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Head and Neck > Otology > Flashcards

Otology Flashcards

1
Q

What is otology?

A

The study of anatomy and diseases of the ear

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2
Q

What are some examples of some symptoms related to otology?

A

Hearing loss

Tinnitus

Vertigo

Otalgia

Otorrhoea

Facial weakness

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3
Q

What is hearing a sound in the absence of external sounds called?

A

Tinnitus

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4
Q

What is a sense of spinning dizziness called?

A

Vertigo

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4
Q

What is discharge from the ear called?

A

Otorrhoea

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5
Q

What is ear pain called?

A

Otalgia

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6
Q

What are some different methods of ear examination?

A

Otoscopy

Microscopy

Rinne’s test

Weber’s test

Whispered voice test

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7
Q

What are the 3 possible outcomes from the Rinne’s test?

A

A (normal ear, air > bone so test is positive)

B (conductive hearing loss, bone > air so test is negative)

C (sensorineural hearing loss, air > bone so test is positive)

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8
Q

What are the 3 possible outcomes of the Weber’s test?

A

A (normal hearing in both ears, left=right so test is central)

B (sensorineural hearing loss in right ear, left>right so test lateralises to the left)

C (conductive hearing loss right ear, right>left so test lateralises to the right)

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9
Q

What is the Whispered voice test?

A

Whispered voice at 60cm with the other ear masked and no lip reading

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10
Q

What are different methods of ear investigations?

A

Pure tone audiogram

Tympanogram

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11
Q

what are the 3 outcomes of pure tone audiogram?

A

A (normal hearing, better than 20dB)

B (conductive hearing loss, bone conduction better than air condiction)

C (sensorineural hearing loss, bone conduction the same as air conduction)

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12
Q

What are the 3 outcomes of tympanogram?

A

A (normal middle ear pressure and compliance)

B (low middle ear compliance)

C (low middle ear pressure)

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13
Q

What is pure tone audiogram?

A

Test to identify hearing thresholds of someone

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14
Q

What is a tympanogram?

A

Graphic representation of the relationship between air pressure in the ear canal and the movement of the tympanic membrane

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15
Q

What is the tympanic membrane also known as?

A

Ear drum

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16
Q

What are examples of disorders of the ear?

A

Auricular haematoma

Forign body

Otitis externa

Malignant otitis externa

Otitis media with effusion

Acute suppurative otitis media

Tympanosclerosis

Chronic suppurative otitis media

Perforation of tympanic membrane

Cholesteatoma

Otosclerosis

Sensineural hearing loss

Tinnitus

Vertigo

Benign positional vertigo

Vestibular neuritis/labyrinthitis

Meniere’s disease

Migraine

Facial nerve palsy

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17
Q

What is auricular haematoma?

A

Collection of blood underneath the perichondrium of the ear

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18
Q

What is the management of auricular haematoma?

A

Incision and drainage

Pressure dressing

Antibiotics

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19
Q

What is a possible complication of auricular haematoma?

A

Cauliflower ear

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20
Q

What is the management of a forign body in the ear?

A

Removal

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21
Q

Explain the order of urgency for different kinds of forign bodies in the ear?

A

Button battery > organic > inorganic

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22
Q

button battery

A

needs to be removed within hours

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23
Q

What is otitis externa?

A

Inflammation of external auditory meatus

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24
Q

What is the management of otitis externa?

A

Antibiotic/steroid ear drops with or without suction under microscopy

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25
Q

What is the prevention of otitis externa?

A

No water or cotton buds to be used in the ear

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26
Q

What is malignant otisis externa?

A

Osteomyelitis of temporal bone

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27
Q

What is the presentation of malignant otitis externa?

A

Severe pain in elderly diabetic

Granulations in external auditory meatus with or without cranial nerve palsies

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28
Q

What is the management of malignant otitis externa?

A

Antibiotics for weeks or months

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29
Q

What is otitis media?

