worse by movement of pinna or tragus
- discharge maybe
- canal can block -> deafness
What is bad about using cotton buds?
damages the epithelium -> impairs the self cleaning mechanism of the external ear
-> can lead to otitis media
What is the aetiology of Otitis externa (infective)?
- bacterial-Gram negative rods
- fungal
- viral-herpes
- furunculosis-staph inf. of hair follicle
What is the aetiology of Otitis externa (seborrhoeic)?
comes with dermatitis of scalp)
What is the aetiology of Otitis externa (allergic)?
from treatments
Acute suppurative otitis media
- 2nd most common childhood disorder
- viral or bacterial
- microorganisms enter from nasopharynx
- neonates: E. coli, S. aureus
- older kids: Strep. pneumonia, H. influenza
- > 14yrs: strep. pneumoniae, Beta hemolytic strep, S aureus
- earache, fever, hearing loss, vomiting, diarrhoea
- erythematous, buldging tympanum
What are the complications of Acute suppurative otitis media?
• possible otorhoea if tympanic membrane is ruptured
- glue ear (very common)
- acute mastoiditis
- labyrinthitis
- meningitis or intracranial infection
- hearing loss
Barotitis media
- damage as result of sudden elevations in environmental pressure
- plane, deep-sea diving
- air can’t move from nasopharynx into auditory tube to equalize pressure on both sides of tympanic membrane
- FROM: allergies, inflammation, damage to middle ear
- severe ear pain
- conductive hearing loss
• tympanum may rupture
What are all the synonyms for glue ear?
- secretory otitis media
- otitis media with effusion
- serous otitis media
What is serous otitis media?
- effusion in middle ear
- FROM: unresolved acute otitis media or obstruction of the auditory tube (allergy, inflammation, enlarged adenoids) -> relative negative pressure in middle ear -> retraction of tympanic membrane and transudation of fluid from blood vessels in middle ear -> fluid up in middle ear -> impaired sound conduction
- variable conductive hearing loss
- often presents as learning difficulties and behavioural problems
What is mastoiditis?
- bacterial infection of mastoid process
- extension of middle ear infection, by same causative agent
- coalescence of mastoid air cells
- Hx of acute otitis media not well treated (2 weeks after)
- increasing aural pain (persistent and throbbing)
- fever, otorrhoea,
- redness, swelling, tenderness over mastoid process
What is otosclerosis?
- bony ossicles disorder
- conductive hearing loss
- hereditary
- foci of new, irregularly arranged bone develop within ossicles -> ankylosis -> impaired vibration of ossicles
- late teens or early adulthood
- slowly progressive
- sensorineural hearing loss if ankylosis adjacent to Scala media
What is Acoustic neuroma?
- tumour of Schwann cells of vestibulocochlear nerve
- unknown aetiology
Pathology: tumour encapsulated -> distorts and compresses nerves V and VII -> compress pons, medulla, obstruct flow of CSF
- gradual sensorineural hearing loss
- tinnitus
- dizziness and unsteadiness
What is Benign paroxysmal positional vertigo (BPPV)?
- severe vertigo >30 seconds
- granular masses in posterior semicircular canal
- result of trauma, infection, degeneration or vascular occlusion
- episodes precipitated by head movements
- lasts weeks-months, may recur
What is Labyrinthitis?
- usually bacterial infection
- often secondary to acute otitis media or purulent meningitis
- severe vertigo, nausea, vomiting
- nystagmus
- hearing loss
What is Menieres disease?
- paroxysmal episodes of vestibular function with increasing deafness
- from increased amount of endolymph
- progressive deafness and tinnitis
- episodes of sudden vertigo (with tinnitus, nausea, vomiting, sweating, weakness, fainting) lasting min-hrs
- frequency of attacks decreases, can last years
- nystagmus and ataxia
What is Noise induced hearing loss?
- sensorineural hearing loss as a result of intense noise
- isolated event or ongoing
- > 85dB damages (industrial, shooting, concerts)
- damages hair cells in Organ of Corti
Features:
• first loose 4kHz, then higher and lower
• high frequency tinnitus
What is Presbycusis?
- age related sensorineural hearing loss
- exposure or genetic
- men > women
- loose high frequency sounds first
- hard to hear when background noise
What is Vestibular neuritis?
• viral infection
• sudden severe vertigo, nausea, vomiting, nystagmus
• episode of 7-10 days
or recurrent
Using your understanding of the conduction of sound through the ear, describe possible causes of hearing loss involving the ear or the vestibulocochlear nerve.
- External auditory canal: blockage (wax, bug), tympanic membrane damage (pressure)
- Middle ear: ossicles (sclerosis, degeneration with age), fluid,
- Inner ear: hair cells in cochlear (loud sounds, old age), nerve (acoustic neuroma, neuritis), tumour
What is the relation between Acute suppurative otitis media and Serous otitis media?
Serous otitis media may be the consequence of repeated or poorly treated Acute suppurative otitis media
