Midterm Flashcards
Define: Otalgia
Pain localizing to the ear
Define: Otorrhea
Drainage or discharge from the ear
-mostly related to infection or inflammation of middle or external ear
Microtia
Abnormally small pinna
Macrotia
Abnormally large pinna
Lop/cup ear
deformity of pine where superior edge of helix is folded down
Melotia
abnormal positioning of pinna - usually low placed and set forward
Preauricular Sinus/Pit
tube or pit located on the ear
Supernumerary Hillocks/Ear Tag
growth on the ear
Stenosis
narrowing of the ear canal
Audiologic findings of STENOSIS
possible conductive hearing loss but hearing is not usually affected
-collapsing EC
- excessive cerumen
-otitis externa
Management of STENOSIS
-canaloplasty
-meatoplasty
removal of granulation
BAHA for amplification
Atresia
closed or lack of ear canal
Symptoms of ATRESIA
-conductive hearing loss
Atresia is commonly seen with ___________.
Microtia
Management of ATRESIA
-surgical creation of ear canal
Occlusion
partial or complete blockage of the ear canal by a foreign body
Keratosis Obturans
abnormal collection of skin cells and keratinous debris causing blockage of EAC
Symptoms of KERATOSIS OBTURANS
-bilateral
-acute CHL
-otalgia
-thick TM
-widened EC
-otorrhea
Management of KERATOSIS OBTURANS
removal of skin cells and debris
Cholesteatoma of EAC
abnormal collection of keratinized skin cells invading the EAC and underlying bone
Symptoms of CHOLESTEATOMA
-unilateral
-purulent pus
-osteonecrosis
Treatment of CHOLESTEATOMA
removal of debris and underlying bone
reconstruction of EAC
What is the difference between cholesteatoma and keratosis obturans
-KO is usually bilateral, cholesteatoma is usually unilateral
-pus with cholesteatoma
-cholesteatoma usually affects older populations; KO affects younger populations
Acute Otitis Externa (swimmers ear)
What is it?
Symptoms?
Treatment?
bacterial infection of the EAC
-sudden onset, pain and extreme sensitivity, Edema/erythema, heat sensation, drainage, shedding of skin cells, CHL due to swelling
-antibiotics
Chronic Otitis Externa
What is it?
Symptoms?
Treatment?
chronic bacterial infection of the external ear/EAC
-bloody discharge, chronic hypertrophy of OE, progressive stenosis, usually bilateral
-remove granulation, no surgery if unilateral, amplification
Malignant Otitis Externa
What is it?
Symptoms?
Treatment?
infection of the OE and temporal bone and skull base
-similar to otitis externa in beginning, otorrhea, HL, Otalgia, Facial weakness
-Systemic/IV antibiotics, surgical cleansing
Cauliflower Ear
swelling caused by blunt force trauma to the pinna
-possible CHL, headaches/blurred vision, pain, swelling, etc
Furunculosis
infected hair follicle in the ear canal
Otomycosis
fungal infection of the ear canal
What is a neoplasm?
new and abnormal growth or tumor on the pinna and ear canal
Exostosis
-BENIGN bony growth in ear canal
Osteoma
new bone growth in ear canal, identified by pearl-like appearance
What are some differences between Exostosis and Osteoma?
- osteoma is usually unilateral, exostosis is usually bilateral
-osteoma usually occurs in children, exostosis more common in adults
What is osteomyelitis and what disorder does it occur with?
infection of the bone; seen with malignant OE
Exotosis usually occurs on the ______.
Annulus of the TM
What section of the TM are tubes usually placed?
Anterior, inferior portion of TM
What are the usually symptoms of absence of ossicles?
-mild to moderat conductive HL
-type Ad tymp
Which ossicles are usually missing in absence of ossicles?
lenticular process of the incus
Congenital Ossicular Fixation
ossification of ligaments in the soft tissue that holds the ossicles
What is Congenital anomaly of TM
part or all of TM covered by bony plate
Persistent Stapedial Artery
pulsatile mass in ME; vascular issue with artery through the stapes
symptoms of persistent stapedial artery
-tinnitus
-dizziness
-CHL occasionally
TM perforation
hols in the TM caused by infection with effusion or trauma from blast or penetration
What is the treatment for TM perforation?
myringoplasty
If a TM perf is untreated, there can be a risk of ___________.
Cholesteatoma
What type of immittance would be expected with TM perf?
-flat tymp with high ECV
Type B
What is a central perforation? Marginal perforation?
