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Head and Neck > Otology > Flashcards

Otology Flashcards

1
Q

what nerve runs right through the ear?

A

the facial nerve

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2
Q

what symptoms someone with ear problems present with?

A 
> hearing loss
> tinnitus
> vertigo
> otalgia
> otorrhoea
> facial weakness
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3
Q

what does otorrhoea mean?

A

discharge from the ear

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4
Q

what does oltagia mean?

A

pain in the ear

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5
Q

what is tinnitus?

A

hearing a sound in your ear such as a buzzing or whining

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6
Q

what can be used to examine the patients ear?

A

otoscope or microscope

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7
Q

in a conductive hearing loss would bone conduction be louder than air?

A

yes it would so the test is negative

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8
Q

what would a positive rinnes test suggest?

A

that either hearing is normal or that the hearing loss is sensorineural

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9
Q

what would the result of a webers test be if there was sensorineural hearing loss in the right ear?

A

the sound would t=be lateralised to the left

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10
Q

what sort of hearing loss in the right ear would lateralise sound to the right in webers test?

A

conductive hearing loss

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11
Q

what investigations can be carried out in hearing loss?

A

> pure tone audiogram

> tympanogram

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12
Q

if you do not drain an auricular haematoma what may it become?

A

a cauliflour ear

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13
Q

describe otitis externa

A

> very common
inflammation of the skin of the ear canal
itching, pain and discharge

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14
Q

how would you treat otitis externa?

A

> topical antibiotics and steroids
if ear is filled with debri treatment may not be effective
preventative measures, don’t put things in ears

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15
Q

what is malignant otitis externa?

A

an aggressive form of otitis externa. this is not a malignant neoplasm. severe pain and granulation tissue in the ear canal

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16
Q

what is glue ear?

A

otitis media with effusion: there is sterile fluid under the eardrum

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17
Q

how does a non-working Eustachian tube create an effusion under the ear drum?

A

the pressure cannot be equalised so a vacuum is create and fluid secreted due to the low pressure

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18
Q

what is a grommet?

A

this is the treatment for glue ear. a plastic tube inserted into the eardrum equalises the pressure. after a few months the eardrum heals and it is pushed out

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19
Q

when would you put in grommets?

A

after watchful waiting of the child and if the hearing loss is persistent and significant

20
Q

what is acute otitis media?

A

infection of the ear durm

21
Q

what can chronic suppurative otitis media lead to?

A

> perforated tympanic membrane

> cholesteatoma

22
Q

what is cholesteatoma?

A

this is a collection of skin in the in middle ear caused by a Eustachian tube dysfunction that creates a vacuum so skin does not migrate out of the ear canal.

23
Q

what problems can cholesteatoma lead to?

A

> erosion of the mastoid process
erosion of the facial nerve
erosion into the brain creating an abscess
infection of the skin lump

24
Q

what complications can arise from suppurative otitis media?

A

> tympanosclerosis- calcium deposits in the tympanic membrane
otosclerosis- extra bone formation creating conductive hearing loss

25
Q

what is presbyacusis?

A

progressive sensory neural deafness occurring with age

26
Q

name an ototoxic medication

A

gentamyacin

27
Q

what is the effect of menieres disease?

A

> deafness
tinnitus
vertigo
build up of fluid in the inner ear

28
Q

what is vestibular schwannoma?

A

a benign tumour with sensorineural hearing loss in one ear

29
Q

what would you investigate form tinnitus?

A

weather it is unilateral or pulsatile then get an MRI

30
Q

how would you treat tinnitus?

A

with sound enrichment or stress management

31
Q

what is the differential diagnosis for vertigo?

A

> benign positional vertigo
menieres disease
vestibular neuritis (labyrinthitis)
migraine

32
Q

what features would you want to find out about vertigo?

A

> duration
frequency
associated symptoms
precipitating factors

33
Q

what is the pathology of benign positional vertigo?

A

otoconia (calcium carbonate particles) in semi-circular canals

34
Q

what are the clinical features of benign positional vertigo?

A 
> precipitated by changes in head position
> lasts seconds
> happens several times a day
> so associated symptoms
> positive dix-hallpike test
35
Q

how would you treat benign positional vertigo?

A

epley manoeuvre

36
Q

what is vestibular neuritis?

A

reactivation of latent HSV infection of vestibular ganglion

37
Q

what are the clinical features of vestibular neuritis?

A 
> spontaneous vertigo
> no associated symptoms
> lasts days
> a few episodes
> residual motion provoked vertigo
38
Q

how would you treat acute vestibular neuritis?

A

vestibular sedatives

39
Q

how would you treat chronic vestibular neuritis?

A

vestibular rehabilitation

40
Q

what is the pathology of menieres disease?

A

endolymphatic hydrops, raised pressure of the endolymphatic part of the cochlear

41
Q

what are the clinical features of menieres disease?

A 
> spontaneous vertigo
> unilateral hearing loss
> tinnitus
> aural fullness
> lasts hours
> happens every few days/weeks/months
> fluctuates and progresses to unilateral hearing loss
42
Q

what is the treatment for menieres disease?

A

> betahistine
bendrofluazide
intratympanic dexamethasone
intratympanic gentamicin

43
Q

what is the last resort treatment for menieres disease?

A

intratympanic gentamicin as this is injected into the middle ear and absorbed to the inner ear killing the nerve cells.

44
Q

what are clinical features of migraine?

A

> spontaneous vertigo
variable frequency and duration
headache, sensory sensitivity
triggers

45
Q

what may cause intratemporal facial palsy?

A

cholesteatoma

46
Q

what may be an extratemporal cause for facial palsy?

A

parotid gland tumour

47
Q

what is bells palsy?

A

acute idiopathic facial palsy (refer to ent to check there is n other cause)

Head and Neck (13 decks)

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