Ear Disease

Question 1

what is otitis media w effusion

Answer 1

middle ear inflammation + accumulation of fluid w/o symptoms of inflammation

Question 2

pathophysiology of OME

Answer 2

Eustachian tube becomes blocked reducing pressure in middle ear and lack of ventilation causing build up of thick clear fluid

Question 3

why do kids get OME more

Answer 3

Eustachian tube is shorter

Question 4

OME RFs

Answer 4

smoking in hosuehold, day care, older siblings, AOM

Question 5

s/s of OME

Answer 5

middle ear effusion, impaired TM mobility, hearing loss, poor school behaviour

Question 6

signs of OME

Answer 6

TM retraction, reduced TM mobility, TM colour is dull, bubbles

Question 7

ix for OME

Answer 7

otoscopy, tuning fork test, tympanogram (flat line if fluid present)

Question 8

tx for OME

Answer 8

watchful waiting review after 3months

<3yo= grommets, >3yo & 2nd intervention= grommets & adenoidectomy

Question 9

what are grommets

Answer 9

little hole in TM

Question 10

what is a cholestatoma

Answer 10

benign accumulation of keratinising sq cells in ear- usually pars flaccida, may cause bone erosion
s/s: persistant recurrent discharge, unilateral HL
mx: surgery

Question 11

tympanogram result for perforation

Answer 11

flat line trace and high canal volume

Question 12

what is mastoiditis

Answer 12

pus build up/spread of infection behind ear in mastoid system

Question 13

s/s of mastoiditis and cause

Answer 13

swelling behind ear - cholesteatoma

Question 14

mx for mastoiditis

Answer 14

IV abx/ drain in theatre

Question 15

ix for hearing loss

Answer 15

pure tone audiometry, tuning fork test

Question 16

what is ostesclerosis

Answer 16

gradual fixation of the stapes, caused by high oestrogen levels. stapedectomy

Question 17

main causes of sensorineural hearing loss

Answer 17

presbycusis, noise induced hearing loss, vestibular schwanoma, meniere’s, meningitis

Question 18

what is a charectrisitc audiogram for NIHL

Answer 18

downward spike

Question 19

trauma may cause…

Answer 19

SN HL, conductive HL, mixed

Question 20

mx for hearing loss

Answer 20

hearing aids (BTE, ITE, ITC), vibrant sound bridge, cochlear inpalants

Question 21

T/F: when applying ear drops in adults you pull the pinna down

Answer 21

F: up and back in adults, just back in kids

Question 22

ear drops are used for..

Answer 22

inflammation, abx, wax solvents

Question 23

facial nerve palsy is what

Answer 23

palsy of CN VII-temporary or permanent paralysis

Question 24

what is Bell’s palsy

Answer 24

CN VII palsy of idiopathic origin

Question 25

s/s of Bell’s palsy

Answer 25

dry eye, drooling, bell’s phenomenon (always visible white sclera)

Question 26

what classification is used for Bell’s palsy

Answer 26

House-Brackmann classification (1-6)

Question 27

mx of Bell’s

Answer 27

oral steroids and antivirals

Question 28

earache is often referred- what is the commonest cause of this

Answer 28

CN V3 neuralgia- dental pathology, TMJ lesions, teeth grinding, salivary gland pathology

Question 29

earache can also be due to other nerves, list these and possible causes

Answer 29

CN VII: herpes
CN IX: tonsillitis, base of tongue pathology
CN X: FBs in piriform fossa