ENT Flashcards
What are the six cardinal symptoms of the ear?
Otorrhoea Otalgia Hearing loss Dizziness Tinnitus FACIAL WEAKNESS (facial nerve runs through temporal bone)
Pulsatile tinnitus suggests?
Vascular origin
What is at the top part of the tympanic membrane
Chorda tympani branch of facial nerve which runs through
What is the size of the tuning fork you use?
512 tuning fork
What is positive rinne’s test?
Air conduction should be better than bone conduction
Lateralised Weber’s test to the left suggests?
Right sensorineural loss (it’s dead so only the left ear
Left conductive loss
Features of acute otitis media on otoscopy
- TM mobility reduced – Bulging TM – TM – pronounced erythema prominent vessels – Poor mobilty – Change of colour – (red or yellow)
Causes of acute otitis media (specify)
Viral URTI Bacterial: S pneumonia H influence Moraxella catarrhalis
What guidelines are used for ear treatment? What does it suggest for children with ear infections?
SIGN guidelines
Delay antibiotics - actually increases risk of vomiting etc
If no improvement, give a 5 day course of delayed antibiotics
What is recurrent acute otitis media?
3/4 times a month/year (
What do you call it when you put a hole in the ear for recurrent ear infections?
Grommets
Abscess behind ear suggests…?
Mastoiditis
What is another name for otitis externa?
Swimmer’s ear
Treatment of otitis externa
local antibiotics
e.g.
Quinolones
Sofradex
What is cholesteatoma?
Stratified squamous epithelium in the middle ear (normally it’s in the skin of the ear)
Congenital vs acquired cholesteatoma
congenital - no problems (no perforation or ottorhoea) normally besides a bulging in in the TM
Acquired:
Foul smelling discharge
‘Attic’ retraction or perforation (attic = top part of ear drum)
Management of cholesteatoma
Surgery: Tympanoplasty Atticotomy Canal wall up mastoidectomy Canal wall down mastoidectomy
What is another name for glue ear?
Otitis media with effusion
What is glue ear?
Effusion in ear with the absence of infection
Note: this is normal but for some it stays for longer
Epidemiology of glue ear
younger than 6 years, boys
Name another ear test besides otoscopy
Tympanogram which looks at teh movement of teh ear drum (if there’s stuff behind it, it wouldn’t move)
Why do you get glue ear?
Cilia in ear doesn’t work so well, plus the eustachian tube doesn’tw ork as well
What is otovent?
It’s a balloon you inflat in the nose that opens up the eustachian tube and opens up the drainage pathway
Differentiate between acute otitis media and otitis media with effusion
acute otitis media (painful, red bulging ear drum) vs otitis media with effusion (painless, retracted ear drum with thick “glue” behind)
If someone has no sparing of forehead - whole face is weak with one sided drooping, what is the droop
lower motor neuron facial palsy - bell’s palsy
What does the facial nerve supply?
Motor to face also:
Lacrimal gland
taste
submadnibular gland
What is bell’s phenomenon?
The eye moves up when we close it, so in Bell’s palsy, the eyelids don’t close but the eye still goes up so you only see the white of teh eye
Causes of conductive hearing loss
Wax
Hole in ear drum
fluid in ear drum
Otosclerosis
Which bone is affected in otosclerosis
Stapes bone
Management of otosclerosis
Watchful waiting
Hearing aid
Stapedectomy
Differential of cholasteatoma
Perforated ear drum
Tempanosclerosis - scarring of ear drum
Why do you get retraction of the ear drum
bulging is from inflammation and pus produciton in infection, whereas in OME, you get reduced drainage through the Eustachian tube, and all the oxygen eventually gets reabsorbed by middle ear mucosa, reducing pressure and sucking the drum in
