Ear pathology

Question 1

What is a cholesteatoma

Answer 1

presence of abnormal keratin producing squamous epithelium in the middle ear
it is a non-cancerous growth but can be locally invasive

Question 2

symptoms + signs of a cholesteatoma

Answer 2

CHL
foul smelling discharge
painful
locally invasive - nerve palsy, ossicles, mastoid
superimposed infection
keratotic lump at pars tensa / flaccida
keratinised mass at middle ear or mastoid - pearly white mass

Question 3

Management of cholesteatoma

Answer 3

surgical excision

Question 4

what is a vestibular schwannoma also known as

Answer 4

acoustic neuroma

Question 5

what is a vestibular schwannoma

Answer 5

benign growth of the Schwann cells in the vestibular portion of CN VIII

Question 6

symptoms and signs of vestibular schwannoma

Answer 6

retrocochlear SNHL
tinnitus 
facial palsy 
vertigo 
(more depending on level of local invasion)
taste disturbance - CNVII 
facial numbness - CNV

Question 7

investigations for vestibular schwannoma

Answer 7

audiogram

MRI

Question 8

management options for vestibular schwannoma

Answer 8

conservative
microsurgery
sterotactic radiotherapy

Question 9

if a patient has bilateral acoustic neuromas, what condition might they have

Answer 9

Neurofibromatosis type 2

Question 10

what is acute otitis media

Answer 10

inflammation / infection of the middle ear

Question 11

what is otitis externa

Answer 11

inflammation / infection of the outer ear

Question 12

RF for cholesteatoma

Answer 12

background of chronic otitis media with tympanic membrane perforation

Question 13

where do the majority of acoustic neuromas form

Answer 13

cerebellopontine angle

Question 14

how long must a child have demonstrable middle ear effusions before being diagnosed with chronic otitis media with effusion?

Answer 14

3 months