ENT buzzwords Flashcards
Cholesteatoma
Rinne result: Bone conduction > air conduction in affected ear, Air conduction > bone conduction in unaffected ear
Weber result: Lateralises to affected ear
What drugs can cause tinnitus?
antimalarial, Loop diuretics, Aspirin and other NSAIDs taken in high doses can cause tinnitus
Rotatory nystagmus
Rotatory nystagmus is indicative of a positive Dix-Hallpike manoeuvre
pain on palpation of the tragus, itching, discharge and hearing loss
Otitis Externa
Unilateral polyps are a red flag symptom for what?
nasopharyngeal cancer and therefore warrant an urgent referral to ENT.
Brandt-Daroff exercises
Brandt-Daroff exercises can be performed by the patient at home to treat BPPV
Dix-Hallpike
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.
presents with sudden vertigo and hearing can be affected. A viral infection often precedes its presentation
Viral labyrinthitis
first line antibiotic for tonsillitis
Phenoxymethylpenicillin
Auricular haematomas
Need urgent ENT referral
Ramsay-Hunt syndrome
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.
Haemorrhage 5-10 days after tonsillectomy
commonly associated with a wound infection and should therefore be treated with antibiotics
common cause of bacterial otitis media
Haemophilus influenzae
contraindication to having a cochlear implant
Chronic infective otitis media
acute epiglottitis infective organism?
Haemophilus influenzae
Elderly patient dizzy on extending neck
vertebrobasilar ischaemia
cranial nerves affected in vestibular schwannomas
Vertigo and unilateral hearing loss indicating CN VIII involvement
Absent corneal reflex indicating CN V involvement
Unilateral facial numbness indicating CN VII involvement
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
Acoustic Neuroma
Distinguishing between viral labyrinthitis and vestibular neuronitis
Unaffected hearing distinguishes vestibular neuronitis from labyrinthitis
Mastoiditis Symptoms?
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
Management of mastoiditis?
IV antibiotics
Management of acute otitis media with perforation?
Oral antibiotics
