Ear Emergencies Flashcards
Pinna haematoma & cauliflower air pathophysiology
Trauma =>
perichondrial blood vessel tear =>
Hematoma between auricular cartilage & perichondrium =>
Pinna haematoma
Pinna haematoma =>
disrupted blood supply to cartilage =>
Avascular necrosis =>
Fibrocartilage overgrowth =>
Cauliflower ear
What patient is most likely to have a pinna haematoma
Boxers & rugby players
Pinna haematoma management
Aspiration,
OR incision and drainage,
OR pressure dressing
What is battle sign & what does it indicate
Bruising over mastoid
Indicates a temporal bone fracture unless proven otherwise
What examinations would you want to do in someone presenting with suspected temporal bone fracture/ battle sign
Cranial nerve examination, especially CN VII
Hearing test
Condition of tympanic membrane & ear canal
Check for CSF leak
Longitudinal vs transverse fracture
Longitudinal fractures
- Typically occurring from a lateral blow to the head
- Fracture parallel to long axis of the petrous pyramid
Transverse fractures
- Occur from fronto-occipital head trauma
- Fracture at right angles to long axis of the petrous pyramid
What is the gold standard investigation fro temporal bone fracture
CT brain
Temporal bone fracture management
Most managed conservatively
Unless facial nerve palsy
Temporal bone transverse fracture complications
If fractures crosses internal acoustic meatus
=> CN VIII damage => Sensorineural hearing loss & vertigo
=> CN VII damage => facial palsy
Temporal bone longitudinal fracture complications
Facial nerve palsy
CSF otorrhoea
Conductive deafness (due to haemotypanum or ossicular chain disruption)
Temporal bone fractures can be classified into transverse & longitudinal. How else can they be classified
Fractures involving the otic capsule &
Fractures not involving the otic capsule
What are the three types of conductive hearing loss
- fluid/ effusion in medial cavity
- tympanic membrane perforation
- ossicular problem
What does sensorineural hearing loss relate to
The cochlea & the vestibular nerve CN VIII
What test can be used to confirm sensorineural hearing loss
Weber test
Sudden sensorineural hearing less treatment
EMERGENCY!
Steroids +/- Intratympanic treatment
