Exam 2: Pathologies Flashcards
Branchio-oto-renal syndrome (BOR)
- inherited
- kidney problems (sometimes no kidney)
- fistulas, clefts and cysts on the neck
- microtia
- conductive loss due to ossicular abnormality or fixation
- abnormal bone structure can also affect the bony labyrinth and cause issues in the inner ear
Treacher-Collins syndrome
- inherited
- abnormalities on eyelids
- downward slanting eyelids
- underdevelopment of jaw
- cleft palate
- microtia
- atresia
- ossicular malformation or fixation
- conductive hearing loss
Apert Syndrome
- widely spaced eyes
- fused fingers, toes (syndactyly)
- abnormal skull bone fusion (craniosynostosis)
- bone abnormality affects the middle ear structures due to bulging in areas of the skull
- conductive hearing loss
Microtia/Anotia:
-Microtia: small or misshapen pinna
-Anotia: no outer ear, complete absence of auricle
-both of these can occur w/ atresia
-generally the inner ear is intact
-often unilateral
Type of HL: conductive
Sight of lesion: outer/middle
Treatment for aesthetics: prosthetic ears, plastic surgery ear from cartilage/implant
Treatment for hearing: depends if atresia is present. Hearing aid, cochlear, bone conduction hearing aid all options
Atresia:
- lack of ear canal
- can occur w/ microtia/anotia
- often unilateral, leaving patient w/ difficulties with sound localization and hearing speech in loud background
- a baby born w/ bilateral atresia is at severe risk of language delay without intervention
- Type of HL: conductive
- Sight of Lesion: outer/middle
- Treatment: bone conduction hearing aids
Otitis Externa:
-infection of the external ear canal
-caused by several types of common bacteria
-can be fungal as well, which we call otomycosis
-can be dangerous for diabetics if it develops into Malignant Otitis Externa
-can inflame the ear canal, causing obstruction
Type of HL: possibly conductive if inflammatory enough
Sight of Lesion: outer
Treatment: treated w/ medication to fight infection and swelling
Tympanosclerosis:
-white plaques seen on the eardrum usually after repeated middle ear infections or after PE tubes
-plaques caused by deposits of calcium in the tissue (collagen) of the tympanic membrane, but doesn’t usually cause hearing loss
-can sometimes cause ossicles to have restricted movement, creating hearing loss
Type of HL: possibly conductive
Sight of lesion: outer (double check if tymp might be middle)
Treatment: treatment is only required if there is hearing loss: amplification
Eustachian Tube Dysfunction:
-tubes won’t drain, causing pressure problems and suction in middle ear, leading to liquid and infection
-can be caused by inflammatory tissue change in the nasopharynx: adenoiditis, sinusitis, tonsillitis, growth of a mass
Type of HL: ETD alone creates a mild conductive loss at most, but the problems it creates in the middle ear space can create worse issues
Sight of Lesion: middle
Treatment: antibiotics, surgical removal of tonsils or adenoids
Otitis Media (general definition, 3 defining characteristics, type and treatment and all that)
-general term for an inflammation/infection of the middle ear, which can invade the mastoid cavity
Three Main Defining Characteristics:
Fluid Present in Middle Ear
Fluid may or may not be infected
Might be degenerative changes to the tissues of the middle ear
-viscosity of the fluid can be thin and watery (called serous) or thick and glue-like
-wide range of how it can affect the patient’s ear
Type of Hearing Loss: conductive
Sight of Lesion: middle
Treatment: varies, antibiotics can help if infected
Otitis Media With Effusion (OME):
-fluid built up in middle ear without infection
-if untreated/unresolved fluid can thicken and become “glue ear”
Type of Hearing Loss: conductive, slight to mild
Sight of Lesion: middle
Treatment: it can away on its own but if you have another infection in the body that’s causing OME, treating that w/ antibiotics will help
-Common version of OM and one of the most common conditions affecting the auditory systems of children
-2 million episodes annually costing $4billion a year
Acute Otitis Media:
-fluid built up in middle ear is infected
-typically the result of bacterial infection, may not present with the hallmarks of infection (pain, fever, elevated white blood cells, secondary body effects)
-most common predisposing factor: upper respiratory infection
Type of Hearing Loss: conductive, usually mild but can be moderate based on thickness of effusion
Sight of Lesion: Middle
Treatment: analgesics, antibiotics, possibly tubes
Chronic Otitis Media:
-unresolved infection of the middle ear including the mastoid spaces and mucosal lining, with non-intact tympanic membrane and discharge
-an infectious, permanent, progressive, erosive, destructive process
-unchecked erosive infection can lead to damage to the inner ear, facial nerve, and ultimately the brain
-medical management is crucial and involves surgeries to get rid of all the infected tissue
-hearing loss ranges from mild to moderate and is usually conductive but can have a sensorineural component
Type of HL: conductive/possibly mixed, mild to moderate
Sight of Lesion: middle, possibly further in or out
Treatment: surgery to remove infected tissue, antibiotic pills, antibiotic drops
Cholesteatoma/keratoma
-accumulation of dead, exfoliated skin cells from the external canal and lateral surface of the tympanic membrane also referred to as a keratoma
-can form at any perforation site, but it is often seen on the edge of the TM or the upper area of the TM when it is pulled into the middle ear space due to eustachian tube dysfunction
-smooth, white, pearl-like growths that can completely erode the ossicles and erode into the brain cavity
-mild conductive hearing loss, usually treated by surgical removal first and may end up using a hearing aid
Type of HL: conductive, usually mild
Sight of Lesion: often outer or middle
Treatment: usually surgical removal, then possibly hearing aid use
Otosclerosis
-progressive conductive hearing loss that results in fixation of the stapes bone in the oval window
-happens because enzymatic and vascular activity degrade the old bone and the new bone grows different–some call it “spongey”
-typically seen in females in their 3rd decade of life, can be triggered by pregnancy
-exact cause unknown, but it does run in families
-typically bilateral, but severity may differ between ears
-loss ranges from mild to severe and may be treated with surgery to replace the stapes bone with a prosthesis. Some get hearing aids.
Type of HL: conductive, mild to severe
Sight of Lesion: often outer or middle
Treatment: surgery to replace the stapes bone w/ prosthesis, possibly hearing aids
Ossicular Discontinuity:
-ossicular chain disrupted by trauma that causes discontinuity or disruption
-any trauma to the tymp membrane can cause the ossicles to the ossicles, but a closed head injury may also be the cause
-disconnection most frequently occurs at the joint between the incus and the stapes
-loss is conductive in nature and can range from mild to severe
-surgery can reconnect the chain in many cases, but some patients OPT for amplification
Type of Loss: conductive, mild to severe
Sight of Lesion: middle
Treatment: surgery to reconnect, amplification
