Ear Disease Flashcards
can otitis external affect hearing?
yes
discharge and increased ear wax can cause blockage causing a temporary conductive hearing loss
investigation of otitis externa?
can swab
management of otitis externa?
topical aural toilet
topical clotrimazole if fungal
what is ramsey hunt syndrome?
shingles of the facial nerve affecting the outer ear
how might ramsey hunt syndrome present?
hearing loss
vertigo
facial nerve palsy
how is ramsey hunt syndrome managed?
systemic anti-herpetic therapy
signs of otitis media?
fullness
bulginess
cloudiness
redness of tympanic membrane
symptoms of otitis media?
otalgia
fever
irritability
can get some conductive hearing loss
investigation of otitis media?
history
otoscopy
audiometry
management of acute otitis media?
80% resolve in 4 days without antibiotics
1st line = amoxicillin
2nd line = erythromycin
describe aetiology of otitis media with effusion (OME)
more common in males
more common in children
signs of OME?
fluid line present on tympanic membrane
retraction of tympanic membrane
altered motility
symptoms of OME?
conductive hearing loss
could have poor performance at school, behavioural issues and speech delay
how is OME investigated?
otoscope
audiometry
tympanometry
how is OME managed?
watch and wait - most resolve within 3 months
management of OME if not resolving after 3 months?
1st occurrence = grommet insertion
2nd occurrence = grommet and adenoidectomy
what is cholesteatoma and what causes it?
abnormal production of keratin in the middle ear
idiopathic or result of chronic otitis media and perforated tympanic membrane
symptoms of cholesteatoma?
hearing loss
discharge
visible keratin in middle ear
how is cholesteatoma diagnosed?
diffusion weighted MRI
how is cholesteatoma managed?
surgery
what is otosclerosis and what causes it?
abnormal thickening of the osicles
idiopathic
signs and symptoms of otosclerosis?
gradual onset conductive hearing loss
how is otosclerosis managed?
stepedectomy
how is vertigo examined?
otoscopy neurological blood pressure including lying/standing balance system audiometry
what is BPPV and what causes it?
benign paroxysmal positional vertigo
calcified otolith becomes dislodged from utricle into semi-circular canal
can be caused by head trauma, ear surgery or can be idiopathic
signs/symptoms of BPPV?
position triggered vertigo that lasts seconds (e.g looking up, turning in bed)
how is BPPV investigated?
dix-hallpike manoeuvre
how is BPPV managed?
epley manoeuvre
brandt daroff manoeuvre
what causes menieres?
idiopathic
signs/symptoms of menieres?
history of recurrent, spontaneous, rotational vertigo with at least 2 episodes lasting >20 mins (often hours)
prodromal vomiting
feeling of fullness in affected ear
sensorineural hearing loss - before or during
how is menieres investigated?
head CT to exclude other causes
how is menieres managed?
supportive treatment during episodes
grommets or vestibular suppressors if severe or continuous
what usually causes vestibular neuritis/labrynthitis?
usually viral
symptoms of vestibular neuritis/labrynthitis?
vertigo for hours/days nausea vomiting no associated tinnitus or hearing loss in vestibular neuritis hearing loss is seen in labrynthitis may have viral prodromal symptoms
how is vestibular neuritis/labrynthitis managed?
usually self limiting may need further investigation/rehabilitation if prolonged or atypical rule of 3s: - in bed 3 days - off work 3 weeks - off balance for 3 months
what is an acoustic neuroma/vestibular schwannoma?
rare benign tumour arising in vestibular portion of vestibulocochlear nerve within the temporal bone
describe the tumours in acoustic neuroma/vestibular schwannoma?
95% are sporadic and unilateral
if a in acoustic neuroma/vestibular schwannoma was bilateral and occurring in a young person, what might this suggest?
Neurofibromatosis 2
signs/symptoms of in acoustic neuroma/vestibular schwannoma?
absent corneal reflex
hearing loss
tinnitus
imbalance
how is in acoustic neuroma/vestibular schwannoma diagnosed?
MRI
noise induced hearing loss has a classical dip at what frequency?
5Hz
what is prebyscuis?
age related hearing loss
usually at high frequency
can treat with hearing aids
