HEARING LOSS

Question 1

Tip of handle of malleus forms deepest concavity of tympanic membrane. What is this called?

Answer 1

Umbo - cone of light radiates from here

Question 2

Label.

what is the weakest part of the tympanic membrane?

Answer 2

Pars flaccida

Question 3

45 yo male presents to GP feeling ears are blocked and hearing reduced. You see this on otoscopy. What is the cause? What is the treatment?

Answer 3

Excessive earwax

• Topical eardrops: warm olive oil, sodium HCO3
• Microsuction
• Wax probe
• Syringing

Question 4

25 yo female presents with hearing loss in left ear and a popping/clicking/pressure. You see the following. what is your differential diagnosis? What are the typical signs seen on otoscopy?

Answer 4

Otitis media with effusion (OME)

Dull tympanic membrane, fluid level/bubbles

Question 5

65-year-old patient presents with discharge from the right ear and hearing loss. You see this on otoscopy. What is the diagnosis?

Answer 5

Perforated eardrum likely secondary to infection

Question 6

What is this?

Answer 6

Cholesteatoma

Question 7

Patients with which type of hearing loss will normally have normal otoscopy?

Answer 7

Sensorineural hearing loss

Question 8

What are the two main investigations that should be carried out in hearing loss?

Answer 8

• Pure tone audiogram (PTA)
• Tuning fork tests: Rinnes and Weber

Question 9

Describe how to do Rinnes and Weber’s tests and what is normal?

Answer 9