H&N WEEK 6 Flashcards
what are auricular haematomas
collection of blood within the cartilaginous auricle which typically results from blunt trauma during sports
management of auricular haematomas
incision and drainage
pressure dressing
antibiotics
complication could be “cauliflower ear”
management of foreign bodies in ear
removal
urgency :
- button battery - within hour
- organic - within days
- inorganic - within weeks
mainly occurs in children
otitis externa
inflammation of external auditory meatus
management of otitis externa
topical
antibiotic/steroid ear drops
+/- suction under microscope - may be needed
prevention - no water or cotton buds - contributing factors
presentation of otitis externa
pain
discharge
itching
and/or hearing loss
malignant otitis externa
osteomyelitis of temporal bone
rare but serious
presentation of malignant otitis externa
severe pain in elderly diabetic
granulations in external auditory meatus
+/- cranial nerve palsies - may spread throughout skull base
management of malignant otitis externa
antibiotics for weeks or months - long term
ciprofloxacin - pseudomonas
few patients may need surgery
otitis media with effusion
sterile fluid in middle ear
“glue ear” - middle ear secretes mucus - sometimes has gluey consistency
presentation of otitis media with effusion (glue ear)
hearing loss - conductive
speech delay
management of otitis media with effusion
observation for 3 months
otovent balloon - child blows up with nose - push air into eustachian tube into middle ear and open eustachiant tube and prevent build up of glue ear
grommet - plastic tube in ear drum - middle ear ventilates through
acute suppurative otitis media
pus in middle ear
presentation of acute suppurative otitis media
otalgia +/- otorrhea
increased pain
discharge when eardrum bursts
resolution of pain
management of acute suppurative otitis media
observation
+/- antibiotics
tympanosclerosis
calicification in tympanic membrane +/- middle ear
presentation of tympanosclerosis
usually asymptomatic
management of tympanosclerosis
usually none
chronic suppurative otitis media
perforated tympanic membrane
cholesteatoma (skin in middle ear +/- mastoid bone)
cholesteatoma
abnormal collection of skin cells deep inside your ear
within temporal bone
rare
if left untreated can damage delicate structures inside ear essential for hearing and balance
can lead to long term discharge from ear
complications of chronic suppurative otitis media
“dead ear”
facial palsy - facial nerve runs through middle ear
meningitis
brain abscess
causes of perforation of tympanic membrane
infection - acute suppurative otitis media
trauma -slap on ear
grommet
presentation of perforation of tympanic membrane
recurrent infections
hearing loss
management of perforation of tympanic membrane
water precautions
+/- mringoplasty
causes of cholesteatoma
eustachian tube dysfunction
impaired skin migration
presentation of cholesteatoma
persistent offensive otorrhea
management of cholesteatoma
mastoidectomy
otosclerosis : presentation
conductive hearing loss - some path you can see
normal tympanic membrane
pathology : otosclerosis
fixation of stapes by extra bone
deposition of new bone where footplate of stapes fits into oval window
reduces movement of stapes footplate causing a conductive hearing loss
management : otosclerosis
hearing aid
stapedectomy
facial nerve palsy : clinical features
lower motor neuron facial palsy (forehead involved)
differential diagnosis of facial nerve palsy
intratemporal eg cholesteatoma
extratemporal eg parotid tumour
idiopathic = Bell’s palsy - diagnosis of exclusion - thought to be viral
management : facial nerve palsy
treat underlying cause (if possible)
steroids
eye care
3 parts of middle ear
malleus (hammer)
incus (anvil)
stapes (stirrup)
middle ear function
amplify sound collected by outer ear
transforms acoustic energy from medium of air to medium of fluid
lever action of ossicular chain
what is main indication for repair of small perforation
recurrent infections
structure of cochlea
hearing mechanism in cochlea
filled with a fluid that moves in response to the vibrations from the oval window
as fluid moves, 25000 nerve endings are set into motion
these transform the vibrations into electrical impulses that then travel along CN VIII (auditory) to the brain
