ENT Flashcards
Lower pitched sound lost more (female easier to hear)
Conductive Hearing Loss
Tinnitus
FH
Otosclerosis
(Squamous epithelial cells) - white debris/crust
Foul discharge, unilateral conductive HL
Vertigo, pain, FN Palsy
Cholesteatoma
Webers louder in affected ear. BC>AC(abnormal Rinnes)
conductive
Webers louder in normal ear (Rinne positive
sensorineural HL
Mx sudden onset sensorineural hL
referred to ENT - treated with high dose oral corticosteroids. MRI usually done to exclude vest schwannoma.
SN HL
High pitched sounds lost first
Presbycusis
meds that cause HL (mostly SN) - ototoxic
loop diuretics, aminoglycosides (gentamicin), chemo drugs (cisplatin). Tend to be SN
Mx otitis media
More in children after URTI
Delay Abc 48-72hrs
(only give Abx to perf tympanic membrane if it occurred after otitis media)
Otitis externa - what Bactria is it usually and mx
More in adults, freq swimmer
Itch/pain
Usually pseudomons (can be staph aureus)
Clean with drops, topical ear drops (ciprofloxacin) +/- dexamethasone
cholesteatoma
Peripheral vs central vertigo
Peripheral Vertigo - Sudden onset, short, often HL/tinnitus, intact coordination, more severe nausea
Central Vertigo - Gradual onset, persistent, usually no HL/T, impaired coordination, mild nausea
Dizziness Triggered by movement. No HL/Tinnitus
dx, mx
BPPV
Dix Hallpike to Dx
Epley is Mx
HL, Tinnitus, vertigo, fullness in ear
Not ass with movement
Spontaneous nystagmus
Menieres D
Betahistine
Acute vestibular neuritis vs
Labyrinthitis and mx of each
AVN - no HL
vest rehab and antiemetics
Labyrinthitis - HL
Prochlorperazine in acute phase only
Both in HINTs exam - eyes saccade.
Elderly patient, dizziness on extension of neck
vertebrobasilar ischaemia
Unilateral sensorineural HL
Unilateral Tinnitus
Dizzy/imbalane
Sensation fullness in ear
FN palsy
Acoustic neuroma
Bilat NF T2
Acute and preventative tx for vestibular migraine
Visual aura + headaches. Triggers
Acute = triptans
Prevent = propranolol/ topiramate/amitriptyline
lump
Upper Ant triangle, pulsatile, painless, bruit. Move side to side but not up and down
carotid body tumour
lump
Mobile, non tender, soft, fluctuant
Move up and down with movement of tongue
Midline
Mor ein <20
Thyroglossal cyst
lump
congenital, mostly LHS at birth
cystic hygroma
lump
Ant to SCM (lateral), oval/round, soft, mobile
Benign, unilateral
Acellular fluid with cholesterol crystals
branchial cyst
lump
Older men, usually not seen but if they are then large midline lump
Gurgles on palpitation
DYsphagia, regurg, chronic cough, halitosis
pharyngeal pouch
UMN vs two types lMN facial nerve palsy
umm = forehead spared -stroke
LMN - forehead affected
-Bells palsy = unila LMN FN Palsy. If <72hrs then prednisolone and lubricating eye drops
- Ramsay Hunt = Unilat LMN FNP. Painful vesicular rash around ear. Oral Prednisolone and aciclovir
Epistaxis mx
Pinch at least 20mins - if successful then antiseptic to decrease crusting
packing/cautery (if source visible)
Haem unstable - admit
All failed = sphenopalatine ligation in theatre
