ENT Flashcards
What is meant by conductive hearing loss?
Failure of sound to be conveyed from the external ear to the inner ear
List common aetiology for conductive hearing loss
Wax Foreign body Otitis externa Eardrum perforation Ossicular damage (otosclerosis)
What is meant by sensorineural hearing loss?
Failure of sound to be transduced from inner ear
List common aetiology for sensorineural hearing loss
Congenital
Ageing (presbycusis)
Meniere’s disease
Vestibular schwannoma
A positive Rinne’s test is a normal finding. True/False?
True
Sound/vibration should be louder over the auditory canal compared to bone conduction
If sound localises to the affected ear in a Weber’s test, what type of hearing loss is this?
Conductive
If sound localises to the unaffected ear in a Weber’s test, what type of hearing loss is this?
Sensorineural
A patient with a +ve Rinne test in both ears and sound localising to the left ear on Weber’s test indicates what type of hearing loss?
Right sensorineural hearing loss
A patient with a +ve Rinne test in the right ear and sound localising to the left ear on Weber’s test indicates what type of hearing loss?
Left conductive hearing loss
Other than Rinne and Weber hearing tests, what other investigations could you do for hearing loss?
Pure tone audiometry
(child normal = 0-15dB, adult normal = 0-20dB)
Tympanogram measures middle ear pressure
(normal = bell-shaped curve)
What is otitis externa?
Inflammation of the skin of the ear canal/external ear
List aetiology/risk factors for otitis externa
Moisture, humidity Swimming Trauma (scratching, cleaning) Absence of wax Narrow ear canal Hearing aids Pseudomonas, Staph aureus
List clinical features of otitis externa
Severe pain, tender pinna and tragus Auricular lymphadenopathy Minimal discharge/debris Swollen ear canal Conductive hearing loss
Outline management of otitis externa
Aural toilet
Topical gentamicin + steroid drops
Strip of ribbon soaked in glycerine-ichthammol/aluminium acetate
What is barotrauma/aerotitis?
Occluded Eustachian tube does not allow middle ear pressure to equalise, particularly during aircraft descent or diving
List clinical features of aerotitis
Severe pain as drum indraws Bleeding Vertigo Tinnitus Deafness
Outline management of aerotitis
Avoid flying with URTI
Nasal decongestants (xylometazoline)
Repeated yawns/swallows/jaw movements
Valsalva maneuvre
List clinical features of TMJ dysfunction
Earache
Facial pain
Joint clicking/popping
Stress, psychological impact
Outline management of TMJ dysfunction
NSAID (diclofenac) Orthodontic prostheses Cognitive behavioural therapy Physiotherapy Acupuncture Surgery
What is otitis media?
Inflammation of the middle ear cavity
List aetiology/risk factors for otitis media
Children Viral Bacterial: H. influenzae, Pneumococcus, Moraxella Blocking of Eustachian tube Preceding URTI Bottle feeding Smoking/passive smoking
List clinical features of otitis media
Acute: rapid onset earache, fever, irritability, vomiting
Chronic: fluid discharge lasting several months
Purulent discharge
Crescendo-decrescendo otalgia
Tender mastoid
Conductive hearing loss
Describe the appearance of the tympanic membrane in otitis media
Bulging, opaque eardrum
Outline management of otitis media
NSAID
Amoxicillin for up to 10 days if unresolving