Ear Disorders Lecture Powerpoint

Question 1

Cone of light orientation on the tympanic membrane

Answer 1

Lies anteriorally

Question 2

Presenting symptoms of otitis externa (5) (one big one!)

Answer 2

• Ear pain
• Pruritus
• Discharge
• Hearing loss
• Tragus tenderness**

Question 3

Antibiotic treatment for nonsevere cases (the overwhelming majority, not those that are refractive or do not respond) is typically ___ performed

Answer 3

empirically

Question 4

Ear wick

Answer 4

Dropping topical antibiotics on a cloth used when delivery of the topical antibiotic is blocked or difficult to reach, acts as a folded up cloth to stick deep in the ear to reach the deep part of the external auditory canal

Question 5

Ciprodex (ciprofloxacin-dexamethasone)

Answer 5

An antibiotic that is an excellent choice for otitis externa when unsure if tympanic membrane perforation exists and otitis media in patients with tympanostomies

Question 6

3 types of cerumen removal

Answer 6

• Cerumenolytic agents (mineral oil, hydrogen peroxide, debrox)
• Irrigation (safe unless tympanic membrane is perforated)
• Manual (curettes, suction)

Question 7

Children’s eustachian tubes run ____, predisposing them to otitis media

Answer 7

horizontally

Question 8

Otitis media is typically treated immediately with antibiotics rather than not. This is because…

Answer 8

…it can result in difficulties reaching life milestones down the road (hearing loss leading to speech delay)

Question 9

Acute vs serrous otitis media

Answer 9

Serous is sometimes seen at the beginning and end of acute otitis media infection as well as with allergies and thus does NOT require antibiotics

Question 10

If a child has artificial ostomy in tympanic membrane (for recurrent ottitis media)***, you can treat otitis media from then on with…

Answer 10

…cipro or ofloxacin otic drops as it goes thru the open tubes to the infection

Question 11

Tympanogram

Answer 11

High tech machine that produces a measure of pressure vs compliance (movement), should typically be within a normal range with normal peak around zero pressure (daPa), if peaks in negative indicative of eustachian tube dysfunction, if cannot move classically seen in otitis media

Question 12

Common pathogens that cause chronic otitis media (3)

Answer 12

• Pseudomonas
• Staph aureus
• proteus

Question 13

1st line and 2nd line treatment of acute otitis media

Answer 13

• Amoxicillin

- amoxicillin-clavulanate (augmentin) or 2nd gen cephalosporin

Question 14

Tympanosclerosis

Answer 14

Scarring of the eardrum, diagnosed clinically via otoscopy, only affects hearing in high levels, rarely requires treatment

Question 15

Barotrauma treatment

Answer 15

• Oral decongestants
• Swallowing or valsalva
• chewing gum or sucking on something (bottle in babies)

Question 16

bilateral vestibular schwannomas are characteristic clinical features of…

Answer 16

…nerofibromatosis type 2

Question 17

Neurofibromatosis definition and 3 types

Answer 17

A genetic condition that causes tumors to form in the brain, spinal cord, and nerves
Type 1 - causes skin changes and deformed bones. It usually starts in childhood,sometimes the symptoms are present at birth
Type 2 - causes hearing loss, ringing in the ears, and poor balance. Symptoms often start in the teen years
Type 3 - Schwannomatosis causes intense pain. It is the rarest type.

Question 18

Ramsay Hunt’s syndrome (Herpes zoster oticus)

Answer 18

Invasion of 8th nerve ganglia and ganglion of facial nerve by the herpes zoster virus causing severe ear pain, hearing loss, vertigo, vesicles in the auditory canal and auricle, paralysis of the facial nerve, taste perception, hearing, and lacrimation

Question 19

Meneire’s disease

Answer 19

Chronic condition with recurrent episodes of vertigo associated with sensorineural hearing loss, tinnitus, and or a sensation of aural fullneess, chronic condition with relief but no cure, paroxysmal lasting 20 min to 24 hours and subsiding gradually

Question 20

Meneire’s disease treatment (3)

Answer 20

Medications such as diuretics or vestibular suppressants, or hearing aids/surgery

Question 21

Hemotympanum

Answer 21

A common result from temporal bone fractures that can cause disruption of the ossicular chain and subesequent middle ear hearing loss requiring urgent referral, may also see “battle’s sign” - bruising behind the ear, requires urgent ENT referral to ensure no hearing loss occurs

Question 22

90% of otitis externa is one of these 2 causative agents

Answer 22

• p. aeruginosa

- staph aureus

Question 23

Otitis externa treatment options (4)

Answer 23

• ofloxacin otic
• ciprofloxacin otic
• corticosporin otic
• ciprofloxacin dexamethasone

Question 24

gtts abbreviation

Answer 24

drops