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EENT > Ear: Middle Ear And Beyond (Final) > Flashcards

Ear: Middle Ear And Beyond (Final) Flashcards

1
Q

The “Big Four” Ear Complaints

A
  1. Hearing Loss
  2. Equilibrium or balance problems
  3. Dizziness, vertigo
  4. Tinnitus (auditory paresthesia)
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2
Q

Cholesteatoma

A

-A benign tumor near eardrum
-Appears as a white mass behind or on eardrum

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3
Q

Most cholesteatomas are due to repeated:

A

Middle ear infections

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4
Q

Symptoms of Cholesteatoma

A

Hearing loss, dizziness, pressure in ear, ear ache, drainage of pus

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5
Q

Treatment of Cholesteatoma

A

-Surgery to remove growth completely/reconstruct damaged ossicles or eardrum
-Goal: Preserve hearing and equilibrium/balance

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6
Q

Vestibular Schwannoma (Acoustic Neuroma)

A

Slow-growing, benign tumor of CN 8 Schwann cells

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7
Q

Vesticular Schwannoma can grow large enough to:

A

Compress facial nerve, leading to facial palsy

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8
Q

Best Diagnosis tools for Vestibular Schwannoma

A

-Contrast-Enhanced MRI: Gold standard of Diagnosis
-CT Scan: If MRI is contraindicated

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9
Q

Treatment of Vestibular Schwannoma

A

-Observation: Wait until symptoms are intolerable
-Microsurgical removal or reduction of tumor
-Stereotactic radiation therapy

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10
Q

What other ear-related symptoms can hearing loss be accompanied by?

A

Tinnitus, ear ache or ear pain, dizziness or problems with balance
-Others: Ear discharge, fullness in the ear, nausea

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11
Q

Conductive Hearing Loss is caused by:

A

Anything that interferes with conduction of sound waves from outer ear to oval window

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12
Q

Causes of Conductive Hearing Loss

A

-Middle ear infections (Otitis media)
-Wax or any blockage of outer ear
-Otosclerosis (growth of surrounding bone)
-Cholesteatoma (growth into the middle ear)

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13
Q

Sensorineural Hearing Loss is due to:

A

-Dysfunctional cochlea, acoustic nerve, or brain
-Usually permanent
-Usually affects both ears, but not necessarily equal

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14
Q

Possible Causes of Sensorineural Hearing Loss

A

-Presbycusis: Decline in hearing due to aging
-Acoustic Trauma: Damages hair cells of inner ear
-Drugs: Aspirin, quinine, opiods (ototoxicity)
-Vestibular Schwannoma: A benign tumor

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15
Q

Presbycusis

A

-Age-related sensorineural hearing loss
-Especially affects high frequency sounds: Difficult to hear & understand voices in a crowded situation

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16
Q

Diagosis of hearing loss

A

-Patient history, doctor suspicion
-Screening tests: Rinne, Weber Tests

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17
Q

Hearing Tests

A

-Hearing acuity: Whisper, Finger Rustle
-Hearing Loss: Weber, Rinne

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18
Q

Conductive Hearing Loss

A

-Weber: Vibration sounds heard best in bad ear
-Rinne: Bone and Air conduction are equal

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19
Q

Sensorineural Hearing Loss

A

Weber: Vibration sounds heard more in good ear
-Rinne: Air>Bone Conduction

20
Q

Audiologist Tests for Hearing

A

-Audiometry
-Tympanometry/Impedance Tests

21
Q

Tx of hearing loss

A

-Conductive: Removal of wax, cholesteatoma, stapedectomy, and prosthesis…
-Sensoryneural: Hearing aid, removal of vestibular schwannoma

22
Q

Cochlear implants

A

Hearing device for people with severe sensorineural hearing loss

23
Q

Tinnitus

A

“Paresthesia of the ear”/Ringing

24
Q

Causes of Tinnitus

A

-Loud noises
-Underlying disease: HBP, allergies, heart disease..
-Ear infection
-Rupture/Perforation of tympanic membrane
-Earwax
-Injury to the neck or head
-Vestibular schwannoma/other tumors
-Drugs

25
Q

Diagnosis in Tinnitus

A

-Check hearing: Auditory acuity, Weber, Rinne
-Otoscopy: Check canal and tympanic membrane

26
Q

Treatment of tinnitus

A

-Treat the cause
-Adjust: Per PARTS findings in cervical spine/occiput
-Muscle work: SCM and suboccipital
-Self-help measures

27
Q

Inputs that contribute to our sense of balance, body position, motion

A

Afferent information from: Ears, proprioceptors, inner ear

28
Q

Labyrinthitis

A

-Infection/inflammation of the labyrinth

29
Q

Labyrithitis is almost always caused by:

A

Viral infection

30
Q

Symptoms of Labyrinthitis

A

-Vertigo, loss of balance (even longer)
-Loss of hearing in one ear
-Dizziness (lasts for days)

31
Q

Treatment of Labyrinthitis

A

-Promote self-healing: Rest, fluids, good nutrition, adjust
-Take care regarding balance: Avoid quick movements
-Seldom recurs

32
Q

Meniere’s Disease

A

Periods of vertigo lasting for minutes to hours
-Unknown etiology

33
Q

Meniere’s Prodromals

A

-Visual: “Explosions of spots”
-Auditory: Tinnitus
-Head: “Feels Full”
-General: Sweating

34
Q

Treatment of Meniere’s

A

-No known cure
-Chiro adjustments and trigger point work: Neck, schoulder and cervicothoracic regions
-Medications to: reduce anxiety
-Reduce intake of: Salt, nicotine, alcohol, caffeine

35
Q

Meniere’s: Diet/Supplementation

A

Manganese, B Complex, Chromium picolinate, Co-Q10, Butchers Broom

36
Q

Benight Paroxysmal Positional Vertigo (BPPV)

A

Extreme spinning sensation when patient looks up or to one side, or when lying on one side

37
Q

Symptoms of BPPV typically last:

A

Only about a minute but are recurrent

38
Q

BPPV is typically caused by:

A

Disruption or malposition of the otoconia/otoliths in the utricle and saccule, especially when head is moved in certain directions
-Younger: Head Injury
-Adults: Age-Related

39
Q

What test would you perform for BPPV

A

Dix-Hallpike Test
-Others: Elecronystagmography, MRI, Rotating Stool Test

40
Q

Dix-Hallpike Test would be positive for BPPV if:

A
  1. Bursts of Nystagmus: As patient turns head when supine
  2. Vertigo
41
Q

Treatment of BPPV

A

-Canalith repositioning maneuvers: Epley maneuver

42
Q

Cervicogenic vertigo

A

Vertigo due to abnormal proprioceptive input from the cervical spine

43
Q

What joints/muscles are affected by Cervicogenic Vertigo?

A

-Joints between occiput and C3
-Muscles of the neck: SCM & suboccipital muscles

44
Q

In cervicogenic vertigo, _____ and ___ are always present and _____ ROM is always found

A

Neck pain, trigger points and decreased ROM

45
Q

Treatment of certicogenic vertigo

A

Chiro adjustments, stretches/neck exercises, postural hygiene, medications, surgery

46
Q

Vertigo Supplementation

A

Niacin, DMG, B Complex, Choline, ginko biloba, zinc, butcher’s broom, ginger

47
Q

Male de Debarkment Syndrome (MdDS)

A

Rare, usually after disembarking from a boat, ride or plane

EENT (7 decks)

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