ENT 2 Flashcards
Conductive hearing loss
Outer causes
Middle ear causes
1 outer ear wax/ FB / no eart 2 conductive hearing loss middle Glue ear Perforation of drum Ossicles damaged Cholesteatoma congenital/acquired
Otitis externa causes and treatment
Bacterial. Pain ++ red swollen ext ear and discharge
Treatment keep clean and dry
No perforation chilacam HC lie on side 5-10min
2 fungal no pain
Looks like wet blotting paper
Dry ear tissue spears Kenacomb drops 30min on side
Glue ear OME
80% of preschoolers
90% resolve spontaneously within 3/12
Very common daycare
50% AOM have a glue ear after
Chronic ome
1 conductive hearing loss
2 can cause 2ary changes to the ossicles
3 can damage the drum dull retracted sandpaper’s the ossicles
4 drum retraction can be the precursor to cholestamoma
Glue ear children prone
Down’s syndrome
Cleft palate
Mid face small
More common in winter/ childcare/ family history/URTI
Consequences of Glue ear >3/12 =chronic OME
1 conductive hearing loss ?? Speech delay /?? Behavioral prob
2 structural changes in the ear. Retraction pockets /drum retracted and can effect the ossicles
Possible treatment of chronic OME
1 antibiotics
2 otovent
3 surgery /grommets
Chronic ome flying
Tympanic B good
Tympanic C. Can’t fly
Acute OM
Peaks 6-12/12 and 4-5 years
Bacterial strep and HI and viral
Watch and wait for most
But <2 / cochlear implants/ family not come back / ATSI
Recurrent AOM
Serious complications eg mastoidist
Recurrent OM >3 episodes in 6/12
?Grommets
Perforation of the drum 2ary to AOM
30dB hearing loss If >30dB ? Ossicles damaged Keep clean and observe many fix themselves Myringoplasty Hearing aid
Acute mastoiditis
2ary to AOM
Red and significant sick
Complications brain abcess
2 venous sinus thrombosis
Cholesteatoma
Congenital white pearl behind the drum Acquired Present with chronic persistent ear discharge Conductive hearing loss Scaly skin on the drum can erode the ossicles and into the cochlear Tip of the iceberg Audiogram flat typmpanogram CT scan
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