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13 ENT > Hearing Loss and Tinnitus > Flashcards

Hearing Loss and Tinnitus Flashcards

1
Q

t/f the inner 2/3 (bony) of the ear does not have ceruminous and sebaceous glands = no cerumen

A

true, skin is thin and tight, prone to injury

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2
Q

most common cause of hearing loss in ph

A

cerumen impaction

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3
Q

causes of cerumen impaction

A

cotton buds use

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4
Q

clinical presentation and treatment of cerumen impaction

A
  • hearing loss or ear fullness
  • pain is uncommon

treatment: manual extraction

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5
Q

represent abnormal accumulation of keratin in the external ear canal

A

keratosis obturans

cholesteatoma of external ear

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6
Q

cause of keratosis obtruans

A

overproduction of sq epithelium and/or faulty migration of epithelium with subsequent accumulation and impaction

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7
Q

presentation and treatment of keratosis obturans

A
  • hearing loss
  • enlarging keratin plug = diffuse widening of ear canal
  • pain

treatment: removal of debris, antibiotics

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8
Q

clinical presentation of external canal cholesteatoma

A
  • hearing loss with pain
  • epithelial plug
  • skin ulceration or bone necrosis
  • granulation tissue and otitis externa
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9
Q

treatment for external canal cholesteatoma

A

remove debris and necrotic tissue, antibiotic therapy

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10
Q

3 types of otitis externa

A

acute circumscribed otitis externa
acute diffuse oe
otomycosis

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11
Q

cause of acute circumscribe oe

A

infection from trauma (s aureus)

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12
Q

presentation of acute circumscribed oe

A
  • circumscribed swelling of outer 1/3
  • hearing loss, pain, tragal tenderness
  • purulent ear discharge
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13
Q

cause for diffuse otitis externa

A
  • dip in water
  • vigorous ear manipulation
  • pseudomonas
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14
Q

presentation of diffuse otitis externa

A
  • hearing loss and pain

- more severe than acoe

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15
Q

cause of otomycosis

A

aspergillus and candida

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16
Q

presentation of otomycosis

A
  • ear pruritus!!
  • hearing loss from cotton like fungal debris and purulent discharge
  • pain
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17
Q

foreign body is more common in __ and can cause ___

A

younger age group

causes obstruction and hearing loss

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18
Q

t/f tumors in the external ear are usually malignant

A

false, malignant uncommon, usually benign (nevi, chondroma, osteoma, papilloma)

  • no symptoms except hearing loss
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19
Q

causes of direct trauma on middle ear

A

overzealous cleaning or compressive barotrauma –> hearing loss, bloody otorrhea, tinnitus

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20
Q

otoscopy findings in direct trauma

A
  • tympanic perforation with jagged edges

- ear drum congested with preset hematoma

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21
Q

what is the persistent infection of the middle ear where drainage accompanied by perforation of the tympanic membrane is seen

A

chronic otitis media

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22
Q

otoscopy findings in chronic otitis media

A
  • tympanic membrane perforation with SMOOTH edge
  • no bleeding or hematoma
  • with mucoid discharge
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23
Q

in acute otitis media, the tympanic membrane can be perforated during the __ stage

A

suppurative stage

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24
Q

thickening of the fibrous middle layer of tympanic membrane (white patches from middle ear infections)

A

tympanosclerosis

otoscopy: whitish plaque

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25
Q

what is bullous myringitis

A
  • primary inflammation of tympanic membrane
  • bleb/blister/bulla
  • caused by m pneumoniae, s pneumoniae, and moraxella
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26
Q

presentation of bullous myringitis

A
  • acute progressive otalgia and hearing loss
  • self limiting
  • otoscopy: bleb/ blister/ bulla in lateral wall
27
Q

cause of eustachian tube problems

A

stiffness of tympanic membrane increases due to negative pressure in middle ear and tympanic membrane is pulled inwards

28
Q

causes of compromise in patency of e tube

A
  • nasopharyngeal or nasal inflammation
  • mechanical compression

== persistent middle ear negative pressure

29
Q

most severe form of tympanic membrane retraction where pars tensa becomes adherent to bony medial wall of middle ear

A

adhesive otitis media

30
Q

presentation of adhesive otitis media

A
  • persistent conductive hearing loss

- otoscopy: retraction of tympanic membrane and outlining of ossicles (han solo)

31
Q

when negative pressure induces transudation of fluid from middle ear mucosa into ear space

