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HEENT > Ear Disorders > Flashcards

Ear Disorders Flashcards

1
Q

Cerumen Impaction methods of removal

A

ceruminolytic agents: debrox, hydrogen peroxide, rubbing alcohol
Irrigation
manual removal through scope or under microscope

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2
Q

Otitis externa is

A

ear canal infection - swimmers ear

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3
Q

Otitis externa sx

A

pain - painful tragus or outer ear
blocked/ full sensation
decreased hearing

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4
Q

Otitis externa PE findings

A

painful tragus or outer ear
swollen ear canal
blocked by debris
cant see TM

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5
Q

Otitis externa bacterial organisms

A

staph aureus
pseudomonas

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6
Q

Otitis externa fungal organisms

A

aspergillus niger
candida albicans
(otomycosis)

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7
Q

Zoster Oticus: Ramsay Hunt syndrome presents as

A

severe pain with facial paralysis
hearing loss/ vertigo
vesicular eruption - ear/face/palate

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8
Q

Zoster Oticus: Ramsay Hunt syndrome treatment

A

Corticosteroids, HSV antiviral
analgesics, topical abx
eye care

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9
Q

Treatment of otitis externa

A

clear ear canal
acidify ear canal - acetic acid, boric acid
place wick if needed to facilitate drops placement
keep water out of ear

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10
Q

Otitis Externa antibacterial ototopicals

A

cortisporin or ciprofloxacin

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11
Q

Otitis Externa anti inflammatory ototopicals

A

abx combined with steroids to reduce inflammation
VoSol HC
Ciprodex
Cipro HC
Cortisporin

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12
Q

Otitis Externa Antifungal ototopicals

A

clotrimazole
nystatin
voraconizole

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13
Q

Otitis externa fungal infections strongly suggest

A

EENT for evacuation of canal
expect recurrence ~ 4-6 wks later

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14
Q

Auricular Hematoma is usually from

A

trauma - wrestling
shear injury at anterior auricular skin
hematoma between cartilage/ perichondrium

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15
Q

Auricular Hematoma treatment

A

needle aspiration - inadequate
I&D recommended
compressive dressing
anti-staph abx

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16
Q

Auricular Hematoma complications

A

Infection/ abscess - cauliflower ear

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17
Q

Foreign body ear canal removal - bugs how to do it

A

drown insects with mineral oil or lidocaine before attempting removal

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18
Q

Eustachian tube is the connection between

A

middle ear and nasopharynx

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19
Q

function of the eustachian tube

A

equalizes pressure in middle ear
drains thin mucus produced in middle ear
prevents reflux of fluid into middle ear

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20
Q

The eustachian tube is normally

A

closed - by tissue elasticity

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21
Q

The eustachian tube is opened by

A

palate muscles - yawning swallowing, etc

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22
Q

Eustachian tube treatment

A

treat underlying sinus issue
nasal steroid spray
air travel - gum chewing, decongestant spray

PET - patulous eustachian tube = estrogen nasal drops, wt stabilization, surgery?

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23
Q

PET - patulous eustachian tube is when

A

TM moves with nasal respiration and may be seen on exam
rapid wt loss
‘bucket over the head’ (autophony)

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24
Q

TM perforation causes

A

infection
eustachian tube dysfunction
penetrating trauma (Qtip)
base of skull fracture
pressure changes (barotrauma)

25
Q

TM perf evaluation

A

side, location, size
condition of mucosa
secondary structures involved
safe vs unsafe
degree of hearing loss

26
Q

Treatment of TM perf

A

Most close with time (4-6 wks)
Keep water out of ear
surgical eval if non-healing after 6 wks

27
Q

Types of otitis media

A

serous or suppurative

28
Q

Two durations of otitis media

A

acute or chronic

29
Q

two designations of otitis media

A

with or without perforation

30
Q

otitis media with effusion (OME) is

A

presence of fluid in the middle ear without signs or sx of an acute ear infection

