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Clin Med I - ENT > Ears > Flashcards

Ears Flashcards

1
Q

What are the indications to remove cerumen clinically?

A
  • EVERYTHING!
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2
Q

What is ceruminosis?

A
  • excessive buildup of cerumen
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3
Q

What treatments soften the cereumen?

A
  • H2O2/glycerin

- docusate sodium (laxative)

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4
Q

What are the mechanincal type treatments for cerumen?

A
  • curreting
  • irrigation
  • suctioning
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5
Q

_________ complicated by _________ can lead to pericondritis.

A
  • auricular hematoma (cauliflower ear)

- infection

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6
Q

What should be in the ddx list for pericondritis and how do you r/o?

A
  • auricular cellulitis

- lobe is less involved with pericondritis

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7
Q

What are the treatments for pericondritis?

A
  • systemic abx

- I&D

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8
Q

What is otitis externa?

A
  • inflammation of the skin of the external ear canal & surrounding soft tissues
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9
Q

What are some enviornmental causes of otitis externa?

A
  • maceration from loss of cerumen & increased moisture
  • increased pH
  • trauma
  • ear plugs
  • contact dermatitis (neomycin)
  • infection s/p OM with perforation
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10
Q

What are the most common bug causes of otitis externa?

A
  • S. aureus
  • P. aerunginosa
  • yeast is rare
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11
Q

What can occur with otitis externa?

A
  • facial cellulitis
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12
Q

What is the treatment for otitis externa?

A
  • otic drops
  • ear wicks
  • moist heat
  • avoid water in the ear
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13
Q

How can otitis externa be prevented?

A
  • one footed dance
  • 1:1 sol’n vinegar/70% ethyl ETOH before and after water exposure
  • 2% acetic acid drops
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14
Q

What are the classifications of otitis media?

A
  • acute (AOM)
  • with effusion (OME)
  • chronic suppurative
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15
Q

What is AOM?

A
  • acute otitis media

- acute onset of middle ear inflammation AND middle ear effusion (MEE)

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16
Q

How is a MEE determined?

A
  • bulging TM
  • limited or absent mobility of the TM
  • air-fluid level behind the TM
  • otorrhea
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17
Q

Define otorrhea

A
  • fluid leaking from a hole in the TM
18
Q

What are signs and symptoms of middle ear infection?

A
  • TM erythema
  • otalgia
  • bluging TM 2ndary to crying
19
Q

How does OM present?

A
  • fever with otalgia

- disrupted sleep/activity

20
Q

What is the exam for OM?

A
  • pneumatic otoscopy (insuflation)
  • cerumen removal
  • tympanometry
21
Q

What are complications from OM?

A
  • typanosclerosis
  • cholesteatoma
  • TM perforation
  • chronic suppurative OM
  • mastoiditis
  • facial n. paralysis
22
Q

What is the treatment for OM?

A
  • pain management/analgesia
  • watchful waiting
  • abx (1st: amoxicillian 2nd: augmentin)
  • typanocentesis
23
Q

What is the toynbee test?

A
  • closed nose swallowing to generated (-) middle ear pressure
  • pressure changes if TM is intact
24
Q

What is serous otitis media?

A
  • prolonged eustachian tube dysfunction causing (-) pressure builds up transudate in middle ear
25
Q

What is the treatment for serous otitis media?

A
  • PE tubes if MEE lasts longer than 4mo or (B) hearing impairment of 20dB+
26
Q

What are the two types of cholesteatomas?

A
  • central TM perf

- peripheral TM perf

27
Q

What is a central TM perf?

A
  • drainage of purulent fluid from middle ear
28
Q

What is a peripheral TM perf?

A
  • squamous epithelium from auditory canal invade middle ear through perf
  • keratinaceous debris (tumor) forms at site
  • bony errosion
29
Q

What is congenital cholesteotoma and when is it found?

A
  • squamous epithelium trapped in the temporal bone during embryogenesis
  • discovered 6mo-5y/o
30
Q

What is primary acquired cholesteotoma?

A
  • pars flaccida of TM retracts medially over ossicles with their desctuction
  • may erode into the mastoid or lateral semicircular canal
31
Q

What can 2nd type of primary acquired cholesteatomas lead to?

A
  • facial n. exposure
32
Q

What is secondary acquired cholesteotoma?

A
  • occurs 2ndary to TM injury

- squamous epithelium implants in middle ear

33
Q

What are complications from cholesteotomas?

A
  • menigitis
  • brain abscess
  • facial n. paralysis
34
Q

What is the treatment for cholesteotoma?

A
  • refer to ENT for mastoidectomy, myringoplasty, tympanoplasty
35
Q

What is mastoiditis?

A
  • spectrum ranging from mastoid periostium inflammation to bony destruction
  • complication of OM
36
Q

How does mastoiditis present?

A
  • postauricular pain
  • down or outwardly displaced pinna
  • sore
37
Q

What is the treatment for mastoiditis?

A
  • IMMEDIATE ENT REFERRAL
  • myringotomy w/ or w/o PT tubes
  • IV abx
  • cortical mastoidectomy
38
Q

What are common foreign bodies found in adults v. children?

A
  • adults: insects (i.e. cockroaches)

- children: food and small inorganic objects

39
Q

When do children start putting foreign bodies in their ear and why?

A
  • after 9 mo

- pincer grip

40
Q

What are techniques to remove foreign bodies in the ear?

A
  • mechanical extraction/curetting
  • irrigation
  • suction
41
Q

When is irrigation contraindicated for removal of a foreign body in the ear?

A
  • when the item might swell (organic matter)

Clin Med I - ENT (13 decks)

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