Middle Ear Pathologies

Question 1

What is Otitis Media (OM) with Effusion?

Answer 1

Swelling of the middle ear space with fluid buildup.

Fluid can become infected if left unchecked.

Question 2

What is the presentation of an Otitis Media with Effusion?

Answer 2

Presents as a flat tymp and flat CHL

Question 3

What treatment is used for OM w/Effusion?

Answer 3

1. Typically resolves on its own
2. Can be treated with antibiotics
3. Can be treated with myringotomy for severe or chronic cases.

Question 4

Which population is affected by OM w/Effusion?

Answer 4

1. Children due to immature Eustachian tube

2. Common in kids with craniofacial anomalies

Question 5

What is ossicular discontinuity (OD)?

Answer 5

Condition where the ossicles become detached or dislocated

Question 6

What causes OD?

Answer 6

1. Physical trauma
2. Cholesteatoma
3. Chronic OM

Question 7

What is the presentation of OD?

Answer 7

Causes CHL of 30-50dB for complete discontinuity

Question 8

What is the treatment for OD?

Answer 8

Must be sugically repaired to partially restore middle ear function

Question 9

For OD treatment, what does the surgical success depends on?

Answer 9

The extent of the damage

Question 10

Which population is OD more common in?

Answer 10

1. Patients with history of temporal bone fracture

2. Continuous OM and Choleseotoma

Question 11

What is Otosclerosis?

Answer 11

Abnormal growth that causes fixation of the stapes in the oval window

Question 12

T/F: Otosclerosis runs in the family and is thought to be hereditary.

Answer 12

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Question 13

What is the presentation of Otosclerosis?

Answer 13

1. Causes CHL or MHL

2. Characteristic is a dip in bone conduction at 2kHz with better thresholds at 4kHz

Question 14

What is the common name association with Otosclerosis on the audiogram?

Answer 14

Carhart’s Notch

Question 15

What is the treatment for Otosclerosis?

Answer 15

1. Amplification
2. Stapes surgery in severe cases
3. Drugs and vitamins can be used to help support healthy bones

Question 16

Which population is affected the most with Otosclerosis?

Answer 16

1. Develops in young adulthood
2. Progress throughout life
3. More common in women than men
4. Can be brought on by pregnancy

Question 17

What is Cholesteatoma?

Answer 17

An infectious growth of dead skins in the middle ear & smells

Question 18

T/F: Cholesteatoma has bad smell due to infectious nature?

Answer 18

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Question 19

What occurs if Cholesteatoma is left untreated?

Answer 19

1. Spread to surrounding tissues
2. Cause meningitis
3. Facial nerve paralysis
4. Vertigo
5. Bone erosion

Question 20

What is the treatment options for Cholesteatoma?

Answer 20

1. First treated with antibiotics

2. May require surgical removal and repair of damaged structures in ME.

Question 21

Cholesteatoma is common in?

Answer 21

Patients with a history of recurrent OM

Question 22

What is a Glomus Tumor?

Answer 22

Benign growths in the vasculature of the head and neck

Question 23

Where does the Glomus Tumor normally grows?

Answer 23

Around the carotid or jugular vein.

Question 24

What is the presentation of a Glomus Tumor?

Answer 24

1. Visible during otoscopy

2. Looks like an angry red mass

Question 25

What can occur if the Glomus Tumor continues to grow?

Answer 25

As it grows, it can press against structures of the ME & IE to cause hearing loss, tinnitus, vertigo, or pain/bleeding

Question 26

What is the treatment for Glomus Tumor?

Answer 26

Can be surgically removed or treated with gamma knife if it starts causing problems

Question 27

T/F: Glomus Tumors are asymptomatic?

Answer 27

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Question 28

Which population is affected by Glomus Tumors and why?

Answer 28

Often diagnosed in older adults than younger adults due to younger adults being asymptomatic since the tumor is small

Question 29

What is Mastoidits?

Answer 29

Infectious swelling of the mastoid bone

Question 30

What is the presentation for Mastoidits?

Answer 30

1. Painful swelling behind the ear | 2. Left untreated, can lead to meningitis or other brain infections and death

Question 31

How is Mastoidits treated?

Answer 31

1. Antibiotics | 2. Surgery to remove infected tissue in mastoid bone

Question 32

For Mastoidits, as an Audiologist, what should you be mindful of?

Answer 32

EMIs since a mastectomy causes changes in the outer ear, there's extra space between the second bend

Question 33

What population is affected my Mastoidits?

Answer 33

Common in kids where recurrent OM gets into mastoid air space through tympanic aditus and antrum.