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Systems: Head and Neck AB > Otology > Flashcards

Otology Flashcards

1
Q

What symptoms are associated with otology?

A
  • Hearing loss
  • Tinnitus
  • Vertigo
  • Otalgia
  • Otorrhoea
  • Facial weakness
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2
Q

What can be performed as part of an otology examination?

A
  • Otoscope
  • Microscope
  • Rinne’s test
  • Weber’s test
  • Whispered voice testing
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3
Q

How does a normal ear present on Rinne’s test?

A
  • Positive

- Air>bone

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4
Q

How does conductive hearing loss present on Rinne’s test?

A
  • Negative

- Bone>air

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5
Q

How does sensorimeural hearing loss present on Rinne’s test?

A
  • Positive

- Air>bone

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6
Q

How does normal hearing present on Weber’s test?

A
  • Test central

- Left=right

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7
Q

How does sensorineural hearing loss in the right ear present on Weber’s test?

A
  • Lateralises to left

- Left>right

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8
Q

How does conductive hearing loss in the right ear present on Weber’s test?

A
  • Lateralises to right

- Right>left

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9
Q

How is whispered voice testing carried out?

A
  • Whispered voice at 60cm
  • Mask other ear
  • No lip reading
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10
Q

What otology investigations can be carried out?

A
  • Pure tone audiogram

- Tympanogram

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11
Q

What are the different types of tympanogram results?

A
  • Type A normal
  • Type B tympanic membrane immobile
  • Type C middle ear pressure low
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12
Q

Give examples of disorders of the outer ear.

A
  • Auricular haematoma
  • Foreign body
  • Otitis externa
  • Malignant otitis externa
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13
Q

Give examples of disorders of the middle ear.

A
  • Otitis media with effusion (glue ear)
  • Insertion of grommet
  • Acute otitis media
  • Chronic suppurative otisis media: perforate tympanic membrane
  • Chronic suppurative otitis media: cholesteatoma
  • Suppurative otitis media: complications
  • Tympanosclerosis
  • Otosclerosis
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14
Q

Give examples of causes of inner ear conditions.

A
  • Prebyacusis
  • Noise induced hearing loss
  • Ototoxic medications
  • Meniere’s disease
  • Head injury
  • Infections
  • Vestibular schwannoma (acoustic neuroma)
  • Treatment of sensorineural hearing loss: hearing aids
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15
Q

Tinnitus

A

Any perception of sound

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16
Q

Pathology of tinnitus

A

No directly treatable pathology in vast majority hearing loss and stress important contributing factors

17
Q

Investigation of tinnitus

A

Unilateral or pulsatile

18
Q

Treatment of tinnitus

A
  • Sound enrichment

- Stress management

19
Q

Differential diagnosis of vertigo

A
  • Benign positional vertigo
  • Menieres disease
  • Vestibular neuritis/labyrinthitis
  • Migraine
20
Q

Features of vertigo episodes

A
  • Duration
  • Frequency
  • Associated symptoms
  • Precipitating factors
21
Q

Pathology of benign positional vertigo

A

Otoconia in semicicular canals

22
Q

Clinical features of benign positional vertigo

A
  • Vertigo precipitated by specific changes in head position
  • Duration: seconds
  • Frequency: several times per day
  • No associated symptoms
  • Positive Dix-Hallpike test
23
Q

Treatment of benign positional vertigo

A

Epley manoeuvre

24
Q

Pathology of vestibular neuritis/ labyrinthitis

A

Reactivation of latent HSV infection of vestibular ganglion

25
Q

Clinical features of vestibular neuritis/ labyrinthitis.

A
  • Spontaneous vertigo
  • No associated symptoms (vestibular neuritis) associated unilateral hearing loss (labyrinthitis)
  • Duration: days
  • Frequency: few episodes
  • Residual motion provoked vertigo
26
Q

Treatment of vestibular neuritis/ labyrinthitis

A
  • Vestibular sedatives for acute

- Vestibular rehabilitation for chronic

27
Q

Pathology of Menieres

A

Endolymphatic hydrops

28
Q

Clinical features of Menieres disease

A
  • Spontaneous vertigo
  • Unilateral hearing loss/tinnitus/aural fullness
  • Duration: hours
  • Frequency: every few days/weeks/months
  • Fluctuating, progressive unilateral hearing loss
29
Q

Treatment for Menieres

A
  • betahistine
  • bendofluazide
  • Intratympanic dexamethasone
  • Intratympanic gentamicin
  • Other
30
Q

Pathology of migraine

A

Possibly vascular or neural

31
Q

Clinical features of migraine

A
  • Spontaneous vertigo
  • Duration: variable
  • Frequency: variable
  • Headache, sensory sensitivity, auras
  • Precipitated by migraine triggers
  • Past history of migraine
32
Q

Treatment of migraines

A
  • Avoid migraine triggers

- Prophylactic medication

33
Q

Give examples of causes of facial palsy

A
  • Lower motor neuron facial weakness
  • Facial nerve components: intratemporal, extratemporal
  • Intratemporal pathology: cholesteatoma
  • Extratemporl pathology: parotid gland tumour
34
Q

Bell’s palsy

A

Acute, idiopathic facial palsy

Systems: Head and Neck AB (15 decks)

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