Ear disease

Question 1

history taking points in Ear disease:

Answer 1

Hearing Loss
Tinnitus
Vertigo
Otalgia
Ear Discharge
Facial Weakness
Previous Ear Surgery
Nasal symptoms
Family History
Specific paediatric history

Question 2

what are the three types of hearing loss?

Answer 2

conductive
sensorineural
mixed

Question 3

ear pain can be?

Answer 3

may be referred or local causes

Question 4

facial weakness can be?

Answer 4

upper motor neurone or lower motor neurons lesions

Question 5

what are the signs of ear disease?

Answer 5

Abnormalities of ear canal
Discharge
Swelling
Bleeding
Masses
External scars
Changes in ear drum
Swelling over mastoid
Facial Weakness
Hearing Loss

Question 6

what is otitis externa?

Answer 6

inflammation of the skin of the ear canal.

Almost always infective

may be bacterial or fungal

Question 7

what are common causes of otitis externa?

Answer 7

water cotton buds, skin conditions

Question 8

acute otitis media:

Answer 8

more common in children
associated with glue ear
commonly associated with URTIs

Question 9

chronic otitis media:

Answer 9

includes: otitis media with effusion (glue ear)
cholesteatoma
perforation

Question 10

otitis media with effusion:

Answer 10

more common in children

associated with Eustachian tube dysfunction or obstruction

Question 11

in adults with otitis media with effusion consider causes such as:

Answer 11

rhino sinusitis
nasopharyngeal carcinoma
nasopharyngeal lymphoma

Question 12

what is seen in the tympanogram of those with otitis media with effusion?

Answer 12

CHL with flat tympanogram

in children hearing loss may present differently to adults

Question 13

perforation:

Answer 13

commonly due to AOM
may also occur after trauma
usually heals spontaneously

Question 14

cholesteatoma:

Answer 14

presence of keratin within middle ear

erodes surrounding bone

Question 15

what does cholesteatoma cause?

Answer 15

hearing loss, discharge, complications

Question 16

what is the treatment of cholesteatoma?

Answer 16

generally requires surgical excision and reconstruction

Question 17

who gets cholesteatoma?

Answer 17

most commonly acquired

rarely congenital

Question 18

what are the medial complications of AOM and cholesteatoma?

Answer 18

SNHL /Tinnitus / Vertigo / Facial Palsy

Question 19

what are the superior complications of AOM and cholsteatoma?

Answer 19

brain abscess/meningitis

Question 20

what are the posterior complications of AOM and cholesteatoma?

Answer 20

venous sinus thrombosis

Question 21

what is otosclerosis?

Answer 21

gradual onset conductive hearing loss due to fixation of stapes footplate

Question 22

who gets otosclerosis?

Answer 22

it is more common in women
progresses more rapidly during pregnancy
familial

Question 23

what is the treatment of otosclerosis?

Answer 23

correction by stapedectomy

Question 24

conditions that cause sensorineural hearing loss?

Answer 24

presbycussis 
noise induced hearing loss 
drug induced hearing loss 
vestibular schwannoma
Menderes

Question 25

presbycussis:

Answer 25

usually high frequency

highly variable onset

Question 26

noise induced hearing loss:

Answer 26

Classical dip at 4 kHz
Preventable with protection
Employers have legal responsibility regarding protection at work

Question 27

drug induced hearing loss:

Answer 27

Certain drugs well known to cause SNHL
Gentamicin and other aminoglycosides
Chemotherapeutic drugs - Cisplatin, Vincristine
Aspirin and NSAIDs (in overdose)

Question 28

vestibular schwannoma:

Answer 28

Benign tumour arising in IAM
Presents with Hearing loss, tinnitus and imbalance
Diagnosis on MRI scan

Question 29

causes of trauma in the ear?

Answer 29

direct trauma to ear
head injury
may cause conductive, sensorineural or mixed hearing loss

Question 30

skull fractures:

Answer 30

Hearing Loss
-Conductive
-Sensorineural
Facial Palsy
CSF Leak