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Head and Neck > Otology > Flashcards

Otology Flashcards

1
Q

What is included in the middle ear?

A

Tympanic membrane
Middle ear ossicles
Ventilated by Eustachian tube

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2
Q

What is included for history of otology?

A

Hearing loss
Tinnitus
Discharge
Otalgia
Dizziness
Facial weakness, headaches, skin conditions and allergies

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3
Q

What is used to examine the ear?

A

Otoscope

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4
Q

What are the 2 tuning fork tests?

A

Rinne’s test
Weber’s test

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5
Q

Describe management if ear wax is blocking

A

Removal is not essential
Removal if symptoms
Ear drops - olive/almond oil, NAHCO3 and saline
Syringe or micro suction if no improvement
Advice not to insert anything into the ear

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6
Q

Describe the types of foreign body

A

Inorganic - beads/plastic, inert and no damage to skin
Organic - cotton bud, nuts, cause irritation of skin and risk of otitis externa

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7
Q

What can penetrating injury cause?

A

Cause rupture of tympanic membrane
May damage the ossicles

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8
Q

What are the symptoms for foreign body?

A

Persistent unilateral discharge
Ear discharge
Bleeding is occasional
Hearing loss if penetrated

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9
Q

How can foreign body be removed?

A

Hawthorne wax hook, right angled hook, syringing and suction

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10
Q

What is the management for penetrating trauma by foreign body?

A

Do nothing
ENT review six weeks later

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11
Q

What are the symptoms for otitis externa?

A

Hearing loss, itch and pain

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12
Q

What is used for treatment for otitis externa?

A

Use Sofradex, Gentisone HC ear drops or Otomize spray
If tympanic membrane perforation or not visible then use Cilodex

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13
Q

What is the management of otitis externa if persists?

A

Arrange microbiology swabs and treat according to sensitivities
If unresponsive then refer to ENT nurse

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14
Q

What is used if otitis externa causes swelling?

A

Pop wick - puts drops in canal and antibiotics

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15
Q

What happens if otitis externa spreads to cause facial pinna cellulitis?

A

Infection is in cartilage
Oral antibiotics needed and referral to hospital

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16
Q

What is the management for fungal otitis externa?

A

Micro suction
Check for underlying perforation
Keep ears dry
Topical Clotimazole or Nystatin drops for 2 weeks

17
Q

What can fungal otitis externa be caused by?

A

Aspergillus or Candida
Can be if wet environment - swimmers

18
Q

Describe malignant otitis externa

A

Infection spread to skull base
Granulation tissue on external ear
Longstanding process and systemic upset
Cranial nerve deficits
Diabetic or immune suppressed patient

19
Q

Describe necrotising otitis externa

A

Elderly diabetic or immune-suppressed
Topical treatment not working
Increased CRP and fasting blood sugar
Granulation tissue
Facial palsy/ cranial nerve deficits

20
Q

What is the management for necrotising otitis externa?

A

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

21
Q

What is exostoses?

A

Multiple body swellings
May need surgery to widen canal
History of water exposure
Presents with hearing loss

22
Q

What is osteoma?

A

Benign tumour of the bone causing small swelling - solitary bony lesion
Monitor
Usually asymptomatic

23
Q

How is chronic otitis media with perforation managed?

A

2 week course of Cilodex (ciprofloxacin and dexamethasone) ear drops 4 drops twice daily
If discharge in ear persists then refer to ENT

24
Q

Describe tympanic retractions

A

Part of ear drum lies deeper in ear than normal due to vacuum as lack of ventilation from Eustachian tube
If asymptomatic then no treatment needed

25
Q

What are the types of chronic otitis media?

A

Mucosal - active, inactive, or healed
Squamosal - retracted pockets and active

26
Q

What is acute mastoiditis?

A

Complication of SOM
Can cause brain abscess so acute emergency
Drain pus and abscess
IV antibiotics and put in grommets

27
Q

What is the diagnosis if dizziness lasts few seconds when turns head?

A

BPPPV
Positive on Dix Hallpike test
Needs Epley manoeuvre

28
Q

What is the differential diagnosis for vertigo?

A

BPPV - seconds and positional
Meniere’s/ Vest migraine - minutes to hours
Vestibular neuritis - days

29
Q

What is the treatment for Meniere’s Disease?

A

Betahistine - vasodilator
Stemetil PRN - anti-emetic

30
Q

What are complications of otitis media?

A

Fluctuant peri-aural swelling, facial palsy, vertigo, severe headache, new onset of neurological symptoms

Head and Neck (14 decks)

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