ENT

Question 1

Presbyacusis

Answer 1

age-related sensorineural hearing loss
difficulty following conversations
audiometry: bilateral high frequency hearing loss

Question 2

Otosclerosis

Answer 2

autosomal dominant replacement of normal bone by vascular spongy bone, onset 20-40yrs
px: conductive deafness - normally bilateral, tinnitus

Question 3

Glue ear

Answer 3

otitis media with effusion, peaks at 2yrs
px: hearing loss, possible delayed language development
usually clears or treat surgically with grommets to release fluid

Question 4

Meniere’s disease

Answer 4

more common in middle-aged adults

recurrent episodes of vertigo, tinnitus and sensorineural hearing loss, sensation of aural fullness

Question 5

Acoustic neuroma

Answer 5

features can be predicted by the affected cranial nerves:
VIII: unilateral hearing loss, vertigo, tinnitus
V: absent corneal reflex
VII: facial nerve palsy
Risk factors: neurofibromatosis
Ix: MRI
Tx: conservative or surgical

Question 6

Cholesteatoma

Answer 6

lesion within middle ear
progressive conductive hearing loss +/- vertigo, headache or facial nerve palsy
may be foul smelling discharge
treat surgically

Question 7

Ramsey-Hunt syndrome

Answer 7

reactivation of the varicella zoster virus in the seventh cranial nerve
auricular pain, facial nerve palsy, vesicular rash around ear, could have vertigo and tinnitus
manage with oral aciclovir and corticosteroids