A

Inflammation of the middle ear

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30
Q

What is otitis media with effusion also known as?

A

Glue ear

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31
Q

What is the presentation of otitis media?

A

Hearing loss

Speech delay

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32
Q

What is the management of otitis media with effusion?

A

Observation for 3 months

Otovent

Grommet

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33
Q

What is an otovent?

A

Autoinflation device used to open up the euchachian tubes

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34
Q

What is grommet?

A

a tube surgically implanted in the eardrum to drain fluid from the middle ear

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35
Q

What is acute suppurative otitis media?

A

Inflammation of middle ear and mastoid cavity that is characterised by pus in the ear

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36
Q

What is the presentation of acute suppurative otitis media?

A

Otalgia with or without otorrhoea

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37
Q

What is the management of acute suppurative otitis media?

A

Observation

Amoxicillin

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38
Q

What is tympanosclerosis?

A

Calcification in tympanic membrane with or without middle ear involvement

39
Q

What is the presentation of tympanosclerosis?

A

Usually asymptomatic

40
Q

What is the management of tympanosclerosis?

A

Usually none

41
Q

What is the pathology of chronic suppurative otitis media?

A

Perforated tympanic membrane or cholesteatoma (skin in middle ear with or without mastoid bone involvement)

42
Q

What are possible complications of chronic suppurative otitis media?

A

Dead ear

Facial palsy

Meningitis

Brain abscess

43
Q

What are potential causes of perforation of tympanic membrane?

A

Infection

Trauma

Grommet

44
Q

What is the presentation of perforation of tympanic membrane?

A

Recurrent infections

Hearing loss

45
Q

What is the management of perforation of tympanic membrane?

A

Water precautions

With or without myrinoplasy

46
Q

What is myrinoplasy?

A

Operation to repair a perforation of the tympanic membrane

47
Q

What is cholesteatoma?

A

Abnormal, non-cancerous skin growth in the middle ear

48
Q

What are possible causes of cholesteatoma?

A

eustachian tube dysfunction

Impaired skin migration

49
Q

What is the presentation of cholesteatoma?

A

Perisistent offensive otorrhoea

50
Q

What is the management of cholesteatoma?

A

Mastoidectomy

51
Q

What is a mastoidectomy?

A

Surgical procedure to remove diseased mastoid air calls

52
Q

What is otosclerosis?

A

One of staples in middle ear gets stuck in place

53
Q

What is the presentation of otosclerosis?

A

Conductive hearing loss

Normal tympanic membrane

54
Q

What is the pathology of otosclerosis?

A

Fixation of stapes by extra bone

55
Q

What is the management of otosclerosis?

A

Hearing aid or stapedectomy

56
Q

What is a stapedectomy?

A

Procedure in middle ear where stape is removed
A stapedectomy is surgery to treat hearing loss caused by otosclerosis. This condition affects your hearing by damaging your stape, a tiny U-shaped bone in your middle ear. Your stape helps you hear by sending sound waves from your middle ear to your inner ear.

57
Q

What is sensorineural hearing loss?

A

Type of hearing loss where the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve (CN VIII)

58
Q

What are possible causes of sensorineural hearing loss?

A

Presbyacusis

Head injury

Viral infections

Noise exposure

Ototoxic medications

Acoustic neuroma

59
Q

What is the management of sensorineural hearing loss?

A

Hearing aids

60
Q

What is tinnitus?

A

Sensation of hearing a sound in the absence of external sounds

61
Q

What should be investigated with tinnitus?

A

Unilateral

Pulsatile (pulsating)

62
Q

What is the management of tinnitus?

A

Treat underlying cause

Soud enrichment

Stress management

63
Q

What is vertigo?

A

Sense of spinning dizziness

64
Q

What are the differential diagnosis of vertigo?

A

Benign positional vertigo

Menieres disease

Vestibular neuritis/labyrinthitis

Migraine

65
Q

What is benign positional vertigo?

