Ear Pathology Flashcards
5 types of external ear infection
otitis externa,
malignant otitis externa,
piercing infection,
mastoiditis,
furunculosis - hair cell abscess
pathologies affecting the middle ear
acute OM chronic OM OM with effusion / glue ear cholesteatoma perforated Tympanic membrane (trauma / AOM) otosclerosis blocked eustachian tube
pathologies affecting the inner ear
Vestibular Schwannoma labryrinthitis neuritis Menieres BPPV
what does Battle’s sign show?
it is bruising over the mastoid (behind the pinna)
it shows a base of skull fracture - middle cranial fossa
what can a base of skull fracture cause? (3)
hearing loss - both sensorineural + conductive
facial palsy if CN7 affected
CSF leakage
describe the complications of a cholesteatoma
- direct problems in hearing
- serious complications
the keratinising epithelium can become infected.
this infection can spread in multiple directions within the head, with the capacity to cause
- conductive hearing loss through erosion of the ossicles
- sensorineural hearing loss
- tinnitus
- vertigo
also. ..
- brain abscess
- meningitis
- posterior venous sinus thrombosis
- facial nerve palsy
what is a cholesteatoma?
a collection of abnormal keratinizing epithelium that forms when the TM gets sucked in, forming a pocket.
how can you manage a glue ear?
- initial period
- threshold for Tx
- options
- observation only for 3 months*
- assess if hearing loss is worse than 25dB*
nasal autoinflation with balloon
you can make a hole (m?) in the TM and insert a grommet
you can give temporary hearing aids
high risk / complicated groups of children with glue ear? how are they generally treated?
down’s syndrome - prone and thick glue
cleft lip / palette
straight to specialist. hearing aid
what do swimmers + psoriasis patients + diabetics classically get?
otitis external
itchy skin conditions inc eczema make people itch their ears, leading to trauma + infection
associated Hx with AOM?
history of an URTI
what does “chronic otitis media” encompass? (3)
glue ear (OM with E)
perforation
cholesteatoma
classic presentation of a kid with glue ear
hearing loss
bad behaviour / speech delay
big adenoids causing them to sit with mouths open
name for age related hearing loss?
what freq is lost first?
presbycusis
lose high frequency sounds first
what drugs can cause hearing loss? (3 types)
gentamicin and other aminoglycosides - irreversible
chemotherapy - vincristine, cisplatin
OVERDOSE on aspirin or NSAIDS - may be reversible
what are the presenting features of a vestibular schwannoma?
rate of onset?
hearing loss
tinnitus
balance problems
very slow growing!
what is the classic audiogram for noise-induced hearing loss?
a dip at 4 kHz
classic age for cholesteatoma
younger than you’d think….
5-15 years old
what 2 bacterial commonly cause otitis externa?
how would you treat a mild case of it?
pseudomonas aeuringinosa
staph aureas
topical antibiotics +/- steroid drops
describe the dangers of severe otitis externa and who you’d expect to get it
“malignant” or necrotizing
can cause temporal bone destruction / osteomyelitis of the base of skull
commonly diabetics with pseudomonas
where does Furuncluosis occur and what bacteria causes it?
very painful abscess from the hair follicles within the ear canal
staph aureas
jemma is 14, has bilateral SNHL, tinnitus and balance problems. she gets headaches.
what 2 conditions are you worried about?
young + bilateral symptoms of vestibular schwannoma
so you are worried about Neurofibromatosis type 2, too
a tender cartilaginous inflamed nodule on the upper helix of a builder?
Chondrodermatitis Nodularis Helicis
cause unknown but could be ischaemia / vasoconstriction in cold
what happens in a pinna haematoma?
blunt trauma causes bleeding in the subperichondrial area, causing a haematoma to form in the perichondrium
cartilage ischaemia causes fibrosis –> misshapen –> Cauliflower ear