31
Q

Acute otitis media (AOM) is

A

infectious, inflammatory condition of the middle ear
effusion behind the intact TM
may be suppurative or serous

32
Q

Contributing factor for AOM

A

URI
Eustachian tube dysfunction

33
Q

Acute serous Otitis Media treatment

A

treat underlying illness
NOT a bacterial middle ear infection, abx not needed
surgical drainage

34
Q

Acute suppurative otitis media treatment

A

amoxicillin
augmentin
PCN allergy = erythromycin or clindamycin with bactrim
fluoroquinolone (for adults only)

35
Q

Otitis Media complications

A

mastoiditis
meningitis
brain abscess
facial paralysis

36
Q

Unilateral Otitis Media in adults should raise suspicion for

A

nasopharyngeal mass blocking eustachian tube orifice

37
Q

Indication for tubes

A

Recurrent AOM:
greater than or equal to 3 seperate episodes of AOM in 6 months or greater than or equal to 4 episodes of AOM in 12 months

38
Q

Cholesteatoma is

A

keratoma or skin where it does not belong - this is a surgical disease

39
Q

Acute mastoiditis is associated with

A

AOM

40
Q

Acute Mastoiditis is

A

infection that spreads beyond mucosa of middle ear cleft

41
Q

Vertigo is

A

an abnormal sense of motion characterized by a spinning sensation

42
Q

Vertigo testing

A

audiogram
positional testing
MRI with Gadolinium contrast - gold standard

43
Q

A positive Dix Hallpike is pathognomonic for

A

BPPV - but a neg test is meaningless

44
Q

BPPV is

A

benign paroxysmal positional vertigo - a phantom sensation of motion elicited by specific changes in head position

45
Q

Meniere’s syndrome four main features

A

attacks of vertigo
fluctuating hearing loss
tinnitus (ringing in ears)
aural fullness (pressure sensation in ears)

46
Q

Meniere’s syndrome is a

A

condition of excess pressure accumulation in inner ear

47
Q

Vestibular neuritis / neuronitis labyrinthitis is usually due to

A

viral infection / inflammation of nerve/ labyrinth
watch for ramsey hunt syndrome

48
Q

Vertigo treatment

A

BPPV - Epley maneuver
Meniere’s Disease - low salt diet, avoidance of alcohol and caffeine, diuretics, vasodilators

49
Q

Hearing loss two types

A

conductive or sensorineural

50
Q

Conductive hearing loss is

A

caused by something that stops sounds from getting through the outer or middle ear
common reasons - blockage of ear canal, perforated drum, problems with the ossicles or fluid in middle ear

51
Q

Sensorineural hearing loss is

A

most common type
loss due to pathology (damage) of cochlea, auditory nerve, or CNS
exposure to loud noises, genetic factors, or natural aging process

52
Q

Acoustic Neuroma is

A

Sudden cause of unilateral sensorineural hearing loss
dizzy but not usually vertigo
MRI scan

53
Q

Acoustic Neuroma treatment

A

observation if tumor is small and does not cause sx
surgical removal
radiation to stop from growing

54
Q

Presbycusis is

A

age related hearing loss - gradual overtime
usually bilateral - usually greater for high pitched sounds

55
Q

Presbycusis treatment

A

devices/ mechanical aids - vibrating alarms, flashing phone or doorbells, tv listening systems, personal amplifiers
hearing aids

56
Q

Any child with speech delays suspect

A

hearing concerns

57
Q

Tinnitus is

A

defined as the perception of noise in the absence of an acoustic stimulus outside of the body
sx not a disease - most often idiopathic, SNHL m/c identified cause

58
Q

Tinnitus treatment

A

avoid dietary stimulants - coffee, soda, tea
smoking cessation
avoid meds - aspirin, NSAIDS, many others
reassurance
feedback training
white noise and other maskers

HEENT (7 decks)

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