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CS&D 320 > lecture 14: disorders of the outer & middle ear - exam 3 > Flashcards

lecture 14: disorders of the outer & middle ear - exam 3 Flashcards

1
Q

congential

A

born w/ it

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2
Q

acquired

A

aquire it

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3
Q

low set pinna

A

congenital

caused by interruptions during fetal development

does not cause HL in isolation
can indicate malformations that do cause HL

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4
Q

protruding ear

A

congenital

not associated w/ hearing loss

can be corrected w/ setback otoplasty after age 5 (when pinna is fully formed)

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5
Q

lop ear

A

congenital

not associated w/ hearing loss

treatment:
do nothing
split to reshape ear when child is a baby
otoplasty after age 5

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6
Q

microtia

A

congenital

external ear underdeveloped

caused by interruptions in fetal development

expressed externally
may indicate middle or inner ear deformities

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7
Q

Grade I malformed pinna

A

smaller than typical sized ear

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8
Q

grade II malformed pinna

A

stenosis

partially formed outer ear w/ small ear canal

audiogram, OAEs, & reflexes would all be normal

Tymps would have a smaller ECV

can’t use insert transducers

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9
Q

grade III malformed pinna

A

atresia

absent / closed ear canal

small peanut-shaped outer earlobe

conductive HL
no inserts
can’t test for tymps, OAEs, or reflexes because can’t get the probe in

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10
Q

grade IV malformed pinna

A

anotia

absence of ear canal & pinna

can still have a cochlea

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11
Q

preauricular pits & tags

A

do not cause HL in isolation

may be indicative of genetic syndromes associated w/ HL

indicates possible ME malformations

surgical treatment if necessary

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12
Q

craniofacial anomaly

A

abnormalities in the structure of the head & face

often part of a constellation of signs associated w/ a syndrome

conductive HL

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13
Q

treacher collins

A

craniofacial anomaly

1 in 50000

wears hearing aids on top of head – has a mic & vibrates bones

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14
Q

goldenhar syndrome

A

craniofacial anomaly

incomplete development of head & facial structures (& sometimes organs) on ONE side of the body

1 in 5600

conductive or SNHL (if organs underdeveloped, cochlea could be affected) on ONE side

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15
Q

down’s syndrome

A

craniofacial anomaly

3rd copy of chromosome 21

1 in 700 –> most common chromosomal disorder

ET dysfunction & partially formed airway –> chronic otitis media –> HL

low freq (ME infections tend to cause low freq HL) conductive

probably no OAEs, maybe ARTs

Type B tymp

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16
Q

cauliflower ear

A

aquired

caused by repeated blunt trauma to pinna
blood accumulates in pinna which disrupts blood supply

does not cause HL in isolation unless ear canal becomes stenotic & occluded w/ cerumen –> conductive HL

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17
Q

keloid

A

aquired

forms where skin is damages (surgery, cut, piercing, etc)

excessive scar tissue grows instead of skin
smooth, hard, benign

doesn’t cause HL in isolation

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18
Q

contact ulcer

A

acquired

injuries to the skin & tissue caused by prolonged pressure on the skin

very common from many HL treatments (hearing aids & CIs)

usually not a big deal but can become infected

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19
Q

frostbite

A

acuired

freezing of skin & tissue leading to tissue damage or death

remove blisters
topical antiobiotic
pain meds
amputation if tissues are dead

20
Q

collapsing ear canal

A

acquired

common in older adults as cartilage becomes less firm

can’t use inserts

high freq HL

21
Q

foreign object

A

acquired

audiologist might take out solid objects w/ a tool

generally no hearing loss associated, unless object is occluding

22
Q

exostoses

A

acquired

abnormal growth of bone in ear canal

long term exposure to wind & cold water - “surfer’s ear”

relatively common

BILATERAL

not necessarily progressive but does tend to get worse w/ continued exposure

23
Q

osteomas

A

acquired

slow growing, benign, bony tumor

relatively rare

UNILATERAL

progressive

24
Q

exostoses & osteomas tymps, oaes, arts, audiogram

A

presentation similar to exostoses & radiology required to differentiate

doesn’t cause HL in early stages but can cause conductive if becomes severe –> surgical removal

tymps = low ECV

OAEs & arts = can’t measure cuz can’t fit probe

25
Q

otitis externa

A

acquired

inflammation of the outer ear & ear canal

red w/ white flaky

due to high humidity, exposure to water/moisture, allergic reactions to earplugs

hard to test audiogram etc bcs it’s very painful
but, OAEs & arts would probably be normal

