ENT - Otology

Question 1

What are the 4 principles of treatment for acute otitis externa?

Answer 1

Thorough cleaning
Antiobiotic Therapy
Control inflammation/pain
Behavior modification

Question 2

What nerves can be involved in necrotizing otitis externa? What imaging should be done?

Answer 2

CN VII, X, and XI

CT of temporal bone

Question 3

How does eczematoid otitis externa differ from AOE?

Answer 3

“Preinflammtory” - scaling and edema and otorrhea, can be bilateral
Tx: conservative debriedment and daily steroid creams

Question 4

What are two symptoms required for AOM?

Answer 4

Ear Pain

Hearing loss

Question 5

What is the primary indication for myringotomy with pressure equalization tubes?

Answer 5

Persistent effusion > 3 months

Question 6

If an adult has persistant unilateral middle ear fluid, what else should be inspected? Why?

Answer 6

Nasopharynx - worried about a tumor

Question 7

What is the definition of COM? What is the treatment(4-5)?

Answer 7

Persistant > 6 weeks
Aural hygiene, water protection, drops, systemic antibiotics
(Can reconstruct TM and middle ear - paper patch, simple closure, tympanoplasty, ossicular chain reconstruction)

Question 8

What is unique about otosclerosis on tympanogram? How do you treat it?

Answer 8

Type A - normal
Aka - conduction hearing loss with a type A tympanogram
Hearing air, observation, or stapedectomy

Question 9

Differentiate labyrinthitis from vestibular neuronitis

Answer 9

Labyrinthitis - bacterial invasion into labyrinth - permanent hearing loss from OM or meningitis
Vestibular neuronitis - presumed viral infection, no hearing loss

Question 10

What is exostoses associated with? Where are the protusions?

Answer 10

Cold water swimming

Medial osseous canal

Question 11

What is the difference between primary cholesteatoma primary and secondary?

Answer 11

Primary - invagination of retraction pocket

Secondary - ingrowth through pre-existing TM perforation