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ENT > Ear Diseases > Flashcards

Ear Diseases Flashcards

1
Q

what are the possible symptoms of ear disease

A 
hearing loss
tinnitus
vertigo 
otalgia 
ear discharge 
facial weakness
nasal symptoms

previous ear surgery
FHx

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2
Q

what are the types of hearing loss

A

conductive
sensorineural
mixed

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3
Q

what is normal hearing on audiometry

A

0-20

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4
Q

what is otalgia

A

ear pain

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5
Q

when should you considered referred otalgia

A

if ear looks normal and no history suggesting ear problem

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6
Q

what is an incomplete facial palsy

A

have palsy and weakness but have retained some movement

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7
Q

what are the possible signs of ear disease

A 
discharge 
swelling 
bleeding 
masses 
external scars 
changes in ear drum 
swelling over mastoid 
facial weakness 
hearing loss
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8
Q

what are the features of a normal ear drum

A

cone of light (always anterior)
lateral process of the malleous
pars flaccida (flaccid portion at top)
pars tensa (tense main portion)

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9
Q

what is otitis externa

A

inflammation of the skin of the ear canal

almost always infections (bacterial or fungal- esp if used antibiotics then colonised by fungi)

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10
Q

what are common causes of otitis externa

A

water, cotton buds, skin conditions (e.g. eczema)

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11
Q

what are the symptoms of otitis externa

A 
itchy
discharge 
sore 
ear canal swollen 
can follow an upper respiratory tract infection
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12
Q

what are the risk factors for acute otitis media

A 
children 1-3 
males
smoking in house
day/care nursery attendance
not breast fed 
craniofacial abnormalities
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13
Q

what are the symptoms of acute otitis media

A

systemically unwell
pain (younger children may pull at their ear)
malaise
irritability, crying, poor feeding, restlessness
fever
coryza/rhinorrhoea
vomiting

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14
Q

what is acute otitis media

A

inflammation of the middle ear

may be cause by bacteria or viruses

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15
Q

what are the signs of acute otitis media

A

no light reflex
bulging ear drum
air fluid level may be present

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16
Q

what can chronic otitis media cause

A

otitis media with effusion (glue ear)
cholesteatoma
perforation

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17
Q

who gets otitis media with effusion

A

more common in children

associated with eustachian tube dysfunction or obstruction (e.g. inflamed adenoids)

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18
Q

what should you consider in adults with otitis media with effusion

A

consider causes (something obstructing eustachian tube)
rhinosinusitis
nasopharyngeal carcinoma
nasopharyngeal lymphoma

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19
Q

what are the features of otitis media with effusion

A

conductive hearing loss
flat tympanogram
children HL may present as behavioural problems, delayed language development
mild intermittent ear pain
may have balance problems
history of recurrent ear infections, URTI or nasal obstructions

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20
Q

why is the ear drum yellow in otitis media with effusion

A

as colour of the fluid behind the eardrum

21
Q

what is the treatment for otitis media with effusion

A

reassurance- self limiting condition, 90% complete resolution in one year (although recurrence is common)
observation
is hearing <25 dB and persisting for more than 3 months:
-grommet
-could do adenoidectomy
-hearing aid

consider decongestants, antihistamines or steroids if due to nasal congestion

22
Q

does the effusion drain out of the grommet

A

no, allows air into ear to equalise the pressure

23
Q

what can cause ear drum perforation

A

commonly AOM

trauma

24
Q

do ear drum perforations heal

A

yes, usually heal spontaneously with no problems- may need surgical repair if very large hole

25
Q

what is a cholestestoma

A

the presence of keratinising squamous epithelium within the middle ear, or mastoid
has independent growth causing expansion and resorption of the underlying bone

26
Q

what is external canal cholesteatoma

A

focal erosion of external bone with accumulation of keratin

27
Q

what are the symptoms of cholesteatoma

A

conductive hearing loss
ear discharge resistant to antibiotics
tinnitus

can also get:
otalgia
altered taste (facial nerve)
dizziness (erosion into semicircular canal)
facial nerve weakness
28
Q

what are the risk factors for cholesteatoma

A

middle ear disease, eustachian tube dysfunction, prior otological surgery, traumatic blast injury to ear, congenital abnormalities (cleft palate, craniofacial abnormalities, turners or downs syndrome)

29
Q

what is the management for cholesteatoma

A

generally requires surgical excision and reconstruction

30
Q

what are the possible complications of AOM and cholesteratoma

A

SNHL, tinnitus, vertigo, facial palsy
brain abscess, meningitis
venous sinus thrombosis
mastoiditis (causes swelling under periosteum which pushes ear forward)

31
Q

what is otosclerosis

A

where one or more foci of irregularly laid spongy bone replace normal dense bone of the otic capsule (in bony labrynth)
results in fixation of the stapes footplate

32
Q

who gets otosclerosis

A

women more commonly affected- usually in teens/20s

familial

33
Q

what are the symptoms of otosclerosis

A

gradual onset conductive hearing loss, vertigo, tinnitus

34
Q

how is otosclerosis treated

A

stapectomy

or hearing aids

35
Q

what is sensorineural hearing loss

A

hearing loss where the cause is within the inner ear/ sensory organ or the vestibulocochlear nerve

36
Q

what is presbycusis

A

old age hearing loss - sensorineural hearing loss caused by gradual changes in the inner ear
(usually high frequency)

37
Q

what is the classic sign of noise induced hearing loss

A

classical dip at 4 kHz

38
Q

what type of hearing loss is noise induced

A

sensorineural

39
Q

what drugs can cause (SN) hearing loss

A 
gentamicin + other aminoglycosides 
chemotheraputic drugs (cisplatin, vincristine)
aspirin and NSAIDs in overdose
40
Q

what is a vestibular schwannoma

A

benign tumour arising in the internal acoustic meatus from the myelin-forming cells of the vestibulocochlear nerve

41
Q

how does a vestibular schwannoma present

A

hearing loss, tinnitus and imbalance (grows slowly so patients often adjust to changes in balance)

42
Q

how do you diagnose a vestibular schwannoma

A

MRI

43
Q

what is the treatment for a vestibular schwannoma

A

need to consider risks of surgery and benefit

symptoms might not be that bad, wont grow

44
Q

what type of hearing loss is menieres

A

sensorineural

45
Q

what type of hearing loss can trauma cause

A

conduction, sensorineural or mixed

46
Q

what is a haemotympanium

A

middle ear filled with blood

47
Q

what is a battles sign

A

bruising over the mastoid- suggests a base of skull fracture

48
Q

what are the complications of a skull fracture

A

hearing (conductive/ SN), facial palsy, CSF leak, brain damage

ENT (27 decks)

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