ENT buzzwords

Question 1

Cholesteatoma

Answer 1

Rinne result: Bone conduction > air conduction in affected ear, Air conduction > bone conduction in unaffected ear
Weber result: Lateralises to affected ear

Question 2

What drugs can cause tinnitus?

Answer 2

antimalarial, Loop diuretics, Aspirin and other NSAIDs taken in high doses can cause tinnitus

Question 3

Rotatory nystagmus

Answer 3

Rotatory nystagmus is indicative of a positive Dix-Hallpike manoeuvre

Question 4

pain on palpation of the tragus, itching, discharge and hearing loss

Answer 4

Otitis Externa

Question 5

Unilateral polyps are a red flag symptom for what?

Answer 5

nasopharyngeal cancer and therefore warrant an urgent referral to ENT.

Question 6

Brandt-Daroff exercises

Answer 6

Brandt-Daroff exercises can be performed by the patient at home to treat BPPV

Question 7

Dix-Hallpike

Answer 7

The Dix-Hallpike manoeuvre is used to diagnose BPPV. In patients with BPPV, this manoeuvre provokes vertigo and torsional upbeating nystagmus following a short latent period (5 to 20 seconds). They should resolve within 1 minute if the patient’s position is not changed.

Question 8

presents with sudden vertigo and hearing can be affected. A viral infection often precedes its presentation

Answer 8

Viral labyrinthitis

Question 9

first line antibiotic for tonsillitis

Answer 9

Phenoxymethylpenicillin

Question 10

Auricular haematomas

Answer 10

Need urgent ENT referral

Question 11

Ramsay-Hunt syndrome

Answer 11

Ramsay-Hunt syndrome is shingles affecting the facial nerve. This results in ear pain, vesicles in the external ear canal associated with vertigo and deafness.

Question 12

Haemorrhage 5-10 days after tonsillectomy

Answer 12

commonly associated with a wound infection and should therefore be treated with antibiotics

Question 13

common cause of bacterial otitis media

Answer 13

Haemophilus influenzae

Question 14

contraindication to having a cochlear implant

Answer 14

Chronic infective otitis media

Question 15

acute epiglottitis infective organism?

Answer 15

Haemophilus influenzae

Question 16

Elderly patient dizzy on extending neck

Answer 16

vertebrobasilar ischaemia

Question 17

cranial nerves affected in vestibular schwannomas

Answer 17

Vertigo and unilateral hearing loss indicating CN VIII involvement

Absent corneal reflex indicating CN V involvement

Unilateral facial numbness indicating CN VII involvement

Question 18

Features can be predicted by the affected cranial nerves
cranial nerve VIII: hearing loss, vertigo, tinnitus
cranial nerve V: absent corneal reflex
cranial nerve VII: facial palsy

Answer 18

Acoustic Neuroma

Question 19

Distinguishing between viral labyrinthitis and vestibular neuronitis

Answer 19

Unaffected hearing distinguishes vestibular neuronitis from labyrinthitis

Question 20

Mastoiditis Symptoms?

Answer 20

otalgia: severe, classically behind the ear
there may be a history of recurrent otitis media
fever
the patient is typically very unwell
swelling, erythema and tenderness over the mastoid process
the external ear may protrude forwards
ear discharge may be present if the eardrum has perforated

Question 21

Management of mastoiditis?

Answer 21

IV antibiotics

Question 22

Management of acute otitis media with perforation?

Answer 22

Oral antibiotics