ENT 2

Question 1

Conductive hearing loss
Outer causes
Middle ear causes

Answer 1

1 outer ear wax/ FB / no eart
2 conductive hearing loss middle 
Glue ear
Perforation of drum
Ossicles damaged
Cholesteatoma congenital/acquired

Question 2

Otitis externa causes and treatment

Answer 2

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

Question 3

Glue ear OME

Answer 3

80% of preschoolers
90% resolve spontaneously within 3/12
Very common daycare
50% AOM have a glue ear after

Question 4

Chronic ome

Answer 4

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

Question 5

Glue ear children prone

Answer 5

Down’s syndrome
Cleft palate
Mid face small

More common in winter/ childcare/ family history/URTI

Question 6

Consequences of Glue ear >3/12 =chronic OME

Answer 6

1 conductive hearing loss ?? Speech delay /?? Behavioral prob
2 structural changes in the ear. Retraction pockets /drum retracted and can effect the ossicles

Question 7

Possible treatment of chronic OME

Answer 7

1 antibiotics
2 otovent
3 surgery /grommets

Question 8

Chronic ome flying

Answer 8

Tympanic B good

Tympanic C. Can’t fly

Question 9

Acute OM

Answer 9

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

Question 10

Recurrent AOM

Answer 10

Serious complications eg mastoidist
Recurrent OM >3 episodes in 6/12
?Grommets

Question 11

Perforation of the drum 2ary to AOM

Answer 11

30dB hearing loss
If >30dB ? Ossicles damaged 
Keep clean and observe many fix themselves
Myringoplasty 
Hearing aid

Question 12

Acute mastoiditis

Answer 12

2ary to AOM
Red and significant sick
Complications brain abcess
2 venous sinus thrombosis

Question 13

Cholesteatoma

Answer 13

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 

C