Central perforation - smaller hole in TM, most of TM still present/surrounding perf
marginal perforation - most of perf framed by annulus (large hole)
Tympanosclerosis
calcification of connective tissues on TM or head of ossicles
Audiologic findings of tympanosclerosis
CHL
Type As tymps due to increased stiffness
Myringosclerosis
calcification of only the TM caused by long-term OM, repeated PE tubes, and spontaneous healing of perf
Otogenic vs. Non-otogenic
otogenic pain originates in the ear
non-otogenic originates outside of the ear, usually TMJ
If the EAC is partially occluded with cerumen, what would the hearing loss be expected to look like? Fully occluded?
partial occlusion = high frequency conductive HL
complete occlusion = flat 40-50 dB HL conductive HL
What is the audiogram expected to look like for a patient with collapsing Canal?
50-55dB HL conductive hearing loss above 2kHz that varies with movement of headphones
What are some ways to help reduce affects of collapsed canal?
-insert earphones
-tymp tip in hear
-rolled gauze behind ear
Irregularly small middle ear space is common in __________.
children with Down syndrome
Otic Barotrauma
discomfort or damage caused by rapid changes of pressure
What are the two classifications of TEMPORAL BONE FRACTURE? How do each affect hearing?
- Otic capsule sparing fracture (inner ear intact): mild to moderate flat CHL
-Otic capsule disrupting/violating fracture (cochlea and vestibule fractured): SNHL and vertigo
Describe audiologic findings of traumatic discontinuity of ossicular chain
-CHL or mixed HL with larger ABG in high frequencies
-Ad tymp - hyper mobility, no reflexes, type B tymp is TM rupture
Myringitis
Inflammation of the TM
Define 3 different types of myringitis
Acute Myringitis - short-lived caused by otitis externa from canal against TM or OM in ME
Bullous Myringitis - blisters between outer and middle layers of TM
-fluid filled, could be blood
Granulomatous/granular Myringitis - outer layer of TM and skin of ear canal replaced by abnormal tissue
What is a myringotomy? When is it used?
Surgical incision (cut) in the TM to relieve pressure from fluid
Eustachian tube Dysfunction (ETD)
ET fails to open or is blocked causing air in ME to be absorbed and create negative pressure
What tymps are expected with ETD?
Type C, negative pressure in the ear
What is OTITIS MEDIA?
Inflammation of the middle ear
Otitis media is usually preceded by ________ and can be accompanied by ___________.
ETD; effusion
Describe hearing loss with OM.
flat 10-40 dB conductive hL with slight peak at 2kHz
may be LF CHL in beginning
What is an example of recurrent OM treatment?
Myringotomy with PE tubes
Which part of the ossicular chain is usually affected by otosclerosis ?
Stapes and oval window
Two stages of otosclerosis
Otospongiosis - active growth of bone
Otosclerosis - final stage, hardening of new bone growth
Schwartz sign
reddish glow visible through TM around cochlear promontory due to increased vascularity during otospongiosis
Paracusis of Willis
Better understanding in noise than normal hearing
What is the most common ME tumor?
Paraganglioma Tumor or Glomus Tumor
Most cases of congenital deafness involve ____________________.
Membranous labyrinth of the IE; involving IHCs
What are the three classifications of membranous labyrinth malformations?
- Complete membranous labyrinth dysplasia (Bing-Siebenmann Dysplasia)
- Cochlear Basal Turn Dysplasia (Alexander Dysplasia)
- Cochleaosaccular Dysplasia (Scheibe Dysplasia)
Name and describe the most common membraneous labyrinth malformation?
Cochleosaccular dysplasia (Scheibe dysplasia)
Organ of Corti partially or completely missing
scala media collapse
saccule collars
What is the most severe IE deformity? Describe.
Complete labyrinth aplasia (Michel Aplasia)
no development of IE; IE structures and CN VIII absent
Cochlear aplasia
complete absence of cochlea resulting in total deafness; vestibule and SCC present but usually deformed
cochlear hypoplasia
underdevelopment of the cochlea; single turn or less, small cochlear bud protruding from vestibule
Type I Incomplete Partition
Cystic cochleovestibular malformation
cystic/empty cochlea without partition
Type II Incomplete Partition
Mondini Dysplasia
cochlea has 1.5 turns and the middle and apical coils form cystic cavity
What does TORCH stand for and why is it significant to IE disorders?
Toxoplasmosis, Other (Syphilis and HIV), Rubella, CMV, Herpes Simplex Virus
refers to acquired infections that can be contracted by a pregnant person and passed to the baby before or after birth
What is presbycusis?
SNHL due to normal aging process
Another name for complete membranous labyrinth dysplasia
Bing-Siebenmann Dysplasia
another name for Cochlear basal turn dysplasia
Alexander dysplasia
another name for cochleosaccular dysplasia
Scheibe dysplasia
another name for complete labyrinth aplasia
Michel Aplasia
