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Year 4 ENT > Hearing loss > Flashcards

Hearing loss Flashcards

1
Q

a defect in which part of the hearing pathway causes CHL

A

outer ear

middle ear

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2
Q

a defect in which part of the hearing pathway causes SNHL

A

inner ear

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3
Q

what are the different classifications of hearing loss

A

CHL
SNHL - cochlear or retrocochlear
mixed

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4
Q

what feature on an audiogram would suggest CHL

A

air bone gap

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5
Q

list causes of CHL in the ear canal

A

atresia
otitis externa
ear wax
stenosis

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6
Q

list causes of CHL in the middle ear

A 
acute otitis media 
otitis media with effusion (glue ear)
cholesteatoma 
tympanic membrane perforation 
ossicular chain abnormalities 
otosclerosis
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7
Q

what is glue ear

A

otitis media with effusion

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8
Q

describe features of otitis media with effusion

A

more common in children
Eustachian tube dysfunction
straw coloured fluid

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9
Q

causes of otitis media with effusion in adults

A

rhinosinusitis

nasopharyngeal carcinoma / lymphoma

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10
Q

management of otitis media with effusion

A

grommets

further investigations if adult presentation

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11
Q

features of otitis media with effusion on tympanogram and audiogram

A

flat tympanogram

CHL - air bone gap

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12
Q

clinical signs of otitis media with effusion on otoscope

A

retracted membrane

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13
Q

why is myringotomy not effective for otitis media with effusion

A

the membrane would heal very quickly and fluid would reaccumulate

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14
Q

how long do grommets usually last for otitis media with effusion

A

9-12 months

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15
Q

acute otitis media is more common in children/adults

A

children

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16
Q

what is acute otitis media associated with

A

glue ear

URTI

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17
Q

acute otitis media is usually viral/bacterial

A

viral

therefore do not treat with antibiotics until after 3 days

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18
Q

clinical signs of acute otitis media on otoscopy

A

bulging membrane - pars tensa

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19
Q

chronic suppurative otitis media is an old term to encompass which conditions

A

cholesteatoma

perforated tympanic membrane

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20
Q

what is a cholesteatoma

A

collection of keratin in the middle ear

21
Q

clinical signs of cholesteatoma on otoscopy

A

retracted membrane
perforation
keratinous debris at pars tensa or flaccida
erosion of ossicles

22
Q

complications of acute otitis media and cholesteatoma

A

medially –> SNHL, tinnitus, vertigo, facial palsy
superiorly –> meningitis, brain abscess
posteriorly –> venous sinus thrombosis

23
Q

what is otosclerosis

A

gradual onset CHL with normal examination

fixation of stapes footplate

24
Q

features of otosclerosis

A

CHL
F>M
FH - inherited
worsens during pregnancy

25
Q

management of otosclerosis

A

conservative
hearing aids
fixation of stapes footplate
stapedectomy

26
Q

trauma can cause CHL + SNHL, true or false

A

true

27
Q

what is haemotympanum

A

blood collection behind the membrane

28
Q

what is battle’s sign

A

bruising behind the ear indicative of base of skull #

29
Q

symptoms and signs of BOS #

A 
Hearing loss 
CSF leak 
facial palsy 
battle sign 
bilateral periorbital bruising
30
Q

causes of acquired SNHL

A 
presbyacusis 
noise induced 
drug induced 
vestibular schwannoma - CPA
Menieres 
trauma + BOS #
inflammatory 
autoimmune 
meningioma
31
Q

what is presbyacusis

A

age related high frequency sensorineural hearing loss

32
Q

describe features of noise induced hearing loss

A

classical dip ay 4000Hz aka Cahart’s notch

33
Q

causes of drug induced hearing loss

A

aminoglycoside - gentamicin
chemotherapy - cisplatin, vincristine
aspirin overdose
diuretics - furosemide

34
Q

peri/endolymph is found in the bony labyrinth

A

perilymph

35
Q

peri/endolymph is found in the membranous labyrinth

A

endolymph

36
Q

what happens in profound SNHL

A

loss of hair cells in the organ of corti

37
Q

list chromosomal congenital causes of SNHL

A 
Connexin 26 GJB2 - most common deafness 
Waardenburg's - AD
Stickler - AD
Usher's - AR
Pendred's - AR
38
Q

list non-genetic congenital causes of SNHL

A 
rubella 
VZV
HIV 
CMV
Streptococcus 
drugs/alcohol misuse
39
Q

short noise exposure hearing loss is reversible, true or false

A

true

40
Q

causes of inflammatory SNHL

A 
fibrosis of the cochlear duct from: 
meningitis 
labyrinthitis 
mumps, measles
syphilis
41
Q

in CHL there is/not an air bone gap

A

there is an air bone gap

42
Q

in SNHL there is.not an air bone gap

A

there is not an air bone gap

43
Q

list autoimmune causes of SNHL

A

RA
GPA
sarcoidosis

44
Q

Menieres has high/low frequency hearing loss

A

low frequency

45
Q

when would you use an open fitting hearing aid

A

for milder degrees of hearing loss

46
Q

how do cochlear implants work

A

electrically stimulating neural structures in the cochlea which is then transmitted to the brain and perceived as sound

47
Q

when would you use cochlear implants

A

severe - profound SNHL

48
Q

management of ear wax build up

A

olive oil
sodium bicarbonate solution
ear syringing

Year 4 ENT (18 decks)

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