Ear Disease Flashcards
What are the symptoms of ear disease?
Hearing loss, tinnitus, vertigo, otalgia, discharge, facial weakness, nasal symptoms
What are the signs of ear disease?
Discharge, swelling, bleeding, masses, external scars, changes in ear drum, swelling of mastoid, facial weakness, hearing loss
What are the types of hearing loss?
Conductive, sensorineural, mixed
What is otitis externa?
Inflammation of skin of ear canal
What causes otitis externa?
Almost always infective = may be bacterial or fungal
Commonly water, cotton buds or skin conditions
Who gets acute otitis media?
More common in children, associated with glue ear and URTIs
What is chronic otitis media associated with?
Otitis media with effusion (glue ear), perforation, cholesteatomas
What age group commonly suffers from glue ear?
More common in children
What is glue ear associated with?
Eustachian tube dysfunction or obstruction
What should be considered as the causes of glue ear in adults?
Rhinosinusitis, nasopharyngeal carcinoma, nasopharyngeal lymphoma
What do audiograms for glue ear look like?
CHL with flat tympanogram
What causes perforation?
Commonly due to acute otitis media, may occur after trauma
How is perforation treated?
Doesn’t normally need treatment as it heals spontaneously
What is a cholesteatoma?
Presence of keratin within middle ear = erodes surrounding bone
What may a cholesteatoma cause?
Hearing loss, discharge and complications
How do cholesteatomas arise?
Most commonly acquired, rarely congenital
How are cholesteatomas treated?
Generally need surgical excision and reconstruction
What are some complications of acute otitis media and cholesteatomas?
Medially = sensorineural hearing loss, tinnitus, vertigo, facial palsy Superiorly = brain abscess, meningitis Posteriorly = venous sinus thrombosis
What does otosclerosis present with?
Gradual onset conductive hearing loss
Who tends to suffer from otosclerosis?
More common in women = progresses more rapidly during pregnancy, tends to be familial
Why is a stapedectomy required to treat otosclerosis?
There is fixation of the stapes footplate
What are some causes of sensorineural hearing loss?
Presbyscusis, noise-induced, drug-induced, vestibular schwannoma, Meniere’s disease, trauma (i.e skull fracture)
What is the most common cause of sensorineural hearing loss?
Presbyscusis = caused by aging, occurs gradually, highly variable onset, affects high frequency sounds first
What is the classical sign of noise-induced hearing loss on an audiogram?
Classical dip at 4kHz
What occurs in noise-induced hearing loss?
Loss of perception of narrow range of frequencies = preventable with projection (employers legal obligation)
Why may drugs cause hearing loss?
Could be directly toxic to inner ear or auditory nerve
What are some drugs that may cause sensorineural hearing loss?
Gentamicin and other aminoglycosides, chemotherapy drugs (cisplatin, vincristine), aspirin and NSAIDS in overdose
What is a vestibular schwannoma?
Benign tumour of inner auditory meatus = diagnosed on MRI
How do vestibular schwannomas present?
Hearing loss, tinnitus, imbalance
What is Meniere’s disease?
Disorder of inner ear = causes hearing loss and dizziness, usually occurs between 20-40s
Where may trauma that has caused hearing loss be to?
Directly to the ear itself or to the head = can cause any of the three kinds of hearing loss
What are some complications of a skull fracture?
Conductive/sensorineural hearing loss, facial palsy, cerebrospinal fluid leak
