Ear Disease

Question 1

Name some symptoms of ear disease

Answer 1

• hearing loss
• tinitis
• vertigo
• otalgia
• ear discharge
• facial weakness

Question 2

State three types of hearing loss

Answer 2

Conductive, sensorineural, mixed

Question 3

What is conductive hearing loss?

Answer 3

Problem related to the ear external/middle ear (up to the stapedovestibular joint) impacts hearing

Question 4

What is sensorineural hearing loss?

Answer 4

Problem related to the cochlear

Question 5

Where do upper motor lesions spare?

Answer 5

The forehead

Question 6

Name some signs of ear disease

Answer 6

• external scars
• ear canal abnormalities
• ear drum changes
• mastoid swelling
• facial weakness
• hearing loss

Question 7

Define otitis externa

Answer 7

Inflammation of the skin of the ear canal

Question 8

What causes otitis externa?

Answer 8

Water, cotton bud or dermatological conditions, usually begins with a bacterial infection which may lead to a fungal infection

Question 9

How is otitis externa treated?

Answer 9

Ear drops - antibiotics or steroids

Aural toilet

Question 10

What is acute otitis media?

Answer 10

Acute inflammation of the lining of the middle ear

Question 11

What condition does acute otitis media often precede?

Answer 11

Upper respiratory infection

Question 12

Describe the natural progression of disease of acute otitis media

Answer 12

1. Middle ear infection
2. Perforation
3. Release of pus and pressure
4. Healing

Question 13

How is acute otitis media managed?

Answer 13

80% resolve without antibiotics but amoxicillin or clarithromycin can be given

Question 14

What is glue ear?

Answer 14

Otitis media with effusion

Question 15

Name the condition associated with glue ear

Answer 15

Eustachian tube dysfunction - adenoid hyperplasia

Question 16

What conditions should be considered in adults in otitis media with effusion?

Answer 16

Rhino-sinusitis
Nasopharyngeal carcinoma
Lymphoma

Question 17

Describe the tympanogram of glue ear

Answer 17

Flat - type B

Question 18

How is otitis media treated?

Answer 18

Watchful waiting
Autoinflation
Hearing aid
Grommets

Question 19

Does tympanic membrane perforation require treated?

Answer 19

No, usually resolves spontaneously

Question 20

Describe the pathology of cholesteatoma

Answer 20

Ear drum thins and retracts medially to form a retraction pocket. Adhesions form between the pocket and the middle ear contents. Keratin squamous epithelium builds up in the pocket and enzymes dissolve the bone. Bacteria can grow producing discharge.

Question 21

How is cholesteatoma managed?

Answer 21

Surgical excision and reconstruction (sometimes need to make a hole in the mastoid to form a cavity)

Question 22

What are the complications of cholesteatoma?

Answer 22

Sensorineural hearing loss, tinnitus, vertigo, facial palsy, brain abscess, meningitis, mastoiditis, venous sinus thrombosis

Question 23

What is otosclerosis?

Answer 23

Abnormal bone formation results in fixation of the stapes footplate

Question 24

What type of hearing loss does otosclerosis cause?

Answer 24

Conductive hearing loss

Question 25

Which hormone is otosclerosis associated with?

Answer 25

Oestrogen - progresses more quickly on HRT/in pregnancy

Question 26

How is otosclerosis treated?

Answer 26

Stapedectomy - replace stapes with a piston

Question 27

What is presbyacusis?

Answer 27

Normal deterioration of hearing - usually high frequency with highly variable onset

Question 28

In noise induced hearing loss when is there a classical dip on autography?

Answer 28

4kHz

Question 29

What usually occur before noise induced hearing loss?

Answer 29

Tinnitus

Question 30

Which antibiotics can cause hearing loss?

Answer 30

Gentamicin and aminoglycosides

Question 31

In what kind of overdose is hearing loss a risk?

Answer 31

Aspirin/NSAID