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AUDE 5410 Aud-Vestib Disorders > ME Disorders (Trauma) > Flashcards

ME Disorders (Trauma) Flashcards

1
Q

what is some etiology to trauma

A

Blow to the side of the head/falls
Sports injuries such as in racquet ball, football, boxing
Blast injuries (e.g., bombs/improvised explosive device – IEDs)
Motor vehicular accidents
Foreign body insertion such as Q-tips (ossicular disarticulation)

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2
Q

In cases of head trauma, the inner ear may be involved too resulting in SNHL with accompanying ME damage such as

A

™ perforation
ossicular disarticulation
hemotympanum (blood in the tympanic cavity)

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3
Q

how do you get disarticulation with Q tips

A

they are long and thin, happens if you shove it in too far and can result in a dead ear

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4
Q

etiology of ossicular disarticulation

A

Trauma to the head or face
Also seen in medical conditions such as osteoporosis
In cases of cholesteatoma where the pseudo-tumor can destroy the ossicles
Untreated ME infection that can destroy the ossicles

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5
Q

normal appearance of the middle ear ossicles on axial CT scan

A

ice cream cone

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6
Q

The ball of the ice cream is formed by the head of the _____ and cone is formed by the body of the ____, with the tapering conical point formed by the short process of the____

A

malleus, incus, incus

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7
Q

Failure of this normal configuration suggests ossicular chain disruption (incudomalleolar disarticulation)

A

ball of ice cream fell off

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8
Q

otoscopy findings of ossicular disarticulation

A

Depending on the cause of the disarticulation
Perforation of TM
Bleeding in the ear canal with TM perforation
Rarely, the TM and ear canal may appear normal

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9
Q

immitance results of ossicular disarticulation

A

Jerger type Ad tympanogram
Abnormal reflexes

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10
Q

pure tone results of ossicular disarticulation

A

conductive/mixed hl

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11
Q

treatment of ossicular disarticulation

A

Surgical repair
Amplification, if surgery is not successful/not an option

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12
Q

Majority of temporal bone injuries occur as part of multiple injuries following motor vehicular accidents (MVA)

A

true

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13
Q

temporal bone trauma is caused by

A

Industrial accidents
Recreational injuries
Falls
Assaults
Gunshot wounds
Self-inflicted injuries

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14
Q

temporal bone fractures occurs in ______% of head injuries

A

30-75%

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15
Q

types of temporal bone trauma

A

a. trauma with fracture

b. trauma without fracture

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16
Q

type a trauma with fracute
Longitudinal fractures

A

direct blow to temporal/parietal aspect)
Most common fractures of the temporal bone (70 to 90%)
Parallels long axis of the temporal bone in coronal plane
Passes through the postero-superior aspect of the external auditory canal, TM, and roof of ME
Disrupts the ossicles but generally spares the otic capsule

17
Q

transverse fractures

A

commonly due to a blow to the occiput)
Less common fractures of the temporal bone (20 to 30%)
Extends through internal auditory canal or otic capsule – otic capsule disrupting fracture
Can affect the oval or round window

18
Q

blunt trauma with fracture

A

Few temporal bone fracture are purely longitudinal or transverse
About 50 to 75% are mixed

19
Q

otic barotraua

A

Barotrauma refers to injury sustained from failure to equalize the pressure of an air-containing space with that of the surrounding environment such as observed in the ear, face, and lungs
The most common examples of barotrauma occur in air travel and scuba diving
Barotrauma most often occurs during compression (descent) or after a short, shallow dive
Otic barotrauma causes sudden and severe negative ME pressure and trauma to the ear resulting in

20
Q

Inner ear decompression sickness (IEDCS)

A

most often occurs during decompression (ascent) or shortly after surfacing from a dive
It is an injury that closely resembles inner ear barotrauma, however, the treatment is different
It is more common among commercial and military divers who breathe a compressed mixture of helium and oxygen

21
Q

symptoms of IEDCS

A

HL & tinnitus
dizziness

22
Q

Patients with IEDCS should be rapidly transported to a

A

hyperbaric chamber for recompression
Significant correlation between early recompression and recovery

23
Q

thermal injuries

A

Injuries sustained during welding leading to TM perforation
Lightning bolt conducted through phone or other means

24
Q

symptoms of thermal injuries

A

SNHL
Dizziness/vertigo
facial paralysis from devitalized bone and soft tissue

25
Q

what are compressive injuries

A

When slapped or struck on the side of the head
Falling on water during water sports
Most significant is from blast injuries

26
Q

what can bomb explosions cause

A

disruption & implosion of ™
HF SNHL due to disruption of the inner ear

27
Q

what are auditory signs of injury

A

Acute or delayed conductive hearing loss
Clotted blood, debris, and hematoma in the ear canal
Perforated, lacerated, or completely disrupted TM
ME filled with blood or cerebrospinal fluid (CSF)
Bleeding from ears; common sign of temporal bone fracture
Ossicular disarticulation
Ossicular fixation due to fibrous adhesions
High incidence of SNHL

28
Q

vestibular symtpoms of injury

A

Benign paroxysmal positional vertigo (BPPV)
Concussive injury to labyrinth resulting in vestibular symptoms
Perilymphatic fistula

29
Q

80 to 90% of longitudinal temporal bone fractures result in

A

facial n paralysis

30
Q

Self healing in 4 to 6 weeks
Myringotomy to drain is not recommended; high risk of infection

A

hemotympanum

31
Q

Self-healing; observe and manage conservatively
Make sure perforated edges do not get infected, which may result in cholesteatoma
If healthy perforation persists after several months then a myringoplasty can be performed

A

tm perforation

32
Q

Exploration and repair of ossicles
Amplification if surgery is not an option

A

persistent chl

33
Q

treatment of rreversible SNHL and tinnitus

A

HA’s and tinnitus management

34
Q

vestibular treatment

A

Mostly self-limiting resolving within 6 months

35
Q

BPPV treatment

A

Typically self-limiting resolving within 3 months
If not resolved then treatment needed i.e., Epley maneuver

36
Q

otitic meningitis treatmet

A

Meningitis can complicate traumatic encephalocele or CSF leak
may occur months or years later with or without CSF leak
Treated with antibiotics based on culture results

AUDE 5410 Aud-Vestib Disorders (18 decks)

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