A

Sudden sensation of spinning, feels like from the inside of your head

66
Q

What is the pathoogy of benign positional vertigo?

A

Otoconia in semi-circular canals

67
Q

What are otoconia?

A

Bio-crystals which couple mechanical forces to the sensory hair cells in the utricle and saccule

68
Q

What are the clinical features of beign positional vertigo?

A

Vertigo precipitated by specific changes in head position

Duration in seconds

No associated symptoms

Nystagmus is positional and rotatory

69
Q

What is Nystagmus?

A

Vision condition where the eyes make repetative, uncontrolled movements

70
Q

What investigation is done for benign positional vertigo?

A

Dix-Hallpike test

71
Q

What is the management of benign positional vertigo?

A

Epley manoeuvre

72
Q

What is vestibular neuritis?

A

Inflammation of vestibular nerve

73
Q

What is the pathology of vestibular neuritis/labyrinthitis?

A

Reactivation of latent HSV infection of vestibular ganglion

74
Q

What are the clinical features of vestibular neuritis?

A

Spontaneous vertigo

Associated underlateral hearing loss (labyrinthitis)

Duration is days

Nystagmus is horizontal towards the affected ear

75
Q

What is the management of vestibular neuritis/labyrinthitis?

A

Management of acute is vestibular sedatives

Management of chronic is vestibular rehabilitation

76
Q

What is Maniere’s disease?

A

Disorder of inner ear that leads to dizziness and hearing loss

77
Q

What is the pathology of Maniere’s disease?

A

Endolymphatic hydrops

78
Q

What are the clinical features of Maniere’s disease?

A

Spontaneous vertigo

Associated unilateral hearing loss/tinnitus/aural fullness

Duration is hours

79
Q

What is the management of Maniere’s disease?

A

Bendoflumethazide

Intratympanic dexamethasone

Intratympanic gentamicin

80
Q

What is a migraine?

A

Moderate to severe headache felt as throbbing pain on one side of the head

81
Q

What is the pathology of a migraine?

A

Possibly vascular or neural, but is unknown

82
Q

What are the clinical features of a migraine?

A

Spontaneous vertigo

Duration is variable

With or without headache, sensory sensitivity

With or without precipitated migraine triggers

With or without past history of migraine

83
Q

What is the management of migraine?

A

Avoid migraine triggers

Prophylactic medication

84
Q

What is facial nerve palsy?

A

Function of the facial nerve (CN VII) is partly or completely lost

85
Q

What are the clinical features of facial nerve palsy?

A

Lower motor neuron facial palsy (forehead involved)

86
Q

What is the differential diagnosis of facial palsy?

A

Intratemporal such as cholesteatoma

Extratemporal such as parotid tumour

Idiopathic is called Bell’s palsy

87
Q

What is idiopathic facial palsy called?

A

Bell’s palsy

88
Q

What is the management of facial nerve palsy?

A

A
Treat underlying cause (if possible)

Steroids

Eye care

89
Q

what is the treatment for a foreign body removal?

A

Hawthorne wax hook
Right angled hook
Syringing
Suction

90
Q

what is the treatment for penetrating trauma?

A

Do nothing
ENT review six weeks later

91
Q

what is the treatment for acute otitis externa?

A

Use Sofradex, Gentisone HC ear drops or Otomize spray.

If tympanic membrane perforated or not visible use Cilodex

Most better in a week

If persistent symptoms after 2 weeks - ?arrange microbiology swabs and treat according to sensitivities

If unresponsive refer to ENT Nurse - Led clinic

92
Q

what is the treatment for acute otitis external if tympanic membrane perforated or not visible?

A

Cilodex

93
Q

what is the treatment for necrotising otitis externa?

A

Immediate referral
Systemic anti-pseudomonas antibiotics
Surgical debridement
Control of diabetes

94
Q

what is the treatment for Menderes disease?

A

Betahistine
Stemetil PRN – ONLY

Head and Neck (15 decks)

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