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ENT > Otology > Flashcards

Otology Flashcards

1
Q

Otitis Externa

A

Inflammation and infection process of the external auditory canal +/- auricle

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2
Q

Predisposing factors otitis externa

A

Heat
Humidity
Trauma
Exposure to water

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3
Q

Most common pathogen otitis externa

A

Pseudomonas aerugimosa and S. aureus

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4
Q

Otitis media Hx

A

Otalgia
Otorrhoea
Aural fullness
Pruritis
Tenderness
Hearing loss

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5
Q

Mangement otitis externa

A
  1. Abx drops (Sofradex, ciproxin)
  2. Earwick insertion to stent open EAC if there is occlusion (remove after 24hrs)
  3. Aural suctioning
  4. Analgesia
  5. May need surgical management if exostoses (surfers ear) is present
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6
Q

Acute otitis media

A

Inflammation and infection of the middle ear

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7
Q

Underlying pathogenesis of sicure otitis media

A

Pharyngotempanic (Eustachian) tube dysfunction

Usually preceded by a viral URTI

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8
Q

Acute otitis media

A

Otalgia
Fever
Hearing loss
Otorrhoea
Can have decreased appetite and concurrent URTI

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9
Q

Exam finding acute otitis media

A

Bludging TM with erythema can be seen

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10
Q

Acute otitis media management

A
  1. Reassurance with analgesia and watchful waiting (<6m or not improving within 24hrs, Abx is first line)
  2. Abx (Amoxicillin)
  3. Analgesia
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11
Q

Otitis media with effusion

A

Aka glue ear

Inflammation of middle air space with the presence of effusion

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12
Q

Risk factors for OME

A

Parental smoking
Abscence of breast feeding
Adenoid hypertrophy
Day care attendance

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13
Q

Hx OME

A

Often asymptomatic
Decreased hearing
Poor sleep

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14
Q

Otoscopy findings OME

A

Dull grey or yellowish immobile TM

If TM clear air-fluid levels can be seen

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15
Q

Mangement OME

A

High risk - ENT review (grommets)

Low risk - watchful waiting, if still resent after 3 months - ENT referral

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16
Q

Otitis externa complications

A

Malignant otitis externa (skullbase osteomyelitis)

17
Q

Acute otitis media complications

A

TM perforation
Mastoiditis
Facial nerve paresis
Labyrinthitis
Intracranial complications (meningitis, abscess, sigmoid sinus thrombosis)

18
Q

Otitis media with effusion complications

A

Conductive hearing loss (developmental impact)
Speech delay
Atelectasis/TM retraction
Cholesteatoma (retracted membrane causes distraction of squamous epithelium movement)

19
Q

What is a cholesteatoma

A

A destructive lesion of the skull base and middle ear formed by trapped squamous epithelium

Trapped squamous epithelium forms a sac with keratin debris

20
Q

Hx cholesteatoma

A

Persistent or recurrent purulent otorrhoea
Hearing loss
Tinnitus
Rarely: vertigo, ataxia, facial nerve paresis

21
Q

Ix for cholesteatoma

A

Ct scam
Adiometry
MRI

22
Q

Mangement for cholesteatoma

A

Surgery - mastoidectomy
Microscopic removal of debris
Keep ear out of water
Tropical Abx

23
Q

cholesteatoma complications

A

Bone erosion
Sensorineurol hearing loss
Facial nerve injury
Infection (mastoiditis, intracranial abscess, sigmoid sinus thrombosis, meningitis)

24
Q

What is presbycusis?

A

Otherwise unexplained SNHL in the elderly - usually bi, lateral, ynand symmetrical

25
Q

Causes of Presbycusis

A
  1. genetic predisposition
  2. Noise trauma
  3. Diet, nutrition, ototoxin exposure
  4. Multifactorial age-associtated changes
26
Q

History of Presbycusis

A

Progressive hearing loss - particallynworse with ambient noise
Ask about - occupational exposure, family history

27
Q

Examination findings in Presbycusis

A

Usually normal but preformed to excludenother diagnoses

28
Q

Investigations for Presbycusis

A

Audiometry is diagnostic

29
Q

Mangement for Presbycusis

A
  1. Hearing aid
  2. Assistive devices
  3. Cochlear implant
30
Q

Causes of central vertigo

A

Ischemia: TIA, stroke, vertebrobasliar insuffient, migraine
Neoplastic: acoustic neurons (usually unilateral progressive hearing loss)
MS

31
Q

Peripheral causes of vertigo

A

BPPV
Meniere disease
Vestibular neuronitis
Labyrinths
Otitis media, simusitis

32
Q

Examination for vertigo

A

Vital signs
Full ENT exam
Neuro exam
Special tests: Dix hallpike test, romberg and tandem gait, head thrust, caloric testing

33
Q

What vestibulosuppresents can be tried for symptomatic relief

A

Promethazine
Benzodiazepine
Scopolamine

34
Q

Meniere disease aetiology

A

Aka endolymphatic hydrops

Caused by impaired reabsorption if endilymorhatic fluid

35
Q

Hx Meniere disease

A
  1. Unilateral fluctuating SNHL
  2. Vertigo lasting minutes to hours
  3. Constant or intermittent tinnitus
  4. Aural fullness
36
Q

Meniere diase investigations

A

Based on hx and normal exam is diagnostic

Syphilis can perfectlynmimic meniere disease
Is hearing is asymmetric then MRI needs to be preformed

37
Q

Meniere disease tx

A

Acute - vastivulosuppresents, betahistamine

ENT (4 decks)

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