Ear, Nose and Throat Conditions Flashcards
What is the most common cause of otitis externa?
How can you manage someone with it?
- Water in the ear and Pseudomonas infection
- Also Staph/Strep from folliculitis
- Physically clear away material, use topical antibiotics
What is Ramsay-Hunt syndrome?
- Shingles of the ear, can cause pain, hearing loss, dizziness, facial nerve palsy
What tends to cause acute otitis media? How can it be managed?
- Common organisms - Strep, Staph, HIB etc. Mostly oral flora
- Management - analgesia, antibiotics (oral ONLY in certain circumstances - <2, ATSI, immunodeficient, only hearing ear, perforated tympanum, complications)
What is glue ear?
- Chronic otitis media with effusion. Can be managed with grommets
- Extra info: dysfunction of Eustachian tube opening causes lack of replacement of air in the middle ear. The air in there is resorbed into the mucous membranes, creating negative pressure, which pulls out a transudate into the inner ear
What are the two main kinds of chronic suppurative otitis media? Which one is safer to have?
- Tubotympanic disease (safe)
- Few complications
- Cholesteatoma (atticoantral disease - unsafe)
What is a cholesteatoma? How can you manage it? What are the complications?
- Chronic negative pressure sucks in pars flaccida, causes it to grow along the ossicles in the attic area and desquamate. The desquamating skin can develop into a tumour and suprainfect.
- Management: surgery
- Complications: similar to glue ear, destruction of surrounding structures - mixed hearing loss/vertigo symptoms
What is otosclerosis? How can you manage it?
- Pathology of temporal bone (genetic) causing the stapes to thicken and stiffen. Progressive conductive hearing loss results
- Management: surgical stapes replacement
What is BPPV? How can you manage it?
- Displaced otoliths stimulating hair cells in utricle and saccule upon certain movements
- Duration of vertigo is brief
- Can be spontaneouly resolving or otoliths can be repositioned with special manouvres
What are the characteristics of Meniere’s disease? How is it managed?
- Vertigo, fullness in ear, roaring tinnitus, hearing loss progressively
- Lasts for hours but not days
- Management
- Acute (vestibular suppressants e.g. prochlorperazine)
- Chronic - salt restriction, diuretics, grommets, gentamicin injection, inner ear destruction
What are the presentation characteristics of someone with vestibular neuronitis? How is it managed?
- Unilateral, severe rotatory vertigo with nystagmus, no hearing loss/tinnitus
- Lasts days to weeks
- Management - supportive (self-resolving), MRI to exclude tumour
What are some sources of referred pain to the ear?
Oropharynx (tonsils, tumour), laryngopharnyx (CNX - piriform recess supply), molars/parotids, cervical spine
What is conductive hearing loss? What are you likely to find on Weber and Rinne tests?
- Loss of air conduction, maintenance of bone conduction
- Weber + for affected ear
- Rinne - for affected ear (bone > air)
What is sensorineural hearing loss? What might you find on Weber/Rinne tests?
- Loss of air and bone conduction
- Weber + for normal ear
- Rinne + for affected ear (air > bone)
What structures pass through the cavernous sinus? How does it relate to the nose?
- CNI, III, IV, V, VI, ICA and sympathetic nerves
- Posterolateral relation
How might someone with allergic rhinitis present? How can they be managed?
- Clear discharge, nasal blocking/itching, sneezing
- Management - allergen avoidance, IN decongestant, H1 antagonist, steroids
- Chronic decongestant use can cause progressive inflammation
