Otology

Question 1

Masking dilemma

Answer 1

occurs when there is bilateral 50 dB air-bone gap

Question 2

Stenger test

Answer 2

Tester presents subthreshold tone in “bad” ear and suprathreshold tone in “good” ear

Question 3

Recruitment

Answer 3

abnormal growth in loudness that indicates a cochlear lesion

Question 4

Fatigue

Answer 4

Change of auditory threshold resulting from continued acoustic stimu-lation that indicates retrocochlear lesion

Question 5

Rollover

Answer 5

a decrease of word recognition at high intensities (from cochlear distor-tion of eighth nerve adaptation) and is a classic finding for retrocochlear lesions

Question 6

Type As tymp

Answer 6

“S”hallow

Seen in otosclerosis, tympanosclerosis

Question 7

Type AD tymp

Answer 7

“D”eep

Seen in ossicular discontinuity

Question 8

Acoustic reflex pathway

Answer 8

Cochlea
→ CN VIII
→ cochlear nuclei and contralateral olivary complex via the trapezoid body
→ motor nucleus of CN VII
→ stapedius

Question 9

Degree of CHL to affect acoustic reflex

Answer 9

40 dB for the ear receiving the reflex-eliciting tone - or -

as little as 10 dB for the probe ear

Question 10

Degree of SNHL to affect acoustic reflex

Answer 10

> 70 dB

Question 11

When can ABR first detect brain-stem function

When is maturity reached on ABR

Answer 11

28 weeks’ gestational age with the appearance of waves I, III, and V

18 months after birth

Question 12

ABR waves

Answer 12

EECOL

I: distal Eighth nerve
II: proximal Eighth nerve
III: Cochlear nucleus
IV: Olivary complex
V: lateral Lemniscus

Question 13

ABR normal latencies

Answer 13

I-III =2.3 ms

III-V = 2.1 ms

I-V = 4.4 ms

Question 14

Retro-cochlear lesion on ABR

Answer 14

interpeak latency difference greater than 4.4 ms

Interaural latency difference of wave V greater than 0.2 ms

V3-V5 latency of greater than 2.1 ms

Question 15

Electrocochleography (ECOG), diagnostic for Ménière’s disease

Answer 15

elevated (> 0.4)

ratio of the summating potential to the compound action potential

Question 16

Distortion product otoacoustic emissions (DPOAEs) uses (3)

Answer 16

newborn hearing

aminoglycoside induced hearing loss

to help differentiate between cochlear and retrocochlear causes of SNHL

Question 17

Auditory neuropathy — OAEs

Answer 17

normal OAEs

abnormal CNVIII

Question 18

Hennebert sign

Answer 18

= Vertigo with pressure changes

Ménière disease’s
peri-lymph fistula [PLF]
superior canal dehiscence
syphilis

Question 19

Tullio phenomenon

Answer 19

Noise-induced vertigo

Ménière’s disease
PLF
superior canal dehiscence
syphilis

Question 20

Nystagmus fast vs slow phase driving force

Answer 20

Slow

Question 21

Jahrsdoerfer criteria for surgical repair of atresia (9

Answer 21

Stapes: 2

Oval window open: 1

Round window open: 1

Middle ear space: 1

Pneumatized mastoid: 1

Normal CN VII: 1

Malleus and incus: (minus) −1

Incus and stapes: 1

External ear: 1

Question 22

Microtia types

Answer 22

I — mild deformity
(ie, lopear, cupear, etc)

II — all structures are present to some degree, but there is a tissue deficiency

III — ”Classic”
significant deformity with few recognizable landmarks
- lobule often present and anteriorly displaced
- canal atresia

Question 23

Frostbite

Answer 23

Rapidly rewarm with gauze soaked in saline, that is, 38°C to 42°C/100.4°F to 107.6°F

Tissue should not be debrided upon rewarming as demarcation may take several weeks

topical antibiotic, ointment, and oral analgesics

Question 24

Malignant OE, Dx

Answer 24

Technetium99 radioisotope scan

followed with gallium scan

Question 25

Hereditary hearing loss, syndromic vs non-syndromic %

Answer 25

<1% of kids

70% NON-syndromic
- 80% recessive 
-- MCC = connexin 26 or GJB2
- 20% dominant 
< 2% X or mitochondrial

30% syndromic