26
Q

otomycosis

A

acquired

fungal infection - subtype of otitis externa

relatively common in elderly hearing aid users

refer to ENT & treat w/ anti fungal topical

27
Q

furunculosis

A

acquired

infection of hair follicle

accumulation of pus

red, swollen, painful

not associated w/ HL but can affect ability to test

28
Q

impacted cerumen

A

acquired

can’t use inserts

tymps = low ECV

no Oaes or arts

29
Q

TM perforation causes

A

sudden pressure change (like diving or jumping out of a plane0

blow to the ear (car accident, sports injury)

ear infection left untreated

perforation by a swab or other object

30
Q

TM perforation audiogram things

A

may cause no HL or low freq conductive

tymps = high ECV
type B

31
Q

pressure equalization tube

A

TM perforation on purpose

ME fluid drainage & pressure equalization

because of ET dysfunction – used as an alternate ET

typically extrude on their own

32
Q

PE tube audiogram stuff

A

present the same as a perforation

only way to tell is by otoscopy

33
Q

tympanosclerosis

A

TM tissue calcification after chronic otitis media &/or tubes

very common

no HL

tymps = As or normal

34
Q

negative middle ear pressure

A

retracted TM

often associated w/ ET dysfunction

infection creates swelling at opening of tube in nasopharynx

chronic negative ME pressure may lead to effusion (fluid buildup then infection)

35
Q
  • ME pressure audiogram stuff
A

conductive low freq HL

tymps = type C, negative ME pressure
peak all the way to the left

36
Q

otitis media

A

infection of mucous membrane lining of ME

very common in children cuz ET is flat so it can’t drain properly

pain, fever, opaque & bulging TM
leads to TM perf if left untreated –> often feels better, releases pressure

acute or chronic

w/ fluid = otitis media w/ effusion

37
Q

otitis media audiogram stuff

A

low freq conductive

tymps = type C or B depending on stage

OAEs & arts not likely

38
Q

otitis media aftermath

A

common but serious

results in transient (temporary) HL

untreated –> speech & language delays, poor academic performance

necrosis (tissue death)
mastoiditis (bone infection)
cholesteatoma
meningitis (infection of meninges in the brain)

39
Q

mastoiditis

A

infection in temporal bone that begins to erode skull

can extend laterally & protrude out of head

can extend medially causing meningitis or brain abscess

mastoidectomy

40
Q

otitis media treatment

A

1st one = wait & see
don’t want to do antibiotics if not bacterial

antibiotics

myringotomy = incision in TM to relieve pressure & drain fluid
PE tube or tympanoplasty

41
Q

ossicular chain discontinuity

A

break anywhere along chain that causes decrease in stiffness

caused by trauma

usually treated w/ prosthesis
PORP = partial ossicular replacement prosthesis
TORP = total ossicular replacement prosthesis

OAEs & arts hard to predict

42
Q

otosclerosis

A

progressive

most common ME Pathology after otitis media

bone growth around staples –> fixes it to oval window –> can longer push into cochlea (do it’s job)

often affects women during pregnancy

surgical treatment

43
Q

carhart’s notch

A

audiogram sign of otosclerosis

conductive HL

BC thresholds show notch at 2 kHz

tymps = very variable, depends on progression of disease

A or severe As

44
Q

schwartz’s sign

A

sign of otosclerosis

increased vascularity observed on promontory through TM

more blood = causes bone to grow

45
Q

otosclerosis sugery

A

effective but imperfect
avg improvement in thresholds = 10 dB

prosthesis not as good as impedance matching as ossicles

has risks

CS&D 320 (15 decks)

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