Ear disease Flashcards
What are symptoms of ear disease?
Hearing loss Tinnitus Vertigo Otalgia Discharge Facial weakness Previous ear surgery Nasal symptoms
What are the different types of hearing loss?
Conductive
Sensorineural
Mixed
Where should normal hearing be on on audiometry?
Between 0-20
What do the triangles represent on audiometry?
Bone conduction - inner ear
What do the circles represent on the audiometry?
Right ear - air conduction in middle ear
What do the crosses on the audiometry represent?
Left ear - air conduction in middle ear
What does a bone air gap represent?
Conductive hearing loss
What are signs of ear disease?
Discharge Swelling Bleeding Masses External scars Changes in ear drum Swelling over mastoid Facial weakness Hearing loss
What is otitis externa?
Inflammation of the skin of the ear canal
Almost always infective - bacterial or fungal
Commonly caused by water, cotton buds, skin conditions (eczema or psoriasis)
What is acute otitis media?
Associated with glue ear
More common in children
Associated with URTIs
Children will be systemically unwell and in pain
When does acute otitis media become glue ear?
After 3 months and a significant hearing loss of 25-30 decibels
What is included in chronic otitis media?
Otitis media with effusion
Cholesteatoma
Perforation
What can cause otitis media with effusion in children?
Eustachian tube dysfunction or obstruction
What can cause otitis media with effusion in adults?
Rhinosinusitis
Nasopharyngeal carcinoma
Nasopharyngeal lymphoma
What will otitis media with effusion present like?
Conductive hearing loss with a flat tympanogram Abnormal cone of light Membrane sucked inwards Pars flaccida sucked in Yellow appearance
What can cause a perforated ear drum?
Commonly due to AOM
May also occur after trauma to ear and skull#
What is important patient self care with a perforated ear drum?
Will usually heal spontaneously but need to keep dry to prevent infection
What is a cholesteatoma?
Presence of keratin within the middle ear
Erodes the surrounding bone
Causes hearing loss, discharge
How is cholesteatoma treated?
Surgical excision and reconstruction
What are complications of AOM and cholesteatoma?
Sigmoid sinus is in the mastoid which becomes the internal jugular vein Can result in an infective thrombus Brain abscess Mastoditis Facial nerve palsy Meningitis SNHL Tinnitus Vertigo
How will otosclerosis present?
Gradual onset of conductive hearing loss
More common in women and will progress rapidly during pregnancy
What is otosclerosis?
Fixation of stapes footplate
What is presbycusis?
High frequency loss in both ears with no bone air gap
Age related degeneration in hearing
What will noise induced hearing loss present like on an audiometry?
Classical dip at 4000 Hz
No bone air gap = sensorineural hearing loss
What drugs can cause a hearing loss?
Gentamicin
Chemotherapeutic drugs- cisplatin and vincristine
Aspirin and NSAIDs in overdose - this one is reversible
What can trauma to the ear present with?
Skull fracture
Hemotympanum
Eardrum perforation
What is a classical sign of a base of skull fracture?
Battle’s sign
Can be seen with a hemotympanum with a conductive hearing loss
What can a skull fracture lead to?
Hearing loss - conductive or sensorineural
Facial palsy
CSF leak
