Ear Disease Flashcards
What are the 3 main types of hearing loss?
Conductive
Sensorineural
Mixed
What is otalgia?
Pain in the ear
not always from ear structures, can be referred pain
Why may facial weakness be a sign of ear disease?
CN VII runs through middle ear/ tympanic membrane
chorda tympani
CN VII supplies muscles of facial expression
What are the main signs of ear disease?
- abnormalities of ear canal/ drum
- discharge/bleeding
- swelling/masses
- mastoid swelling
- facial weakness
- hearing loss
What is otitis externa
- Inflammation of ear canal skin
- Almost always infective (bacterial or fungal)
What are the most common causes of otitis externa?
water
cotton buds
skin conditions
Otitis media is more common in adults than children. TRUE/FALSE?
FALSE
More common in children
What other common children’s conditions are associated with otitis media?
Associated with glue ear
and after URTIs
Describe what is meant by “glue ear”?
Otitis media with effusion
Chronic otitis media is associated with what other conditions?
Otitis media with effusion (Glue Ear)
Cholesteatoma
Perforation
If the ear drum perforates in otitis media, it can heal without any serious problems. TRUE/FALSE?
TRUE
pressure down, pus out, pain released
What is the most likely cause of glue ear in children?
Dysfunctional eustachian tube OR obstruction
Describe how the “glue” forms in glue ear?
- Eustachian tube should open when we yawn etc
- Children usually have large adenoids which cause dysfunction
- air is absorbed in middle ear causing low pressure
- Effusion thickens and becomes glue substance
What is used to remove glue ear?
Grommets
perforation made in ear drum and grommet left in for around a year
What can cause glue ear in adults if their eustachian tube was previously functioning?
Rhinosinusitis
Nasopharyngeal Carcinoma
Nasopharyngeal Lymphoma
swelling/mass blocking eustachian tube
What type of hearing loss is found in glue ear?
Conductive hearing loss with flat tympanogram
How can hearing loss present in children?
Recurrent otitis media
Speech and Language delay
Poor Behaviour
What usually causes perforation?
Acute otitis media
Post trauma
What is a cholesteatoma?
Keratin build up in a pocket of ear drum
Can erode into bones of ear canal
What symptoms are present in cholesteatoma?
Hearing loss
Discharge
What parts of the tympanic membrane are susceptible to cholesteatoma?
Pars flaccida
Pars tensa
What are the complications of cholesteatoma if it invades medially?
- Sensorineural hearing loss, Tinnitus, Vertigo, Facial palsy
What are the complications of cholesteatoma if it invades superiorly?
- brain abscess, meningitis
What are the complications of cholesteatoma if it invades posteriorly?
- venous sinus thrombosis
What can a mastoiditis swelling behind the ear cause?
One ear pushed further forward than other
What does a signet ring on CT head show?
Lateral semicircular canal
What type of hearing loss is seen in otosclerosis?
Gradual onset conductive hearing loss
Otosclerosis is more common in women. TRUE/FALSE?
TRUE
Also progresses more rapidly during pregnancy
Does otosclerosis have a familial genetic component?
Yes, but it can skip generations
What is otosclerosis and how can it be treated?
Fixation of stapes footplate
Corrected via stapedectomy
What is presbycusis more commonly known as?
Age-related hearing loss
What frequencies are lost as we age?
Higher frequencies lost
Noise induced hearing loss causes a classical dip in hearing at what frequency?
4kHz
Do employers have legal responsibility to provide hearing protection at work if noise induced hearing loss could occur in the occupation?
Yes
Should either provide protection or regular auditory check ups
What drugs are known to cause sensorineural hearing loss?
- Gentamicin and other aminoglycosides
- Chemo - Cisplatin, Vincristine
- Aspirin and NSAIDs (in overdose)
Where does a vestibular schwannoma arise and how is it visualised on imaging?
- Benign tumour in Internal Acoustic Meatus
- Diagnosis on MRI scan
How do vestibular schwannomas present?
Hearing loss, tinnitus and imbalance
What is haemotympanum?
Blood behind the ear drum (usually due to a base of skull fracture)
What is Battle’s sign?
- Bruising over mastoid caused by base of skull fracture
