ENT !! Flashcards
Otosclerosis
remodelling of the bones of the middle ear
leads to hearing loss and tinnitus
otitis media- presentation, diagnosis and tx
- ear pain, discharge, hearing loss
- Dx- otoscopy- visualise tympanic membrane- look for hole/ discharge
- tx- Abx (amoxicllin), delayed prescription if systematically well
otitis externa- presentation, diagnosis and tx
- ear pain, hearing loss, discharge, itching
- Dx- otoscopy- erythema of the middle ear, discharge, intact tympanic membrane
- Tx- Otmizole ear spray
what is benign paroxysmal positional vertigo
calcium carbonate (otoconia) crystals in the semicircular canals- peripheral cause of vertigo
triggered by movement !!
Episodes last around 1 minute
describe the diagnosis of benign paroxysmal positional vertigo
Dix-Hallpike manoeuvre- moving the patients head to trigger vertigo (due to movement of endolyph and otoconia)
Tx of benign paroxysmal positional vertigo
Epley manoeuvre- similar to dix-hallpike manoeuvre
aims to move crystals in the semicircular canal to a position that does not disrupt endolymph flow
what is Meniere’s disease
excess endolymph in the canals
not associated with movement !!
episodes last from 20 mins to a few hours
triad of Meniere’s disease
hearing loss
vertigo
tinnitus
other sx of meniere’s disease (apart from triad)
‘fullness’ in ear
drop attacks (falls) without LOC
inbalance after episodes
nystagmus
management of Meniere’s disease
maanging Sx- prochloroperazine and antihistamines (cyclizine)
prophylaxis- Betahistine
what is vestibular neuronitis
inflammation of the vestibular nerve
presentation of vestibular neuronitis
- acute onset vertigo
- Hx of URTI
- N&V, balance issues
NO TINNITUS/ HEARING LOSS
tx of vestibular neuronitis
prochloroperazine
what is labyrinthitis
inflammation of the bony labyrinth of the middle ear
presentation of labyrinthitis
vertigo, hearing loss, tinnitus
+ Hx of URTI
Tx of labyrinthitis
prochloroperazine
peripheral causes of vertigo
bening paroxysmal positional vertigo
Meniere’s disease
Labyrinthitis
Vestibular neuronitis
central causes of vertigo
tumour
posterior stroke
MS
Vestibular migraine
what is cholesteatoma
abnormal collection of squamous epithelial cells in the middle ear
presentation of cholesteatoma
foul discharge from ear
unilateral conductive hearing loss
can also develop into pain, vertigo and facial nerve palsy
Dx and Tx of cholesteatoma
CT
surgical removal
what is an acoustic neuroma/ vestibular schwannoma (same thing)
benign tumour of the schwann cells surrounding the auditory (vestibulocochlear) nerve in the inner ear
what are bilateral acoustic neuromas/ vestibular schwannoma’s associated with
neurofibromatosis type 2
presentation of acoustic neuromas/ vestibular schwannoma
unilateral sensorineural hearing loss
unilateral tinnitus
dizziness/ imbalance
fullness in ear
associated with facial nerve palsy (compress it- LMN)
