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Neuro and Special Senses > ENT > Flashcards

ENT Flashcards

1
Q

What is Otitis Externa?

A

Inflammation of the skin lining the ear canal

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2
Q

Which types of organisms can cause otitis externa?

A

Bacterial

Fungal

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3
Q

How does Otitis Externa present?

A

Painful ear
Discharge
History of itchy ear
Muffled hearing

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4
Q

Which patients are vulnerable to Malignant Otitis Externa?

A

Diabetics and Immunocompromised patients

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5
Q

What is Malignant Otitis Externa?

A

Infection of the outer ear spreads from soft tissue of the ear to the bone

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6
Q

How does Malignant Otitis Externa present?

A

Chronic ear pain despite topical treatment

Deep=seated severe ear pain

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7
Q

What is the recommended management steps of confirmed Otitis Externa

A 
Topical Empirical ear drops
Swab of discharge
Microsuction of Pus/Debris
Wick if severe infection to hold canal open and allow for drainage
Topical antifungals if fungal
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8
Q

How should malignant otitis externa be managed?

A

IV Abx with extended topical treatment

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9
Q

What is Otitis Media with Effusion?

A

Fluid in the middle ear combined with an intact tympanic membrane

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10
Q

What causes Otitis Media with Effusion?

A

Eustachian Tube Dysfunction

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11
Q

What is a potentially serious cause of Otitis Media with Effusion in adults?

A

Nasal Space Tumours

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12
Q

How does Otitis Media with Effusion present?

A

Middle ear effusion

Conductive hearing loss

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13
Q

Which investigations can be used to assess hearing?

A

Tympanogram

Pure Tone Audiogram

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14
Q

How should Otitis Media with Effusion be managed?

A

Conservative
Hearing aid
Surgery - Grommets +/- Adenoidectomy if severe

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15
Q

What is Otosclerosis?

A

Condition where the bones of the middle ear fuse, and mature bone is replaced with woven bone

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16
Q

How does Otosclerosis present?

A

Progressive hearing loss
Tinnitus
Improved hearing in noisy surroundings early on
FHx of Otosclerosis

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17
Q

How may Otosclerosis appear on Otoscopy?

A

Normal

Pink hue to tympanic membrane - Schwartze’s

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18
Q

What is Schwartze’s sign?

A

Pink hue visible on tympanic membrane, suggests Otosclerosis

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19
Q

How can Otosclerosis be managed?

A

Hearing Aid

Stapedectomy

20
Q

What is acute Otitis Media?

A

Middle ear infection often secondary to Eustachian tube dysfunction. Common in children

21
Q

What are some common causative organisms of acute Otitis Media?

A

Strep. Pneumoniae
H. Influenza
Moraxella

22
Q

How does acute otitis media present?

A

Ear pain - Child may pull at ear

Discharge - Increased middle ear pressure leads to tympanic perforation

23
Q

How can acute otitis media be managed?

A

Conservative - Analgesia

Medical - Abx if severe

24
Q

How can recurrent acute otitis media be managed?

A

Insertion of Grommets can help to alleviate the problem

25
Q

How can active Chronic Otitis Media Present?

A

Mucosal - Tympanic Membrane Perforation and Discharge

Squamous - Formation of a Cholesteatoma

26
Q

How can inactive Chronic Otitis Media Present?

A

Mucosal - Tympanic Membrane Perforation but no discharge

Squamous - Retraction pocket within ear that may become Cholesteatoma

27
Q

How should a Cholesteatoma secondary to Chronic Otitis Media be managed?

A

Mastoidectomy and Clearance

28
Q

How should Chronic Otitis Media without a Cholesteatoma be managed?

A

Medical - Topical Abx, Aural Toilet

Surgical - Repair of Perforation

29
Q

What are some potential complications of mastoid surgery?

A 
Facial Nerve Palsy
Altered taste due to Chordi Tympani nerve damage
CSF leak
Tinnitus
Vertigo
Complete hearing loss in affected ear
30
Q

What is Vertigo?

A

Hallucination of movement due to Vestibular System dysfunction

31
Q

What are some central causes of vertigo?

A 
Stroke
Migraine
Neoplasm
Demyelination
Drugs
32
Q

What are some peripheral causes of vertigo?

A

BPPV
Meniere’s Disease
Vestibular Neuronitis

33
Q

What is BPPV?

A

Transient vertigo associated with particular head movements

34
Q

What causes BPPV?

A

Otoliths in the semicircular canal cause abnormal stimulation of hair cells giving the illusion of movement

35
Q

Which test is used to screen for BPPV?

A

Dix-Hallpike

36
Q

Which maneuvre is used to treat BPPV?

A

Epley

37
Q

What is Meniere’s disease?

A

Increased fluid within the endolymphatic compartment of the ear gives vertigo like symptoms

38
Q

How can Meniere’s disease present?

A

Tinnitus of affected ear
Episodic vertigo associated with N+V
Fluctuating sensorineural hearing loss which can become permanent
Aural fullness

39
Q

Why does Meniere’s naturally improve over time?

A

Eventually Meniere’s “burns out” so the patient is left without vertigo, just with the permanent sensorineural hearing loss

40
Q

Which dietary changes can help to reduce symptoms of Meniere’s disease?

A 
Reduction in the amount of:
Salt
Chocolate
Alcohol
Caffeine
Chinese Food
41
Q

Which medical management options are available for Meniere’s disease?

A

Thiazide diuretic
Beta Histine
Vestibular Sedatives - Prochlorperazine for attacks

42
Q

Which surgical management options are available for Meniere’s disease?

A 
Grommet insertion
Dexamethasone middle ear injection
Endolymphatic sac decompression
Vestibular destruction with Gentamicin injection
Surgical labyrinthectomy
43
Q

What is Vestibular Neuronitis?

A

Inflammation of the inner ear giving incapacitating vertigo lasting several days

44
Q

How does Vestibular Neuronitis present?

A

Horizontal Nystagmus

45
Q

How can Vestibular Neuronitis be managed?

A

Vestibular Sedatives
IV Fluids if needed
Vestibular Rehabilitation

Neuro and Special Senses (5 decks)

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