Ear Conditions (General and OME) Flashcards
Describe what you do in Rhinne’s test?
Put the tuning fork beside of the patient’s ear, and then on the mastoid process and ask them which they hear louder
What finding would be abnormal in Rhinne’s test and what would it suggest?
Hearing the vibration louder on the mastoid suggests a conductive hearing loss
What size tuning fork should be used for Rhinne and Weber’s test?
512 decibels
Describe what you do in Weber’s test?
Place the tuning fork on the patient’s forehead and ask which ear they can hear the sound in loudest or if it is equal
What will be the result of Weber’s test if the individual has conductive hearing loss?
Sound will be localised to the affected side
What will be the result of Weber’s test if the individual has sensorineural hearing loss?
Sound will be localised to the non-affected side
Weber’s test can detect how severe a hearing loss?
5db
Rhinne’s test can detect how severe a hearing loss?
20db
What investigation is diagnostic of most external-middle ear conditions?
Otoendoscopy
What causes conductive hearing loss?
A defect in the passage through the ear e.g. middle ear/eardrum damage
Damage where causes sensory and neural hearing loss?
Inner ear damage, sensory = cochlea, neural = CNVIII
Why are sensory and neural hearing losses grouped together?
Because an audiogram cannot distinguish between the two
What tends to be the cause of sensory hearing loss and why?
Exposure to loud noise causing damage to the cochlea
What type of problem tends to cause neural hearing loss?
Tumours of the brain
What causes central hearing loos?
Problems at the brain e.g. stroke, cva
What nerves are associated with ear sensation?
V, VII, IX, X and C2, 3
Discomfort in the ear usually comes from where?
Referred pain from the larynx/pharynx
If a patient presents with earache and no obvious cause, where should you always look?
In the throat
What diseases most commonly cause discharge (otorrhoea)?
Acute or chronic otitis media
In order to have discharge from the ear, what must have occurred?
Ruptured tympanic membrane
How can CSF leak from the ears?
The lining of the ears is a type of dura since it lies under the middle cranial fossa
If a patient presents with dizziness, what should you always ask about?
Hearing loss
Dizziness alone usually comes from damage where?
Vestibular area
Dizziness with hearing loss usually comes from damage where?
Vestibular area and cochlea
Operating on the middle ear can risk what?
Facial nerve paralysis
What are some drugs which can cause hearing loss?
Aminoglycosides, furosemide, aspirin
What is a classic presentation of acute otitis media?
Child wakes up in the middle of the night crying
The prevalence of OME tends to tail off after what age?
8
OME is more common in which sex?
Males
What are some factors which increase incidence of OME?
Daycare, older siblings, smoking household, recent recurrent URTI
OME is more likely to occur if the child has what?
Recurrent URTI or AOM, prematurity, craniofacial/genetic abnormalities, immunodeficiency
Does OME cause ear pain?
No
What are some signs of OME?
TM retraction, visible fluid in the middle ear
What type of hearing loss does OME cause?
Conductive
How is OME treated initially?
Watch and wait- review at 3 months
If OME is persistent at 3 months, what is the management?
Refer- grommet insertion 1st line, adenoidectomy 2nd line or if nasal symptoms
Grommets will fall out within how long?
A few months
