Ear disease

Question 1

what are causes of conductive hearing loss

Answer 1

otitis externa, wax, acute otitis media, middle ear mass eg cholesteatoma, foreign body, perforation, otosclerosis

Question 2

what often causes otitis externa

Answer 2

water, cotton buds, skin condition

Question 3

how does an ear drum with acute otitis media present

Answer 3

red and swollen - can occasionally burst

Question 4

what are symptoms of acute otitis media

Answer 4

earache and irritability, red, swollen TM, (hearing loss)

Question 5

what bacteria can infect viral oitis media

Answer 5

H influenza, strep pneumonia, moxallera

Question 6

what increases incidence for otitis media with effusion/ glue ear

Answer 6

males, day care, older siblings, smoking exposure, recurrent URTI

Question 7

what does an ear drum with glue ear look like

Answer 7

behind ear drum, TM retraction, reduced mobility, altered TM colour

Question 8

what can cause glue ear in adults

Answer 8

rhino-sinusitis, nasopharyngeal carcinoma, nasopharyngeal lymphoma

Question 9

what are symptoms of glue ear

Answer 9

NO otalgia (ear ache), middle ear effusion, scream on airplane descent HEARING LOSS - poor school performance or delayed speech

Question 10

how do you diagnose glue ear

Answer 10

look at TM, audiometry, tympanogram

Question 11

how do you treat glue ear in a non-recurring patient

Answer 11

auto inflation - blow air through eustachian tube

Question 12

how do you treat glue ear in recurrent patients

Answer 12

grommit (stent) –> remove adenoids –> hearing aids

Question 13

what are complications of grommets

Answer 13

infection, retention, can’t swim deeping

Question 14

what commonly causes TM perforation

Answer 14

acute otitis media or after trauma

Question 15

what can repeated otitis media lead to

Answer 15

choleastoma (and perforation and glue ear)

Question 16

what happens in cholesteatoma

Answer 16

normal cuboidal or comulnar epithelium –> abnormal squamous which causes keratin pocked in middle ear

Question 17

how do you treat cholesteatoma

Answer 17

surgical excision and reconstruction

Question 18

what are complications of cholesteatoma

Answer 18

infection, sensorineural hearing loss, vertigo, facial palsy, brain abscess, meningitis, venous thrombosis

Question 19

what is otosclerosis

Answer 19

bony deposits on footplate of stapes

Question 20

who normally gets otosclerosis and why

Answer 20

women - something to do with oestrogen

Question 21

how do you treat otosclerosis

Answer 21

stapedectomy

Question 22

what causes sensorineural hearing loss

Answer 22

ageing, noise induced, drug induces, vestibular schwannoma, meniere’s, trauma or tumours

Question 23

when can noise induced hearing loss occur

Answer 23

after concerts, employees working with heavy machinery

Question 24

what would you see on an audiogram of noise induced hearing

Answer 24

dip at 4 kHz but rises after

Question 25

what drugs commonly causes hearing loss

Answer 25

GENTAMICIN, chemo, aspirin and NSAIDs

Question 26

what is a vestibular schwannoma

Answer 26

benign tumour from internal auditory meatus of VIII nerve sheath within the temporal bone

Question 27

what are the symptoms of vestibular schwannoma

Answer 27

progressive hearing loss, tinnitus, imbalance asymmetric hearing loss

Question 28

how do you diagnose vestibular schwannoma

Answer 28

MRI diagnosis - if bilateral type 2 neurofibromatosis

Question 29

how can trauma cause hearing loss

Answer 29

blood in middle ear, CSF leak, damage to cranial nerves

Question 30

what would an audiogram showing conductive hearing loss show

Answer 30

difference in air conduction and bone conduction - no relation to frequency

Question 31

what would an audiogram showing sensorineural hearing loss show

Answer 31

no difference in air and bone conductions - less efficient in some frequencies (usually high and low)