Ear Pathology Flashcards
What is auricular haematoma
Collection of blood forms in the pinna
Often follow trauma
If untreated will result in ‘cauliflower ear’
Rx auricular haematoma
Drainage is definitive
Symptoms of ear foreign body
Pain Deafness Discharge (foul smelling) May be a buzzing in the ear Bleeding dy Afebrile
Diagnosis for ear foreign body
Otoscopy
Rx ear foreign body
Removal ASAP
Kill insects prior to removal
What is otitis externa
Inflammation of external ear canal
Usually due to infection
Sometimes due to allergy or irritation
Risk factors otitis externa
External obstruction
Swimming
Where does inflammation not go past in otitis externa
TM
Symptoms otitis externa
Itch Ear discharge Dulled hearing Pain Ear may feel blocked or full
Otoscopy O/E otitis externa
Canal may be swollen
TM should be normal
Treatment otitis externa
Topical ear antibiotics
Paracetamol
Ibuprofen
What is malignant otitis externa
When Otitis Externa spreads to surrounding tissues:
Into mastoid and temporal bones
Aggressive infection
Commonest organism malignant otitis externa
Pseudomona
Aeruginosa
Symptoms malignant otitis externa
Persistent and foul smelling yellow or green pus Ear pain Haring loss Fever Swollen and red skin surrounding ear
Ix malignant otitis externa
Swabs
CT
Rx malignant otitis externa
Long term systemic AB
What is acute otitis media
Infection of middle ear
Where do acute otitis media infections usually come from?
Seeded from upper respiratory tract from eustachian tube
Common organisms acute otitis media
Strep penumonia
Haemophilus influenzr
Symptom of acute otitis media
Otalgia
Hearing loss
Fever
Rx for acute otitis media
Often viral is self limiting
NSAIDS
AB if not resolved or systemic features
Otoscopy O/E for acute otitis media
Healthy ear canal
Often red and sometimes bulging TM
What is glue ear
Infection and fluid in middle ear
What is a common cause of glue ear
Eustachian tube dysfunction
Creates vacuum in middle ear
Draws in fluid from surroundings
Symptoms of glue ear
Hearing dampening
Rx glue ear
Watchful watiing
Grommets
O/E otoscopy glue ear
Bulging TM
Dull TM
Fluid behind TM
What is chronic supparative otitis media?
Chronic inflammation of middle ear and mastoid cavity
Characterised by discharge from middle ear through perforated TM for >6 weeks
Symptoms of chronic supparative otitis media
Recurrent otorrhoea
Hearing loss
Otoscopy O/E supparative otitis media
Perforation of TM
What is tympanosclerosis
Calcification of connective tissue of TM
Symptoms of tympanosclerosis
Sig. hearing loss
O/E tympanosclerosis
Chalky white patches on middle ear
Rx tympanoslcerosis
Hearing aids
What is otosclerosis
New bony deposits occur within the stapes footplate and cochlea
Abnormal bone material grows around the stapes
Symptoms otosclerosis
Hearing loss
Speaking softly
Tinnitus
Ix otosclerosis
Hearing tests
Rx otosclerosis
Hearing aids
Stapedectomy
What is the most common cause of deafness
Presbyacusis
What is presybacusis?
Natural ageing of auditory system
Onet in presbycausis
Onset gradual and slow
Which frequencies are lost first in presbycausis
Higher
Ix for presbycausis
Pure tone audiometry
Rx for presbycausis
High frequency hearing aids
Cochlear implants
What is an acoustic neuroma
Slowly growing benign Schwannoma of vestibular n.
Symptoms of acoustic Schwannoma
Hearing loss
Tinnitus Vertigo
Loss of facial sensation due to pressing on CN
Ix for acoustic schwannoma
MRI
Hearing tests
Treatment acoustic Schwannoma
Watchful waiting
Surgery
What is Meniere’s disease
Rare condition of ear characterised by episodes of vertigo and tinnitus
Triad of Meniere’s Disease
Vertigo
Tinitus
Sensorineural hearing loss
How does Meniere’s disease present
As attacks of dizziness and ringing in ears
Ix Meniere’s
Hearing tests
Clinical diagnosis
Rx during meniere’s attack
Cinnarizine
Rx preventative meniere’s
Betahistine
Why can intratympanic gentamicin be used to treat meniere’s
Damages the nerve endings on the middle ear
What causes benign paroxysmal positional vertigo
Otoconia in semi-circular canals
Should normally be found in ampulla
Ix for benign paroxysmal positional vetgio
Dix-Hallpike Manoeuvre
Rx benign paroxysmal positional vertigo
Epley manouvere
Moves particles into another compartment of the ear
What is vestibular neuritis
Infection of vestibular nerve of inner ear
Symptoms and signs vestibular neuritis
Dizziness
Vertigo
Nystagmus
Vomiting
Rx vestibular neuritis
Steroids
Antiemetics
Antibiotics