ear disease

Question 1

what signs of ear disease do you look for on examination?

Answer 1

External scars
Abnormalities of ear canal:
- Discharge
- Swelling
- Bleeding
- Masses
- Changes in ear drum
swelling over mastoid
facial weakness
hearing loss

Question 2

describe otitis externa

Answer 2

Inflammation of the skin of the ear canal
Almost always infective
May be bacterial or fungal
Common causes include water, cotton buds, skin conditions

Question 3

what conditions are risk factors for otitis externa?

Answer 3

psoriasis and eczema

Question 4

what conditions are associated with acute otitis media?

Answer 4

URTIs, glue ear

Question 5

what is the most common type of causative organism of otitis media?

Answer 5

bacteria

Question 6

what are the causes of otitis media with effusion in children?

Answer 6

eustachian tube dysfunction or obstruction
also commonly associated with adenoids

Question 7

what are causes of otitis media with effusion in adults?

Answer 7

Rhinosinusitis
Nasopharyngeal Carcinoma
Nasopharyngeal Lymphoma

Question 8

what type of hearing loss and tympanogram is seen in otitis media with effusion?

Answer 8

conductive hearing loss with flat tympanogram

Question 9

what are common causes of tympanic membrane perforation?

Answer 9

acute otitis media
trauma

Question 10

describe cholesteatoma

Answer 10

not a tumour!
Presence of keratin within middle ear
Erodes surrounding bone
Causes hearing loss, discharge, complications
Generally requires surgical excision and reconstruction
Most commonly acquired. Rarely congenital

Question 11

what are the complications of acute otitis media and cholesteatoma?

Answer 11

Medially - can spread to cochlea
–> Sensorineural Hearing Loss /Tinnitus / Vertigo / Facial Palsy
Superiorly
–> Brain Abscess / Meningitis
Posteriorly
–> Venous Sinus Thrombosis

Question 12

what is otosclerosis?

Answer 12

fixation of stapes on oval window which doesn’t vibrate with sound so sound cant pass through
–> causes conductive hearing loss

Question 13

who gets otosclerosis?

Answer 13

more common in women, familial
progresses faster during pregnancy

Question 14

what is the management of otosclerosis?

Answer 14

hearing aids, stapedectomy

Question 15

what drugs cause sensorineural hearing loss?

Answer 15

Gentamicin and other aminoglycosides
Chemotherapeutic drugs - Cisplatin, Vincristine
Aspirin and NSAIDs (in overdose)

Question 16

what is vestibular schwannoma?

Answer 16

Benign tumour arising in Internal Auditory Meatus - CN VIII nerve sheath
Presents with Hearing loss, tinnitus and imbalance
(previously known as acoustic neuroma)

Question 17

how is vestibular schwannoma diagnosed?

Answer 17

MRI

Question 18

what type of hearing loss does ear trauma cause?

Answer 18

can cause all 3