Head and Neck Pathology Flashcards
Define otitis externa.
- infection of the external ear canal which is usually bacterial, but may be fungal
List symptoms of otitis externa.
- discharge
- itch
- pain
- eventual hearing loss
How would you investigate otitis externa/media?
- clinically with an otoscope
How would you treat otitis externa?
- topical antibiotics/antifungals
Define otitis media.
- infection of the middle ear due to pathogens coming from the upper respiratory tract via the eustachian tube
Name three common pathogens associated with otitis media.
- RSV
- strep. pneumoniae
- haemophillus influenzae
List symptoms of otitis media.
- otalgia
- hearing loss
- discharge
- TM perforation
- cloudy, red and swollen TM
How would you treat otitis media?
- NSAIDs
- amoxicillin if >72hrs
Define cholesteatoma
- keratinising squamous epithelium within the middle ear cleft
Name two causes of cholesteatoma.
- congenital
- due to infection
List symptoms of cholesteatoma.
- foul smelling ear
- discharge
- hearing loss
- otalgia
- balance distruption
How would you investigate cholesteatoma?
- clinically with an otoscope
How do you treat cholesteatoma?
- surgery
Define otitis media with effusion.
- inflammation in the middle ear not associated with infection
- secretions produced by the mucosa build up
List symptoms of otitis media with effusion.
- hearing loss
- dull TM
- loss of light reflex
How would you treat otitis media with effusion?
- grommet
Define otosclerosis.
- new bony deposits are layed down within the stapes footplate
- the stapes becomes fixed to the oval window, impairments movement of the stapes and so there’s reduced conduction
Give the typical presentation of otosclerosis.
- conductive hearing loss
- usually 20-30 years
- normal looking TM
How would you investigate otosclerosis?
- audiometry
- tympanometry
How would you treat otosclerosis?
- surgery
- hearing aids
Define presbycusis.
- a degenerative disorder of the cochlea
List the symptoms of presbycusis.
- gradual onset hearing loss
- higher frequencies are lost first
How would you treat presbycusis?
- a high-frequency hearing aid
Describe benign paroxysmal positional vertigo.
- neurological balance problem
- otoliths are dislodged into semi-circular canals, stimulating hair cells, making them stop/start on head movements
Define benign paroxysmal positional vertigo.
- positional vertigo that lasts <1 minute and becomes less severe on repeated movements
How would you investigate benign paroxysmal positional vertigo?
- the Dix-Hallpike manoeuvre
How would you treat benign paroxysmal positional vertigo?
- the Eppley manoeuvre
Define vestibular neuronitis.
- inflammation of the inner ear
List symptoms of vestibular neuronitis.
- vertigo
- vomiting
- hearing loss
- tinnitus
How would you treat vestibular neuronitis?
- gaze stability exercises
- habituation exercises
- functional retraining
Define Meniere’s disease.
- an increase in endolymphatic fluid in the inner ear, causing increased pressure in the labyrinth
List symptoms of Meniere’s disease.
- low-frequency sensorineural hearing loss
- the feeling of fullness in the affected ear
- loss of balance
- tinnitus
- vomiting
- dizziness
How would you treat Meniere’s disease?
- vestibular sedatives during an attack
- chemical labyrinthectomy
Define quinsy.
- a collection of pus outside the capsule of the tonsil usually caused by untreated bacterial tonsilitis
List symptoms of quinsy.
- pain
- odynophagia
- fever
- malaise
- deviated uvula
How would you treat quinsy?
- tonsillectomy
- antibiotics
Define a pharyngeal pouch.
- herniation of the mucosa through the inferior pharyngeal constrictor muscles