A

otitis media with effusion

32
Q

presentation of otitis media with effusion

A
  • only mild or no ear pain
  • fullness in ear
  • otoscopy: middle ear fluid is clear, air fluid level
33
Q

occurs due to poor e tube function and drops in barometric pressure during diving/flying

A

otitic barotrauma

34
Q

presentation of otitic barotrauma

A
  • high pressures can retract ear drum and small vessels = hemorrhage
  • hemotypmanum
  • pain, ear fullness, loss of hearing
  • otoscopy: hemorrhagic eardrum or hemotympanum
35
Q

t/f increased stiffness or discontinuity of ossicular chain can cause decreased hearing

A

true

36
Q

t/f chronic external ear infection can cause the gap between bony parts of ossicular chain to occur

A

false, middle ear infections

37
Q

ossicular stiffness in children can be caused by ___

A

congenital underdevelopment of ear structures

38
Q

what happens in cholesteatoma in middle ear

A

chronic infection -> squamous epithelium accumulates in mastoid and middle ear -> erode surrounding bone -> conductive hearing loss

39
Q

hereditary condition that causes progressive hearing loss starting adulthood

A

otosclerosis

40
Q

pathology in otosclerosis

A
  • otospongosis forms at lip of stapes causing fixation of stapes on otic capsules
  • normal otoscopy
41
Q

most common congenital hearing loss

A

scheibe aplasia (aplasia of cochlear duct)

michel aplasia (lack of development of inner ear)
mondini aplasia (underdeveloped cochlea has 1.5 instead of 2.5 turns)
genetic syndromes
42
Q

mechanisms of infectious hearing loss

A
  • oval or round windows
  • pre-formed pathways
  • blood (hematogenous)
43
Q

viruses that can cause hearing loss

A

mumps!!!

chickenpox, measles, influenza, adenovirus

44
Q

t/f ototoxic drugs can use sensorineural hearing loss as well

A

true

45
Q

enlarging masses in the __ can cause dysfunction in cn 8 can cause __ and __

A

internal acoustic canal

cause slowly progressive hearing loss, tinnitus, and vertigo

46
Q

tumors in the iac

A

cn 7 schwannomas, meningiomas, hemangiomas, vascular malformations

47
Q

age related hearing loss

A

presbycusis (loss of hair cells and cochlear neurons)

48
Q

the __ is affected the most in environmental hearing loss

A

basal hair cells

causes hearing loss and reduced speech discrimination

49
Q

abnormal noise perceived in one or both ears in the head

A

tinnitus

50
Q

t/f tinnitus is a diagnosis

A

false, it’s a symptom and very common

51
Q

most common form of tinnitus

A

subjective tinnitus

rare: objective tinnitus

52
Q

hyperacusis and misophonia / phonophonia

A

hyperacusis: perception of over amplification of environmental sounds
misophonia / phonophonia: dislike or fear of environmental sounds

53
Q

causes of tinnitus

A
  • loud noise
  • presbycusis
  • middle ear problems
  • vestibular disorders
  • cn 8 damage or central auditory system change
  • head and neck trauma
  • medications
  • vascular
  • others
54
Q

abnormal amounts of endolymph collecting in the middle ear

tear or rupture of oval windows –> leak of perilymphatic fluid from membranous to middle ear

A

secondary endolymphatic hydrops

perilymphatic fistula

55
Q

damages to the cn 8

A
  • acoustic neuroma (vestibular schwannoma)
  • vestibular neuritis (viral)
  • microvascular compression syndrome
56
Q

hyperactivity in central auditory system is caused by damage to __

A

cochlea and vestibulocochlear nerve (8)

57
Q

t/f tinnitus in head and neck trauma is perceived as louder and more severe

A

true (somatic tinnitus)

58
Q

t/f masking devices can eliminate tinnitus

A

false, can obscure but not eliminate

59
Q

therapy to help person retrain the brain to avoid thinking about tinnitus

A

tinnitus retraining therapy

goal: retrain conditioned negative response

60
Q

t/f psychological treatment can help manage tinnitus

A

true

61
Q

t/f there is a drug to cure tinnitus

A

false, but drugs can treat psychological effects

62
Q

indications for surgery in tinnitus

A

acoustic neuroma, perilymph fistula, otosclerosis

63
Q

most important interventions for reducing risk of tinnitus

A
  • avoid exposure to loud sounds

- get prompt treatment for ear infections

13 ENT (18 decks)

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