ENT Flashcards
What is the role of the semicircular canals
Sensing head movement - the vestibular system
What is the function of the cochlea
Converting the sound vibration into a nervous signal
Management of sudden onset hearing loss Occurring within 72 hours
Urgent need refer to ENT
How is sudden onset sensory neural hearing loss treated
high dose cortical steroids
Weber’s test results in sensorineural hearing loss
Sound will be Louder in the normal ear as a normal ear it’s better sensing the sound
The Web is test results in conductive hearing loss
The sound is louder in the affected ear because the affected ear becomes more sensitive
rinne positive
Air conduction is better than born conduction which is normal
When bone conduction is better than air conduction this suggests
A conductive cause for the hearing loss
What are the causes of sensory neural hearing loss
Sudden sensorineural hearing loss (over less than 72 hours)
Presbycusis (age-related)
Noise exposure
Ménière’s disease
acoustic neuroma
Which three common medications can cause sensorineural hearing loss
Loop diuretics (e.g., furosemide)
Aminoglycoside antibiotics (e.g., gentamicin)
Chemotherapy drugs (e.g., cisplatin)
What are the causes of conductive hearing loss
Ear wax (or something else blocking the canal)
Infection (e.g., otitis media or otitis externa)
Fluid in the middle ear (effusion)
Eustachian tube dysfunction
Perforated tympanic membrane
Otosclerosis
Cholesteatoma
Exostoses
Tumours
rinne and weber results table
image
audiogram interpretation
Anything below 20dB is abnormal (i.e. bad)
A significant difference between AC and BC is >10dB (this is what was taught at our med school)
- Sensorineural = both AC and BC bad with no significant difference between them
- Conductive = AC bad, BC normal, significant difference between
- Mixed = AC bad, BC bad, significant difference between
Presbycusis =
Age-related sensor renewal hearing loss. Affects high pitch sounds first
key rf for presbycusis
Exposure to loud noise over time
Pres of presbycuis
> Speech becoming difficult to understand
Need for increased volume on the television or radio
Difficulty using the telephone
Loss of directionality of sound
Worsening of symptoms in noisy environments
Hyperacusis: Heightened sensitivity to certain frequencies of sound (Less common)
Tinnitus (Uncommon)
diagnosing presbycusis
> audiometry - worse hearing at higher freq, SN pattern
Audiometry: Bilateral sensorineural pattern hearing loss
management of presbycuis
> Hearing aids -> Cochlear implants if not sufficient
causes of SSHL
> 90% are idiopathic
Acoustic neuroma, Ménière’s disease, MS, migraine
Investigations for SSHL
> Audiometry - A diagnosis of SSNHL requires a loss of at least 30 decibels in three consecutive frequencies on an audiogram.
MRI or CT head to exclude a stroke or acoustic neuroma
Presentation of Eustation tube dysfunction
> Reduced hearing
‘popping noises
Fullness sensation in the ear
Symptoms tend to get worse when the external air pressure changes in the middle ear cannot equalize for example flying climbing scuba diving
Most cases of et dysfunction resolve rapidly but in the case of persistent symptoms investigations can be done such as
Tympanometry - measuring air pressure differences
Audiometry
Nasopharyngoscopy
Treatment of ET dysfunction
> no Mx
Valsaba maneuver Deep congestion nasal sprays short term only
Surgery for severe cases
Inheritance of otosclerosis
auto dominant