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EENT > Hearing Loss > Flashcards

Hearing Loss Flashcards

1
Q

tumor that blocks ES

A

Nasopharyngeal tumor

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2
Q

Tx bell’s palsy *extra

A

steroid

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3
Q

DISEASES: external - pinna, canal

A

OE, Exostosis/Osteoma, Cerumen Impaction

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4
Q

DISEASES: middle - TM, Ossicles, ES

A

OM, Cholesteatoma, Otosclerosis, ETD

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5
Q

DISEASES: inner - cochlea, semicircular canals, auditory nerve

A

Meniere’s, BPPV, Aucoustic Neuroma, Sensorineural HL

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6
Q

labyrinth - location, function

A

Inner Ear
Hearing, Balance
Transmit to CN 8

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7
Q

what provide brain w/ info about Head Movement and Motion?

A

saccule

utricle

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8
Q

Conductive hearing loss:

Weber lateralizes to…

A

affected side

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9
Q

Sensorineural Hearing Loss:

Weber lateralizes to…

A

unaffected side

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10
Q

Rinne: AC>BC

A

normal

Sensorineural hearing loss

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11
Q

Rinne: BC>AC

A

Conductive Hearing loss

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12
Q

tinnitus risk factors

A 
noise exposure
old
male
smoker
cardio disease
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13
Q

Intermittent tinnitus workup/Tx

A

NONE

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14
Q

pulsatile tinnitus

A

rhythmic with pulse

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15
Q

Tinnitus causes

A 
idiopathic
acoustic trauma (acute/chronic)
Neuro damage
vascular
TM perf
purulent/serous OM
ETD
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16
Q

Tinnitus Dx

A

Refer ENT
subjective (most) vs. objective
Pulsatile? MRA/carotid doppler
imaging/neuro-otologic tests

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17
Q

Acute Tinnitus Tx

A

oral steroid taper

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18
Q

Chronic Tinnitus Tx

A

Lipoflavinoids
Niacin / B complex
White noise
Hearing aid

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19
Q

Tinnitus prevention

A

minimize noise exposure (<85dB)

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20
Q

which are first sounds to go in elderly hearing loss?

A

low decibel, extreme high + low frequencies

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21
Q

what frequency is cochlea near oval window?

A

high

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22
Q

Presbycusis : characteristics

A

sensorineural hearing loss
old age
symmetrical + high frequency

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23
Q

Presbycusis : risk factors

A

half adults over 75
genetic
noise exposure
DM/ atherosclerosis

24
Q

Presbycusis : presentation

A 
bilateral worsening over time
difficulty w/ social situations
can't localize
tinnitus
isolation
25
Q

Presbycusis : Dx

A

Dx of exclusion

audiogram - symmetrical, high frequency loss

26
Q

Presbycusis : Tx

A

Hearing Aid

Prevention (noise)

27
Q

Acoustic trauma : damage frequency + decibel

A

high frequency, >85 dB

28
Q

Acoustic Trauma : Presentation

A

hearing loss
tinnitus
Hx of noise exposure

29
Q

Acoustic Trauma: Dx

A

PE normal
Audiometry = 4K noise notch
bilat/unilat

30
Q

Acoustic Trauma: Tx

A

hearing aid
possible steroid
Prevention *noise

31
Q

Where does Acoustic Neuroma/Vestibular Schwannoma grow?

A

CN 8 - Schwann cells

32
Q

Acoustic Neuroma/Vestibular Schwannoma

: S/S

A 
UNILATERAL hearing loss + tinnitus
Headaches/dizziness
Facial weakness/numbness
Possibly silent until large
continuous vertigo
33
Q

Acoustic Neuroma/Vestibular Schwannoma
: risk factors

A

Neurofibromatosis Type II (cafe au lait/bilat)

Ionized radiation

34
Q

What should you order if UNILATERAL Sensorineural hearing loss?

A

MRI

35
Q

Acoustic Neuroma/Vestibular Schwannoma
: Dx

A

Audiogram: unilateral loss
**MRI - Cerebellopontine Angle w/ gadolinium contrast
Auditory Brainstem Response

36
Q

Acoustic Neuroma/Vestibular Schwannoma

: Tx

A

Refer ENT/neurosurgery/radiation

Image/audio monitor every 6 mos.

37
Q

Causes of conductive hearing loss

A 
Cerumen impaction
OM/OE
TM perf
Otosclerosis
Mastoiditis
Cholesteatoma
Foreign Body
Exostoses/Osteomas
38
Q

Cerumen impaction : Presentation

A

Hearing Loss
Ear discomfort
Dizziness/tinnitis if impacted against TM

39
Q

Cerumen impaction: Tx

A

Dissolve (H2O2, OTC)
Irrigation, removal
Refer ENT if fail or no audio return

40
Q

Exostoses: cause

A

Cold water swimming as child

41
Q

Exostoses (multiple) : Tx

A

Monitor

If obstruct, refer ENT

42
Q

Osteomas (single - tympanic bone) - Tx

A

Monitor

Refer ENT if obstruction

43
Q

Otosclerosis: risk factors

A

Genetic
White female
Young adult to middle age

44
Q

Otosclerosis: what is

A

Spongy bone growth at stapes-oval window junction
Worsens over time
Possible tinnitus

45
Q

Otosclerosis: Dx

A

TM moves normal
Conductive hearing loss (Carthart notch 2K)
DX: Temporal bone CT/exploratory surgery

46
Q

Otosclerosis : Tx

A

Refer ENT : exploration, stapedectomy, ossicular chain reconstruction
*hearing amp/monitor

47
Q

Cholesteatoma is

A

Middle ear cyst w/ keratin

Destroys middle ear, labyrinth, mastoid air cells, facial nerve, *middle cranial fossa of brain

48
Q

Cholesteatoma: associated w/

A

ETD, TM perf, Congenital

49
Q

Cholesteatoma : presentation

A 
CHRONIC DRAINING EAR (brown/yellow/odor)
PAINLESS
Conductive H.L.
Dizziness
TM pearl
DX: CT temporal bone, otoscope granular tissue
50
Q

Cholesteatoma: Tx

A

Surgical excision

51
Q

ETD : cause

A
  • Hairs can’t remove
  • Bad ES contraction
  • Narrow ES
  • Adenoid blocks ES
  • Swollen nose blocked
  • Adult - NP tumor (unilat OM)
52
Q

ETD: associated w/

A

OM
Barotrauma
Maybe cholesteatoma

53
Q

ETD : presentation

A

Follow URI/allergic rhinitis
Ear pain/pressure
Stuffy - valsalva useless
Hearing loss/ tinnitus

54
Q

ETD : physical exam

A

Retracted TM

Tympanogram flat

55
Q

ETD : Tx

A

Nasal Decongest - *Sudafed, *Afrin
Nasal steroid - *Flonase, *Nasonex
SEVERE - oral steroid, myringotomy/tube

EENT (10 decks)

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