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AB 2nd Year ENT > Ear and Sinuses > Flashcards

Ear and Sinuses Flashcards

1
Q

what is otitis externa?

A

inflammation of the outer ear canal

diffuse or localised (hair follicle)

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2
Q

who gets otitis externa?

A

7-12yrs

SWIMMERS

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3
Q

cause of otitis externa?

A

fungal (most common) - aspergillus niger, candida albicans
bacterial - staph aureus, pseudomonas aerguinosa, proetus
trauma
eczema

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4
Q

treatment for otitis externa?

A

topical aural toilet
fungal - topical clotrimazole
bacterial - swab and antimicrobials e.g gentamicin drops
keep ears water free during treatment

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5
Q

clinical features of otitis externa?

A 
red swollen skin of ear canal
sore
itch
discharge
canal can become blocked - hearing affected
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6
Q

what is malignant otitis externa?

A

extension of otitis externa into the bones surrounding the ear canal (temporal and mastoid)

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7
Q

end result of malignant otitis externa?

A

osteomyelitis will involve skull and meninges

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8
Q

features of malignant otitis externa?

A

pain
headache
facial nerve palsy
exposed bone in ear canal

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9
Q

usual cause of malignant otitis externa?

A

pseudomonas aerguinosa

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10
Q

investigations for malignant otitis externa?

A

PV/CRP
imaging
biopsy
culture

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11
Q

risk factors for malignant otitis externa?

A

diabetes

radiotherapy to H&N

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12
Q

treatment of malignant otitis externa?

A

surgical debridement and systemic antibiotics

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13
Q

what is otitis media?

A

inflammation of the middle ear

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14
Q

cause of otitis media?

A

viral usually
strep pneumonia, h influenzae, moxarella catarhallis
if chronic - pseudomonas aeruginosa

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15
Q

symptoms of otitis media?

A

occuring after a URT infection
earache
fever
irritability

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16
Q

investigations for otitis media?

A

swab of pus if eardrum perforates

otoscopy - bulging TM, opaque

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17
Q

treatment for otitis media?

A

usually resolves

if antibios - amoxicillin or erythromycin

18
Q

what is chronic otitis media?

A

tympanic membrane perforation in the setting of recurrent of chronic ear infections

19
Q

define benign chronic otitis media?

A

perforation with no active infection

20
Q

define serous chronic otitis media?

A

straw coloured fluid drainage

21
Q

define suppurative chronic otitis media?

A

persistent purulent discharge through perforation

22
Q

define OME?

A

inflammation of the middle ear, accompanied by accumulation of fluid
(without symptoms and signs of acute inflam)

23
Q

another name for OME?

A

glue ear

24
Q

who gets OME?

A

children

recurrent URTI/AOM

25
Q

symptoms of OME?

A 
deafness
behavioural problems
speech delay
balance problems
NOT OTALGIA
26
Q

investigations for OME?

A

otoscopy - dull, grey, yellow, TM retraction, visible fluid/bubbles, prominent blood vessels
tuning fork tests - shows conductive hearing loss
may need to do hearing tests

27
Q

treatment for OME?

A

watch and wait
persistent for >3/12 REFER
grommets

28
Q

what is a cholesteatoma?

A

chronic otitis media with an acquired perforated tympanic membrane, due to an abnormal growth of keratinising squamous epithelium

29
Q

where can a cholesteatoma occur?

A

superior/posterior/middle ear

petrous apex

30
Q

what is normal ear lining?

A

cuboidal/columnar glandular epithelium

31
Q

what lining is present in a cholesteatoma?

A

abnormally situated squamous epithelium

32
Q

pathology behind cholesteatoma?

A

high cell turnover
keratin production
inflammation

33
Q

clinical features of cholesteatoma?

A 
foul discharge
headache
pain
paralysis
vertigo
34
Q

investigation for cholesteatoma?

A

CT

diffusion weighted MRI

35
Q

risks with a cholesteatoma?

A 
OM
eustachian tube dysfunction 
#
36
Q

treatment of a cholesteatoma?

A

surgery - canal wall up/down mastoidectomy

37
Q

causes of acute sinusitis?

A

viral usually

strep pneumonia, h influenzae, moxarella catarhallis

38
Q

clinical features of acute sinusitis?

A

mild discomfort over frontal/maxillary sinuses due to congestion
often alongside URTI

39
Q

features of bacterial sinusitis?

A

severe pain
tenderness
purulent nasal discharge

40
Q

treatment of acute sinusitis?

A

usually self limiting, in around 10 days

if still bad after 10 days, consider antibios

41
Q

treatment for bacterial sinusitis?

A

1 - penicillin

2 - doxycycline (not in children)

AB 2nd Year ENT (9 decks)

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