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otolaryngology > Hearing Loss > Flashcards

Hearing Loss Flashcards

1
Q

What is a perforated tympanic membrane associated with

A

Acute otitis media

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2
Q

What can cause a perforated tympanic membrane

A

Trauma

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3
Q

Clinic presentation of perforation

A

Sudden severe pain followed by bleeding from the ear, hearing loss and tinnitus

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4
Q

2 main investigations for perforation

A

Audiology and Otoscopy

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5
Q

Audiometry in perforation

A

Conductive hearing loss

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6
Q

Management of perforation

A

Usually heals spontaneously
Surgical repair if symptomatic with recurrent discharge

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7
Q

What is otosclerosis

A

Hereditary condition in which bony deposit is within the stapes footplate and cochlear lead to gradual conductive hearing loss

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8
Q

When is otosclerosis usually seen

A

2nd - 3rd decade

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9
Q

Who is otosclerosis more common in

A

Females - linked to high oestrogen

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10
Q

Pathophysiology of otosclerosis

A

Fixation of the stapes footplate

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11
Q

Clinical presentation of otosclerosis

A

Gradual onset hearing loss

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12
Q

Classic finding when investigating otosclerosis

A

Carharts notch at 2KHz

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13
Q

Investigation of otosclerosis

A

Audiometry

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14
Q

Management of otosclerosis

A

Hearing aids
Stapedectomy

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15
Q

What is presbycusis

A

Degenerative disorder of the cochlear resulting in hearing loss

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16
Q

When does presbycusis usually present

A

Old age

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17
Q

What causes presbycusis (3)

A

Loss of outer hair cells
Loss of ganglion cells
Strial atrophy

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18
Q

Clinical presentation of presbycusis

A

Gradual onset hearing loss

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19
Q

Investigation for presbycusis

A

Audiometry

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20
Q

Audiometry in presbycusis

A

Higher frequencies affected most
Usually sensorineural hearing loss

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21
Q

Management of presbycusis

A

High frequency specific hearing aid

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22
Q

What is vestibular schwannoma

A

Rare benign tumour of the CN8 nerve sheath

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23
Q

Where does vestibular schwannoma arise

A

Internal auditory meatus

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24
Q

What has vestibular schwannoma been associated with

A

Extensive exposure to excessively loud noise

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25
Q

What do you need to consider in a young patient with bilateral vestibular schwannoma

A

Neurofibromatosis type 2

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26
Q

Where do vestibular schwannoma occur

A

Within the temporal bone

27
Q

Gross appearance of vestibular schwannoma

A

Circumscribed white/tan/yellow mass

28
Q

What are the 2 growth patterns associated with vestibular schwannoma

A

Antoni A and B

29
Q

Clinical presentation of vestibular schwannoma

A

Progressive sensorineural unilateral hearing loss and tinnitus
Imbalance in larger tumours
Compression of Trigeminal nerve can cause facial numbness

30
Q

Investigation for vestibular schwannoma

A

MRI

31
Q

Definitive management of vestibular schwannoma

A

Surgical excision

32
Q

What is another name for otitis media with effusion

A

Glue ear

33
Q

What is glue ear

A

Inflammation of the middle ear with an accumulation of fluid
WITHOUT symptoms and signs of acute inflammation

34
Q

Who usually gets glue ear

A

Children

35
Q

When is the most common time to get glue ear

A

2-8

36
Q

What is associated with glue ear

A

Eustachian tube dysfunction or obstruction

37
Q

Common organisms associated with glue ear

A

Strep pneumo
H, influenza
Moraxella

38
Q

Risk factors for glue ear

A

Day care, older siblings, smoking household, recurrent URTI, prematurity, immunodeficiency

39
Q

Causes of glue ear in adults

A

Rhinosinusitis
Nasopharyngeal carcinoma or lymphoma

40
Q

Symptoms of glue ear

A

Often asymptomatic !!!
May present with hearing loss: poor performance or bad behaviour at school
No otalgia

41
Q

Clinical signs of glue ear

A

Middle ear effusion
TM retraction and discolouration
Impaired TM mobility

42
Q

Investigations for glue ear

A

Otoscopy
Tuning fork tests: conductive hearing loss

43
Q

Management of glue ear

A

Watchful waiting

44
Q

When do you refer a patient with glue ear

A

Persistent bilateral OME
Conductive hearing loss
Speech/language problems
Behavioural problems

45
Q

General management of glue ear

A

Grommets

46
Q

Secondary intervention of glue ear

A

Adenoidectomy

47
Q

Complications of grommets

A

Infection/discharge
Early extrusion
Retention
Persistent perforation
Swimming/bathing issues

48
Q

What is the most common tumour of the ear

A

Squamous cell carcinoma

49
Q

What is squamous cell carcinoma of the ear associated with

A

Chronic inflammation or radiation

50
Q

Clinical presentation of squamous cell carcinoma on the ear

A

Firm red nodules and sores on the skin of the ear
Discomfort
Hearing problems, tinnitus, vertigo

51
Q

Name some other tumours of the ear

A

Meningioma
Middle ear adenoma

52
Q

How does noise-induced hearing loss look on Audiometry

A

Sensorineural hearing loss
Dip at 4 KHz

53
Q

Name some drugs that can induce hearing loss

A

Gentamicin
Cisplatin
Vincristine
Aspirin and NSAIDs

54
Q

How do we classify hearing loss

A

Based on which part of the auditory system is affected
Sensorineural, conductive or mixed

55
Q

What is sensorineural hearing loss

A

No significant air-bone gap on audiogram

56
Q

What are other names for sensorineural hearing loss

A

Sensory, cochlear or inner ear hearing loss

57
Q

How does sensorineural hearing loss occur

A

Damage to the hair cells within the cochlear or the hearing nerve

58
Q

Name some other causes of sensorineural hearing loss

A

Trauma, Ménière’s, vestibular schwannoma, loud sounds, genetics, complications at birth

59
Q

What is conductive hearing loss

A

Significant air-bone gap on an audiogram

60
Q

What causes conductive hearing loss

A

Usually as a result of sounds not being able to pass freely to the inner ear

61
Q

Presentation of conductive hearing loss

A

Fluctuating hearing loss

62
Q

Name some causes of conductive hearing loss

A

Otitis media and externa, perforation, cholesteatoma

63
Q

What is mixed hearing loss

A

Combination of conductive and sensorineural hearing loss, meaning there’s damage in the outer or middle ear and the inner ear

otolaryngology (18 decks)

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