Ear pathology

Question 1

What is the most common cause of a ruptured TM

Answer 1

Suppurative AOM

Question 2

How long does it take a rupture TM to heal

Answer 2

Roughly 4 weeks

Question 3

What generally causes mastoiditis

Answer 3

AOM complication
*suppurative fluid can cause an abscess and lead to more serious CNS/bone infections

Question 4

Where in the Eustachian tube does dysfunction generally occur

Answer 4

Cartilaginous portion

Question 5

What is Eustachian tube dysfunction most commonly associated with

Answer 5

Inability to regulate pressure (edema)
decreased protection (Kiddos)
decreased clearance (CF)

Question 6

What will be seen on PE with Eustachian tube dysfunction

Answer 6

otalgia
retracted TM
effusion
decreased pneumatic changes
diminished hearing

Question 7

Where do acoustic neuromas typically occur

Answer 7

porus acusticus (CNS to PNS transition point)

more commonly on the superior and inferior branches

Question 8

What is the concern in the pediatric population if an acoustic neuroma is present

Answer 8

Nuerofibromatosis type 2
-effects chromosome 22
-generally will have bilateral tumor

Question 9

What increases risk for acoustic neuromas

Answer 9

radiation exposure

Question 10

What is the presentation if the acoustic neuroma effects the cochlear nerve

Answer 10

decreased hearing / tinnitus

Question 11

What is the presentation if the vestibular nerve is involved with an acoustic neuroma

Answer 11

Gait instability

Question 12

What occurs is the acoustic neuroma compresses CNVII

Answer 12

change in taste
facial paralysis
xerostoma

Question 13

What is the most common cause of benign paroxysmal positional vertigo

Answer 13

calcium debris in the semicircular canal (canalithiasis)

Question 14

What are labrynthitis and vestibular neuritis typically associated with

Answer 14

viral / post viral infection
*results in peripheral vertigo

Question 15

How do you differentiate between labrynthitis and vestibular neuritis

Answer 15

Based on unilateral hearing loss or change in hearing with tinnitus
*if no hearing loss = pure vestibular neuritis

Question 16

What is seen on PE with labrynthitis and vestibular neuritis

Answer 16

Unidirectional nystagmus
-beats away from the effected side

Question 17

What is tinnitus

Answer 17

Perception of sound without external stimuli

Question 18

What is the most common cause of tinnitus

Answer 18

damage to cochlear nerve cells

Question 19

What are objective causes of tinnitus

Answer 19

Vascular abnormalities (AVM / Bruits)
Mechanical (stapedial muscle spasm)

Question 20

What are subjective causes of tinnitus

Answer 20

trauma
conductive hearing loss
TMJ
HTN
Acoustic neruoma
meneires

Question 21

What are non-hereditary causes of sensorineural hearing loss

Answer 21

CMV
Hepatitis
toxoplasmosis
HIV
Syphillis

Question 22

What are hereditary causes of sensorineural hearing loss

Answer 22

autosomal dominant or recessive
m/c: abnormal conexxin 26

congenital cochlear malformation (1.5 turns instead of 2.5)

Question 23

When does meneires disease generally present

Answer 23

between 20-40

Question 24

What is the cause of meneires disease

Answer 24

end-lymphatic hydrops
*there is an increased endolymph pressure and causes distention in the labyrinth

Question 25

What are some causes of end-lymphatic hydrops

Answer 25

Trauma
chronic OM
congenital hearing deficit
labyrinth concussion
otosclerosos
pagets
syphillis