Ear pathology Flashcards
What is the clinical name for ear pain?
otlagia
What are the 2 types of hearing loss?
conductive
sensorineural
Which type of hearing loss is more likely to be genetic?
sensorineural
What frequency are the tuning forks for the test?
512 hz
What investigation is carried out for vertigo?
Dix-Hallpike test
What is the difference between Rinnes and Webers test?
Rinnes - tests conduction (fork over mastoid process)
Webers - localises problem (fork on forehead)
Is a positive or negative Rinnes test normal?
positive
In an audiogram, what is normal?
anything over 20db
What is conductive hearing loss?
air conduction is impaired
What is sensorineural hearing loss?
air and bone conduction are impaired
What is the Dix-Hallpike manouvre?
patient sits upright and turns head 45 degrees
if positive - will see nystagmus
What is a pinna haematoma?
collection of blood in ear after trauma
What can a pinna haematoma lead to?
avascular necrosis
leads to cauliflower ear
Tx for pinna haematoma…
incision and drainage
What is cerumen impaction and what can it lead to?
build up of ear wax
can lead to conductive hearing loss
Tx for cerumen impaction?
ear drops for 3-5 days
or
ear irrigation
What is an infection of the external ear called?
otitis externa
What are the 2 most common bacterial causes of otitis externa?
staph aureus
pseudomonas aeruginosa
Tx for otitis externa…
topical ABs and a topical steroid
What is malignant otitis externa?
spread of infection. Can occur if immunocompromised.
Can lead to facial nerve dysfunction
Tx for malignant otitis oxterna…
Urgent ENT referral
IV antibiotics
What is acute otitis media?
infection of middle ear space
What is chronic otitis media?
otitis media that has lasted >6 weeks with a perforated tympanic membrane
Who is otitis media most common in and why?
chhildren
shorter eustachian tube so easier for infection to spread
What organisms cause acute otitis media?
Haemophillus
Strep pneumoniae
Triad of Sx for acute otitis media…
Otalgia
Conductive hearing loss
Fever
What is ear discharge a sign of in acute otitis media?
perforated tympanic membrame
Tx for acute otitis media…
1 - analgesia (Self-limiting)
2 - amoxicillin
What is OME and who is it most common in?
Otitis media with effusion (sterile fluid in middle ear)
peak age - 2
Presentation for OME…
conductive hearing loss
speech and language delay
behavioural problems
Tx for OME…
observe for 3 months
no improvement - myringotomy + grommets
What are the complications of mastoiditis?
meningitis, brain abscess
Tx for mastoiditis…
IV antibiotics
What is a cholesteatoma?
build up of squamous epithelium (Skin)
What is a risk factor for a cholesteatoma?
cleft palate
Presentation of cholesteatoma…
foul smelling non resolving discharge
hearing loss
sign - attic crust
Tx for cholesteatoma…
surgery
What is prebycusis and what is the Tx?
Age associated sensorineural hearing loss
hearing aids
What is otosclerosis?
replacement of cortical bone by vascular bone
causes conductive deafness in young pt
Tx for otosclerosis?
hearing aids/stapedectomy
Dx if vertigo symptoms last seconds?
BBPV
Dx if vertigo symptoms last minutes-hours?
Menieres disease
Dx if vertigo symptoms last hours-days?
labyrnthitis/vestibular neuronitis
Dx if vertigo symptoms are chronic?
acoustic neuroma
symptoms of BBPV?
N & V
vertigo seconds-minutes
no tinnitus/hearing loss
Ix for BBPV…
Dix-Hallpike
Tx for BBPV…
Epley manouvre
What causes menieres disease?
excessive pressure in endolymphatic system
Sx of menieres disease..
tinnitus
HEARING LOSS
aural fullness
Ix and findings for menieres disease…
audiogram
low frequency sensorineural hearing loss
Tx for menieres disease…
Stop driving until controlled
low salt diet
attacks - prochloperazine
What is labyrinthitis?
inflammation of membranous lymph
Sx of labyrinthitis…
Vertigo - hours-days N&V tinnitus hearing loss horizontal nystagmus gait disturbance
Tx for labyrinthitis…
self-limiting
What is vestibular neuritis?
inflammation of vestibular nerve
can develop after viral infection
Sx of vestibular neuritis…
vertigo
N&V
Tx for vestibular neuritis…
vestobular rehabilitation
prochloperazine
What is vestibular schwannoma?
benign tumour of vestibular and cochlear nerves
What are bilateral vestibular schwannomas associated wtih?
NF 2
Sx of vestibular schwannoma…
vertigo
unilateral hearing loss
unilateral tinnitus
(facial palsy, absent corneal reflex)
Ix and Tx for vestibular schwannoma?
MRI
Surgery
