Middle Ear Flashcards
what separates the external ear from the middle ear?
tympanic membrane
what drains the middle ear into the nasopharynx?
eustachian tubes
a patient whose ears crackle/pop with swallowing or yawning, has a history of URI or allergies, intra-aural fullness, and +/- mild decrease in hearing is most likely experiencing …
eustachian tube dysfunction
what 2 things must be present in a physical exam to diagnose a patient with eustachian tube dysfunction?
- retracted TM
- decreased valsalva
what is a differential diagnosis of e-tube dysfunction in kids?
adenoid hypertrophy
what is a differential diagnosis of e-tube dysfunction in adults?
nasopharyngeal carcinoma
what is the treatment for e-tube dysfunction?
treat underlying URI or allergies
what 2 things should a patient do with e-tube dysfunction?
- valsalva
- avoid pressure changes
what are 5 possible complications of e-tube dysfunction?
- conductive hearing loss
- acute SOM
- chronic SOM
- TM perforation
- cholesteatoma
what are 4 etiologies of a TM perforation?
- rapid descent
- overpressure
- infection
- myringotomy
a patient that presents with tinnitus, pain, and otorrhea most likely has …
TM perforation
how would I diagnose a TM perforation?
otoscope (look at it) - see a hole
what is a differential diagnosis for a TM perforation?
cholesteatoma
what to do for a patient with a TM perforation?
refer to ENT
what would ENT do for a small TM perforation?
nothing - heals spontaneously
what would ENT do for a large TM perforation?
tympanoplasty
what should a patient with a TM perforation avoid?
water
an abnormal collection of keratin skin cells deep inside the ear due to chronic negative middle ear pressure retraction of the pars flaccida
cholesteatoma
a patient with persistent purulent otorrhea, progressive unilateral hearing loss, tinnitus, and sometimes vertigo/facial nerve twitch is experiencing …
cholesteatoma
how would I diagnose a cholesteatoma?
otoscope (look at it)
what will I see in a patient with cholesteatoma?
attic retraction or perforation
what would ENT do for a patient with cholesteatoma?
CT of temporal bone
what is the treatment for cholesteatoma?
surgical excision
