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CP2 - ENT > Ears - Hearing Loss, Tinnitis and Facial Palsies > Flashcards

Ears - Hearing Loss, Tinnitis and Facial Palsies Flashcards

1
Q

Causes of inner ear damage (2)

A

Sudden acoustic drainage

Prolonged exposure to XS noise –> cochlear fatigue

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2
Q

What is presbycusis caused by

A

Progressive atrophy to larbryinth and cochlear nn

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3
Q

Mx presbycusis

A

No cure :(

Hearing aids

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4
Q

What type of HL is NIHL

A

Mostly SNHL

But also conductive due to ™ trauma

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5
Q

Sx NIHL

A

Tinnitus

4KHz dip

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6
Q

Mx NIHL (3)

A

Supportive
tinnitus counselling
Hearing aids

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7
Q

What is otosclerosis

A

Disease of the otic capsule and bony labryinth

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8
Q

How does otosclerosis lead to CHL

A

Bony outgrowth –> footplate stapes –> fixation

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9
Q

How dose otosclerosis lead to SNHL

A

Hard bone –> spongy bone –> toxins –> cochlea

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10
Q

RF otosclerosis

A

FHx

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11
Q

What age does otosclerosis occur

A

Begins c. 30

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12
Q

Sx otosclerosis

A

Bilateral HL

Paracusis wissi

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13
Q

What is paracusis wissi

A

Hearing better in background noise

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14
Q

Diagnosis otosclerosis

A

Tympanometry

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15
Q

Tx otosclerosis (3)

A

Observe
Hearing aids
Stapedectomy

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16
Q

Drugs causing ototoxicity (4)

A

Salicylates
Aspirin
Gentamicin
Furosemide

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17
Q

Def tinnitus

A

Perception of noise in absence of external stimuli

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18
Q

Objective tinnitus

A

Vascular origin - bruit

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19
Q

Subjective tinnitus

A

Aural hallucination, outer hair cell activation

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20
Q

Causes of pulsatile tinnitus (4)

A

Bruits
Anaemia
AV malformation
Hyperthyroidism

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21
Q

Causes of non pulsatile tinnitus (4)

A

Otosclerosis
Head injury
Meniere’s
Presbycusis

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22
Q

Mx tinnitus

A 
Explanation of what it is 
Reassure 
Sound enrichment 
Hearing aids
Tinnitus masker 
Tinnitus retraining therapy
23
Q

What is a vestibular schwanoma

A

Benign slow growing tumour of the ear

24
Q

Sx vestibular schwanoma (4)

A

Unilateral hearing loss
TInnitus
Vertigo
Absent corneal reflex

25
Q

When vestibular schwanomas are bilateral, what are they associated with

A

NFM-2

26
Q

Diagnosis vestibular schwanoma

A

MRI

27
Q

Pathway of the facial nn

A

From between the pons + medulla –> IAM –> facial canal –> temporal bone –> geniculate ganglion –> petrosal nn –> lacrimal glands
Branches –> chordi tympani + post auricular nn

28
Q

Fct of chordi tympani (2)

A

Anterior ⅔ taste

nn stapedius

29
Q

Fct post auricular nn (3)

A

EAM
T M
Pinna (sensory)

30
Q

What are the 5 motor branches of the facial nn

A 
Two zebras buggered my cat 
Temporal 
Zygomatic 
Buccal
Marginal Mandibular 
Cervical
31
Q

Causes of facial palsy - idiopathic

A

Bells palsy

32
Q

Causes of facial palsy - trauma (2)

A 
Iatrogenic injury (surgery) 
Temporal bone fracture
33
Q

Causes of facial palsy - neoplastic (2)

A

Malignant parotid tumour

Temporal bone tumour

34
Q

Causes of facial palsy - congenital (6)

A 
= CHARGE
Coloboma heart 
Heart defects
Atresia of choana 
Retardation of growth 
GU abnormalities 
Ear abnormalities/deafness
35
Q

Causes of facial palsy - systemic/inflamm (3)

A

Sarcoidosis
GBS
MS

36
Q

Hx for facial palsy (10)

A 
Lesion - DDx UMN + LMN w/ frontalis sparing 
Onset - congenital/rapid/slow
Severity - complete/incomplete
Other Sx - dry painful eye,  drool, hyperacusis 
Otological Sx 
Neuro Sx 
Parotid disease
Systemic illness
Head,,facial trauma
37
Q

What scale is used for grading facial movements

A

House-Brackman Scale

38
Q

1 on House Brackman scale

A

Normal

39
Q

5 on House Brackman scale

A

Asymmetry at rest

40
Q

Ix Facial palsy (4)

A

PTA
Stapedial reflex
Electroneuronography (specific for Bells palsy)
MRI/CT

41
Q

Important facial pain conditions to exclude - paeds (4)

A

Moeibius syndrome
Forceps delivery
HZV
Acute OM

42
Q

What is Moebius syndrome

A

Bilateral 6/7 nn palsy

43
Q

Important facial pain conditions to exclude - peripheral - adult (4)

A 
Trauma 
Iatrogenic (post gland surgery) 
Tumours - parotid 
Sarcoidosis 
= TITS
44
Q

Imporant facial pain conditions to exclue - middle ear - adult (5)

A 
MANIC
Mastoiditis 
AOM
Acoustic Neuroma
Iatrogenic - mastoid surgery 
Cholesteatoma
45
Q

What are the 2 types of temporal bone fractures

A

Longitudinal
Or
Transverse

46
Q

What type of temporal bone fracture is most serious

A

Transverse

47
Q

What is ramsay hunt syndrome due to

A

HZV reactivation in GG

48
Q

PS Ramsay Hunt syndrome

A

Facial palsy
Auricular pain
Vesicles on T M/ Pinna
Pain so severe + many never recover

49
Q

Mx Ramsay Hunt syndrome

A

Aciclovir

50
Q

What is Bells palsy?

A

Viral infection CN VII

51
Q

What is Bells Palsy preceded by

A

URTI

52
Q

PS Bells Palsy (2)

A

Sudden onset

COmplete hemiparalysis of the face

53
Q

Mx Bells palsy (3)

A

High dose PO pred 7 days
Aciclovir
Artificial tears + night eye patch

54
Q

Prognosis Bells palsy

A

Recovery takes c 2 months

75% make a full recovery :)

CP2 - ENT (13 decks)

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