ENT - Ears Flashcards
what is presbyacusis?
age related SN hearing loss
features of presbyacusis?
gradual
high frequency lost first
worse when background noise present
audiogram of presbyacusis?
high Hz affected
no air bone difference
what are the classifications of tinnitus?
objective / subjective
pulsatile / clicking / high pitch/ low pitch
unilateral / bilateral
causes of clicking tinnitus?
contraction of tensory tympani/tensor veli palatini
TMJ
what are the causes of tinnitus?
conductive
sensorineural
central
Ix for tinnitus?
audiometry
Rinnes
Webbers
tympanometry
what is rinnes? results?
place behind ear
positive is louder in air than bone
conductive means louder in bone
what is webers? results?
place in central forehead
conductive heard loudest in affected air
SN is louder in unaffected ear
what is otosclerosis?
autosomal dom cause of hearing loss
features of otosclerosis?
adult hearing loss
worsened by preg/menopause/menstruation
conductive hearing loss
tinnitus
pathology of otosclerosis?
new bone formation fixes the stapes footplace
Ix for otosclerosis?
audiometry has carhart notch
air to bone conductive difference
CT
Tx for otosclerosis?
hearing aids
piston insertion
cochlear implant
risk factors for otitis externa?
swimming
allergy
DM
features of otitis externa?
otorrhoea tender ear swollen/obstructed EAC decreased hearing itch fullness child may pull ear pain
causes of otitis externa?
pseudomonas
staph
eczema
aspergillus
candida
Tx for otitis externa?
painkillers
cleaning and warm compress
acetic acid
sofradex eardrops
clotrimazole gel if funal
what happens in malignant otitis externa?
temporal bone destruction and base of skull osteomyelitis for ear infection
features of malignant otitis externa? who gets it?
persistent ear pain and fullness
pain out of proportion
DM
immunocompromised
Ix and Tx for malignant otitis externa?
CT
debride and Abx
features of TMJ dysfunction?
clicking facial pain earache headache masticatory muscle tenderness
Tx for TMJ dysfunction?
analgesia
avoidance
physio
CBT
what commonly causes acute otitis media?
viral: rhino adeno parainfluenza corona
bacterial: pneumococcus haemophilus strep moraxella
features of acute otitis media?
otalgia Hx of URTI fever otorrhoea (purulent) pain can subside once eardrum bursts vomiting ear pulling
features of acute otitis media on otoscopy?
red TM
bulging
tear with discharge
Tx for acute otitis media?
analgesia
Abx if:
<2 years and bilateral
bulging membrane + symptoms
otorrhoea
amox or clarithro
what causes OME?
inflam of middle ear, which causes accumulation of fluid, with no acute signs of inflam
risk factors for OME?
big adenoids boys recurrent URTI recurrent AOM smoking bottle fed
features of OME?
conductive deafness inattention poor language balance problems no otalgia
Ix for OME and results?
otoscopy: TM retracted reduced mobility grey dull/yellow fluid line
audiometry (conductive)
tympanometry (flat tracing: Type A)
Tx for OME?
watch over 3 months
if > and delay -> grommets ± adenoid removal
what happens in chronic otitis media?
ear with a perforated TM in the setting of recurrent infections
risk factors for chronic otitis media?
smoker asthma URTI increased BMI GORD
what are the types of chronic otitis media?
benign chronic serous (straw coloured fluid) chronic suppurative (purulent)
Tx for chronic otitis media?
Abx
aural cleaning
myringoplasty
what are those with chronic otitis media at risk of? why?
cholesteatoma
retraction pocket can form due to low middle ear pressure
can form here
what is a cholesteatoma?
presence of keratinising squamous epithelium within the middle ear or temporal bone
features of a cholesteatoma?
hearing loss foul discharge tinnitus otalgia altered taste vertigo facial nerve weakness dizziness
Ix for cholesteatoma?
otoscocopy
CT
risk factors for cholesteatoma?
chronic OM
surgery
trauma
congenital abnormalities
what drugs can cause irreversible hearing loss?
gentamicin
cisplatin
what drugs can cause tinnitus?
NSAIDs
furosemide
quinines
