Ears 2 Flashcards

1
Q

Pt presentation of chronic OM

A

Chronic otorrhea (ear drainage)

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2
Q

2 PE findings for chronic OM

A
  • Perforated TM

- Conductive hearing loss

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3
Q

4 tx options for chronic OM

A
  • Removal of infected debris
  • Earplug use
  • Topical/oral abx
  • Surgery - TM repair
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4
Q

Otitis media w/ effusion is also called?

A

Serous Otitis Media

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5
Q

2 pathophysiologies of serous otitis media

A
  • blocked eustachian tube for prolonged time

- negative pressure causing transudation of fluid into middle ear

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6
Q

Describe eustachian tubes in children

A
  • Narrow

- More horizontal

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7
Q

3 epidemiologies of Serous Otitis Media in adults

A
  • After URI
  • Barotrauma
  • Chronic allergies
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8
Q
  • No acute signs of illness/inflammation
  • Conductive hearing loss
  • Fullness/pressure
A

Clinical presentation of serous OM

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9
Q

PE findings of serous OM

A
  • TM dull
  • TM hypomobile
  • Clear/yellow bubbles
  • Conductive hearing loss
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10
Q

Which ear condition might we consult a speech/ hearing therapist for child?

A

Serous OM

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11
Q

4 tx options for serous OM

A
  • Decongestants
  • Antihistamines
  • Nasal steroids
  • Ventilating tubes
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12
Q

Specific types of chronic OM described as a “sac”

A

Cholesteatoma

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13
Q

Most common cause of cholesteatoma

A

Prolonged eustachian tube dysfunction

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14
Q

Chronic negative middle ear pressure draws in part of TM

A

Etiology of cholesteatoma

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15
Q

Creates a sac lined w/ squamous epithelium- produces keratin

A

Cholesteatoma

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16
Q

Cholesteatoma can get secondarily infected w/ which 2 bacteria?

A
  • pseudomonas

- proteus

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17
Q
  • Asymptomatic
  • Hearing loss
  • Chronic infections w/ otorrhea
A

Presentation of cholesteatoma

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18
Q

PE findings of cholesteatoma

A
  • TM pocket

- TM perforation exuding debris

19
Q

Tx for cholesteatoma

A
  • Abx drops

- Surgical removal (most common - send to ENT)

20
Q

3 complications of cholesteatoma

A
  • Erosion into inner ear
  • Affects facial nerve
  • Brain abscess
21
Q

The eustachian tube connects what to what?

A
  • Middle ear

- Nasopharynx

22
Q

Function of eustachian tube

A

Provide ventilation and drainage for middle ear

23
Q

Is the eustachian tube open or closed?

A
  • Normally closed

- Open during swallowing/yawning

24
Q
  • Edema of tubal lining

- Air trapped in middle ear causing negative pressure

A

Etiology of Eustachian Tube Dysfunction

25
What 2 things can cause ETD?
- Viral URI | - Allergies
26
- Fullness - Fluctuating hearing - Pain w/ pressure change - Popping/crackling sensation
Presentation of ETD
27
PE findings of ETD
- Retracted TM | - Hypomobility (decreased mobility of TM on pneumatic otoscopy)
28
How should a patient manage ETD?
- Avoid air travel (if possible) - Avoid altitude changes - Avoid underwater diving
29
5 tx options for ETD
- Decongestants - Autoinflation (plug nose and blow) - Desensitization therapy (for allergies) - Intranasal corticosteroids - Surgery
30
Complications of ETD
Increased risk of: - serous OM - cholesteatoma
31
Damage to middle ear when you don't have appropriate pressure equalizing
Otic Barotrauma
32
What 3 things cause otic barotrauma?
Inability to equalize pressure exerted on middle ear during: - air travel - rapid altitude change - underwater diving
33
What is a precursor to otic barotrauma?
Poor eustachian tube function due to: - mucosal edema - congenital narrowing
34
A person will experience otic barotrauma during what?
Descent while on airplane
35
Tx options for otic barotrauma
Enhance eustachian tube function by: - decongestants few hours before air travel - topical nasal decongestants 1 hr before descent on plane
36
Patient education for otic barotrauma
- swallow, yawn, autoinflate frequently during descent of plane - equalize pressure during descent phase of underwater diving
37
What causes eustachian tube blockage for otic barotrauma patients?
Negative middle ear pressure, causes collapse of ET
38
Complications divers with otic barotrauma may experience if they do not descend slowly
- hemotympanum | - perilymphatic fistula, rupture of oval window, sensory hearing loss, acute vertigo, vomiting
39
2 complications of otic barotrauma
- TM rupture, which can then lead to OM | - Persistent pressure after landing
40
What 4 things can be done to relieve persistent pressure after landing?
- Decongestants - Autoinflation - Myringotomy - Ventilating PE tubes (pressure equalizing)
41
Small ruptures, less than what % of TM, will close on their own?
25%
42
Large ruptures, more than what % will require tympanoplasty from ENT?
25%
43
If the TM is perforated/ruptured, what should we avoid?
- Water in ear | - Ototoxic ear drops (aminoglycoside abx)