Middle ear pathologies

Question 1

What is otitis media with effusion also known as?

Answer 1

Glue ear

Question 2

What is otitis media with effusion

Answer 2

Inflammation of the middle ear which can present with STERILE fluid in the ear.
Due to dysfunction of the Eustacian tube- it creates a vacuum which drains out fluid from the inner ear

Question 3

How to manage otitis media with effusion

Answer 3

• Observation for 3 months

- If no improvement then grommets/otovent

Question 4

What are the symptoms of otitis media with effusion?

Answer 4

• Hearing loss

- Speech delay

Question 5

What is acute suppurative otitis media?

Answer 5

• Build up of malignant fluid in the ear.
• Usually related to a burst ear drum- pain will increase until the eardrum bursts then will die down
• Will usually present with a history of URTI

Question 6

What are the symptoms of acute suppurative otitis media?

Answer 6

• otalgia
• otorrhoea
• Bulging ear-drum

Question 7

Management of acute suppurative otitis media?

Answer 7

• Observation

- Amoxycyllin

Question 8

Tympanosclerosis

Answer 8

Calcification of the tympanic membrane and/or middle ear

• No management
• No presentation

Question 9

What is chronic suppurative otitis media and what is it due to?

Answer 9

Chronic discharge of malignant fluid from the ear.
Aetiology:
-Choleastoma
-Perforated tympanic membrane

Question 10

Consequences of suppurative otitis media?

Answer 10

Fluid can make its way into the inner ear

• Dead ear
• Facial palsy
• Meningitis
• Brain abcess

Question 11

What is Choleastoma?

Answer 11

Abnormal growth of Skin in the middle ear
Usually forms a pouch that doesn’t shed so builds up.
It perforates into important structures such as the ear, facial nerve and brain

Question 12

What are the causes of choleastoma

Answer 12

• Dysfunction in Eustacian tube

- Skin moves into middle ear

Question 13

What are the classic symptoms of Choleastoma?

Answer 13

-Chronic otorrea

Question 14

How to manage choleastoma?

Answer 14

mastoidectomy

Question 15

What is Tinnitus

Answer 15

Perception of sound even when there isn’t one e.g. ringing sounds

Question 16

What is the management of tinnitus?

Answer 16

• Treat an underlying cause if there is one
• Sound enhancement e.g. a hearing aid
• Relieve stress

Question 17

What is Otosclerosis

Answer 17

Abnormal growth of bone in the middle ear

Question 18

Presentation of otosclerosis

Answer 18

Conductive hearing loss

Question 19

Management of otosclerosis

Answer 19

• Hearing enhancement

- Stapedectomy

Question 20

Causes of a perforated tympanic membrane?

Answer 20

Infection
Grommet
Trauma

Question 21

Presentation of perforated tympanic membrane

Answer 21

• Recurrent infection

- Hearing loss

Question 22

Management of perforated tympanic membrane

Answer 22

• Avoid water

- Myringoplasty: closure of perforation

Question 23

Causes of tinnitus

Answer 23

Damage to the cochlear hairs which is associated with presbycusis, noise related hearing loss and stress -

Question 24

Investigation for tinnitus

Answer 24

• Hearing test

- If pulsatile then do a scan

Question 25

Common conditions of the inner ear

Answer 25

• Presbycusis (old age hearing loss/starts at a frequency)
• Noise induced hearing loss (starts at a higher frequency)
• Vestibular schwannoma

Question 26

What is vestibular schwannoma

Answer 26

A benign tumour of the vestibular nerve

Question 27

what does vestibular schwannoma cause

Answer 27

Sensorineural hearing loss in one ear.