Otology Flashcards
conductive vs sensory hearing loss
conductive hearing loss = disruption of sound waves to get to inner ear (outer, TM, middle ear)
sensory = irrev damage to hair cells or cochlear structures in translating sound to electrical
conductive loss on audiogram
affects all freq in hearing
damaged air conduction
normal bone conduction
bone conduction = how well inner ear functions
sensory hearing loss on audiogram
affects high freq initially
no difference between bone and air conduction because no conduction problem (sound wave still reach cochlea but just no electrical transduction)
bone conduction = how well inner ear functions
acute otitis media
1) symptoms
2) physical exam
3) signs of perf
4) treatment
1) pain, fullness, pressure, hearing loss
2) inflammed TM, can’t see through,
3) erythema, edema, otorrhea, perf
4) watch wait in low risk or amoxicillin high dose
tympanocentesis for culture or acute pain (extraordinary) to decr pressure
myringotomy/mastoid for complex to drain TM
if fluid left in middle ear after 3 months in acute otitis media what do you do
can be normal does not have to be infected
otitis media with effusion
1) symptoms in ear
2) motor effects
3) often due to
1) pain, fullness, pop, irritability, sleep problem, conductive hearing loss,
2) school problem, imbalance, delay gross motor, speech or language development
3) recurrent AOM
4) pressure-equalizer tube surgery to drain fluid since eustacian tube not in right place
or adenoidectomy if nasal obstruct or apnea
otitis media with effusion
what does not work
antibiotics
histamines
steroids
DON’T WORK
externa otitis media due to
inflamm of external ear
swimmer’s ear, diabetes
suppurative (pus) otitis media
1) caused by (2)
1) TM perf from trauma, infection, tube
or cholesteatoma = skin drawn into mid ear and pinched off (keratin ball) can grow/erode labyrinth causing vertigo and CN 8 palsy
most common cause of persist draining ear in adult
cholesteatoma
TM perforation
1) can lead to …
2) treatment
1) cholesteatoma = pars flaccida
2) treat with tympanoplastic surg if not yet cholesteatoma
Otosclerosis
1) age group, race, gender
2) disorder of …
3) progression
4) treatment
1) 30-50, white, women
2) disorder of bone remodeling, can cause stapes fixation –> sensorineural hearing loss
3) progressive uni/bilateral hearing loss
4) stapedectomy to free foot plate and replace with prostethic
genetics of otosclerosis
inheritance
assoc with
mutation
AD variable penetrance
assoc with measles virus/bone disorders
COL1A1 and aggrecan mutation
congenital aural atresia
malformation where?
treatment?
malformation of external auditory canal, TM, middle ear, or ossicles
surgery
presbycusis
1) progression
2) assoc with
3) symptoms
4) where is impairment
1) gradual progressive, bilateral
2) aging
3) decr hearing threshold sensitivity
decr high freq sensitivity
can’t understand suprathreshold speech (understand loud speech)
can hear things but can’t understand details of words
4) central auditory process
Noise trauma
1) comes from?
2) phenomenon of …
what is seen on audiogram
3) due to?
1) comes from acute or chornic loud noise
2) temporary threshold shit –> 4 kHz notch (resonant freq so energy amplified here)
3) resonance of outer ear
Meniere’s disease = endolymphatic hydrops
1) mechanism
2) symptoms
1) swelling of endolymphatic space from problem with stria vascularis and loss of endocochlear potential (poor ion movement)
2) vertigo more than 20 min, tinnitus, fullness, fluctuating hearing loss
meniere’s disease
1) uni or bilateral
2) progression
3) treatment
1) usu unilateral
2) chronic with acute phase and remission, unpredictable course, reach burnout or flat hearing loss
3) diuretic for swelling, Mg2+ for vertigo, surgery if not responsive
CN8 schwannoma
1) describe basics
2) assoc with which nerve
3) two forms
1) benign, slow growing tumor
2) vestib nerve»_space; acoustic > facial
3) NF2 = mutation in gene for merlin in cell-cell or cell-matrix
OR
sporadic = double mutation at merlin
CN8 schwannoma
early vs late signs and symptoms
early = hearing loss
unilateral tinnitus
mild/fleeting vertigo
late = facial numbness, ataxia, HA, visual loss, long tract signs, death by herniation
CN8 schwannoma
treatment
1) watchful waiting
2) surgical resection
radiosurg or radiotherapy
causes of sensory hearing loss
1) presbycusis
2) noise trauma
3) ototoxicity
4) meniere’s
5) CN 8 schwannoma
causes of conductive hearing loss
1) acute otitis media
2) otitis media with effusion
3) TM perf
4) otosclerosis
5) congential aural atresia
word recognition score means
ability to discriminate words presented at normal conversational loudness levels (0-100%).
represents the “neural” aspect of hearing ability (inner hair cell, 8th nerve and central auditory pathways)
if you see unilateral hearing loss on audiogram think what
asymmetric hearing loss
meningioma or acoustic neuroma
difference between bone and air conduction
normal bone
abnormal air
conductive hearing loss
most common viral cause of congenital hearing loss
most common cause of genetic hearing loss
CMV in utero
AR non-syndromic due to mutation in connexin 26/GJB2
disordered inner ear fluid homesotasis assoc with
1) vasculitis
2) DM, hypothyroid, renal failure, arteriosclerosis
3) immune related
flat, moderate, and severe sensorineural hearing loss
causes of neural hearing loss
8th nerve tumors
auditory neuropathy
multiple sclerosis
