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ENT > Ear Disease > Flashcards

Ear Disease Flashcards

1
Q

list common symptoms of ear disease

A 
hearing loss 
earache - otalgia 
discarge 
tinnitus
vertigo 
facial weakness/nerve palsy
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2
Q

what are the signs of ear disease

A 
external scars 
discarge
swelling 
bleeding masses 
swelling over mastoid 
facial weakness 
hearing loss
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3
Q

describe conductive hearing loss

A

impaired sound transmission via external canal and middle ear ossicles to the foot of stapes

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4
Q

describe sensorineural hearing loss

A

defect is central to the oval window of the cochlea

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5
Q

list some causes of conductive hearing loss

A 
otitis externa 
acute otitis media 
perforation of tympanic membrane 
OME 
cholesteatoma 
otosclerosis
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6
Q

list some causes of sensorineural hearing loss

A

presbycusis
noise/drug induced hearing loss
vestibular schwannoma

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7
Q

describe what otitis externa is and its presentation

A

inflammation of the outer ear

presents with discharge, itch, pain, reduction in hearing later on

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8
Q

what microorganisms cause otitis externa

A

bacterial - most commonly pseudomonas or staph aureus
fungal - aspergillus or candida
trauma
swimming pools

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9
Q

otitis externa is more common in adults/children

A

adults, otitis media is more common in children

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10
Q

describe the likely mechanism of how someone could develop acute otitis media

A

previous URTI which has spread to the middle ear via the Eustachian tube

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11
Q

what are the most common pathogens associated with acute otitis media

A

RSV
strep. pneumonia
haemophilus influenza
moraxella

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12
Q

what is the clinical presentation of otitis media

A

otalgia, hearing loss and tympanic membrane perforation - usually resolves spontaneously

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13
Q

at what point is otitis media defined as chronic

A

> 3 months

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14
Q

chronic otitis media is associated with what condition and why?

A

glue ear - usually eustachian tube dysfunction or problems with adenoids

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15
Q

chronic otitis media in adults is associated with what conditions

A

rhinosinusitis
nasopharyngeal carcinoma
nasopharyngeal lymphoma

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16
Q

what is the treatment for chronic otitis media

A

surgery using laryngotomy - slit in ear drum to allow fluid to escape and insert grommet

17
Q

describe cholesteatoma

A

presence of keratinising squamous epithelium in the middle ear - erodes bone and can spread around body leading to abscesses

18
Q

how does cholesteatoma present

A

foul smelling discharge
tympanic membrane full of white gunk
possible invasion of ossicles and facial nerve
headache

19
Q

what are the complications of untreated cholesteatoma

A

meningitis
abscess
mastoiditis
most commonly presents aged 5-15

20
Q

what is otosclerosis

A

fixation of the stapes footplate causing slowly progressing conductive hearing loss

21
Q

what are the causes of otosclerosis

A

genetics

linked to oestrogens - progresses more quickly in pregnancy and more common in women

22
Q

how is otosclerosis treated

A

stapedectomy

23
Q

what is presbycusis

A

gradual loss of hearing related to age - usually high frequency but rate of hearing loss variable

24
Q

what are the clinical features of presbycusis

A

slurred speech
difficulty hearing high pitched ‘s’ and ‘h’ sounds
tinnitus

25
Q

what is the management of presbycusis

A

hearing aids

26
Q

what does noise induced hearing loss present with on audiometry studies

A

classical dip at 4kHz

27
Q

what drugs are known to cause sensorineural hearing loss

A

gentamycin
chemotherapy eg cisplastin
aspirin and NSAIDs when in overdose

28
Q

what is a vestibular schwannoma

A

benign tumour of vestibular nerve - arising from internal auditory meatus

29
Q

how does vestibular schwannoma present

A

hearing loss
tinnitus
imbalance

30
Q

what is the investigations and treatment of vestibular schwannoma

A

investigate with MRI

management - surgical removal depending on size, otherwise radiation and observation

31
Q

glue ear presents with fluid in the ear with signs of acute inflammation true/false

A

false - presents with fluid in the middle ear but no acute inflammation

32
Q

does otitis media with effusion present with otalgia or hearing loss

A

otalgia - no

hearing loss - yes

33
Q

how does the tympanic membrane appear with OME

A

retracted with reduced motility

34
Q

what is the initial treatment for OME

A

nothing - wait and see as majority resolve within 3 months

35
Q

if OME has no resolved within 3 months what intervention is done

A

refer to ENT for grommet insertion, if second intervention is required grommet insertion + adenoidectomy

ENT (8 decks)

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