Otology

Question 1

what are the common presenting symptoms in otology cases?

Answer 1

hearing loss 
tinnitus 
vertigo 
otalgia 
otorrhoea 
facial weakness

Question 2

what is the medical term for discharge form the ear?

Answer 2

otorrhoea

Question 3

what is the medical term for sensation of movement?

Answer 3

vertigo

Question 4

what is the medical term for sensation of sound when there is no external sound?

Answer 4

tinnitus

Question 5

why is facial weakness a common symptoms associated with otology cases?

Answer 5

the facial nerve which supplies the face supplies sensation to the anterior part of the external auditory canal

Question 6

what examinations are carried out in otology cases?

Answer 6

otoscopy
microscopy
tuning fork tests - Rinne’s & Weber’s
whispered voice test

Question 7

what investigations are carried out in otology cases?

Answer 7

pure tone audiometry

tympanogram

Question 8

in someone with sensorineural hearing loss, would they test positive or negative in the Rinne’s test?

Answer 8

positive

Question 9

in someone with conductive hearing loss would they test positive or negative in the Rinne’s test?

Answer 9

negative

conduction bone > air

Question 10

if someone has conductive hearing loss what would you expect the results to be like in the Weber’s test?

Answer 10

they would have lateralisation of sound > in the ear affected

i.e. if they had conductive hearing loss in their right ear they would hear the sound greater in the right ear during the test

Question 11

if someone has sensorineural hearing loss what would you expect the results to be like in the Weber’s test?

Answer 11

they would hear sound greater on the side that isn’t affected.
i.e. if they had hearing loss in the left ear then they would hear the sound greater on the right ear

Question 12

concerning pure tone audiometry, what is considered normal hearing?

Answer 12

> 20dB

Question 13

concerning typanogram, what is type B and Type C?

Answer 13

type B = low middle ear compliance (perforated drum or fluid in the middle ear)
type C = low middle ear pressure (eustachian tube not working)

Question 14

is conductive and sensorineural hearing loss reversible?

Answer 14

conductive is reversible

sensorineural isn’t reversible

Question 15

what is a complication from a pinna haematoma?

Answer 15

cauliflower ear

Question 16

what is the management for auricular/pinna haematoma?

Answer 16

incision and drainage
antibiotics
pressure dressing

Question 17

what is a condition of inflammation of the external auditory meatus?

Answer 17

otitis externa

Question 18

what is malignant otitis externa?

Answer 18

osteomyelitis of the temporal bone

Question 19

what is the management for otitis media with effusion?

Answer 19

observation for 3 months
otovent
grommets

Question 20

what is characteristic of acute suppurative otitis media?

Answer 20

pus in the middle ear

Question 21

what is the presentation of acute supportive otitis media?

Answer 21

otalgia with or without tympanic membrane rupture which eases the pain and then causes otorrhoea

Question 22

what is the management for acute supportive otitis media?

Answer 22

observation

amoxicillin

Question 23

what are 2 conditions of chronic suppurative otitis media?

Answer 23

perforation of the tympanic membrane

cholesteatoma

Question 24

what are causes of perforation of the tympanic membrane?

Answer 24

infection
trauma
grommet

Question 25

what is the presentation of perforated tympanic membrane?

Answer 25

hearing loss recurrent / chronic infection otalgia

Question 26

what is the management of a perforated tympanic membrane?

Answer 26

water precautions | myringoplasty

Question 27

what are the causes of cholesteatoma ?

Answer 27

eustachian tube dysfunction | impaired skin migration out of the ear

Question 28

what is the presentation of cholesteatoma?

Answer 28

persistant offensive otorrhoea

Question 29

what is the management of cholesteatoma?

Answer 29

mastoidectomy (remove diseased mastoid cells)

Question 30

what are the managements for tinnitus?

Answer 30

treat underlying cause sound enhancement stress management

Question 31

what are the differential diagnoses of vertigo?

Answer 31

benign paroxysmal positional dysfunction migraine menieres disease vestibular neuritis/ labrynthitis

Question 32

what causes BPPD?

Answer 32

otoconia in the semis circular ear canals

Question 33

what are the clinical features of BPPD?

Answer 33

vertigo precipitated by specific changes in head movement lasts only seconds no associated symptoms nystagmus is positional and rotatory

Question 34

what is the investigation and management for BPPD?

Answer 34

dix-halpike test | epley manoeure

Question 35

what is vestibular neuritis/ labyrinthitis?

Answer 35

reactivation of latent HSV infection of vestibular ganglion

Question 36

what is the difference between vestibular neuritis and labyrinthitis?

Answer 36

there is hearing loss in labyrinthitis | no hearing loss in vestibular neuritis

Question 37

what is the clinical features of vestibular neuritis / labyrinthitis?

Answer 37

spontaneous vertigo lasting for days | nystagmus is horizontal and towards the ear

Question 38

what is the management for vestibular neuritis / labyrinthitis?

Answer 38

acute - vestibular sedatives | chronic - vestibular rehabilitation

Question 39

what is Meniere's disease?

Answer 39

``` endolymphatic hydrops (raised pressure in the endolymph) ```

Question 40

what are the clinical features of Menieres disease?

Answer 40

spontaneous vertigo associated unilateral hearing loss/ tinnitus / aural fullness last for hours

Question 41

wha is the management for menieres disease?

Answer 41

bendroflumethazide intratympanic dexamethasone intratympanic gentamicin

Question 42

what can be the differential diagnosis of facial nerve palsy?

Answer 42

intratemporal e.g. cholesteatoma extratemporal e.g. parotid tumour idiopathic e.g. Bell's palsy

Question 43

what is the treatment for bells palsy?

Answer 43

steroids | eye care

Question 44

what is the name of the condition caused by calcification of the tympanic membrane?

Answer 44

tympanosclerosis

Question 45

what is malignant otitis externa and how do you treat it?

Answer 45

osteomyelitis of the temporal bone | amoxicillin

Question 46

what is otosclerosis?

Answer 46

fixation of the stapes by an extra bone causing conductive hearing loss hearing loss

Question 47

what are the causes of sensorineural hearing loss?

Answer 47

``` presbycusis (old age) tumour i.e. acoustic neuroma head injury noise exposure ototoxic medications viral infections ```

Question 48

if there is a facial nerve palsy, is it typically LMN or UMN? and how would you differentiate the two?

Answer 48

a facial nerve palsy is LMN damage and damage of UMN causing facial palsy is typically due to a stroke with the LMN affected in facial palsy the forehead is involved (so the forehead won't be able to move either). however if it is UMN then the forehead isn't involved

Question 49

what causative organism is responsible for otitis externa?

Answer 49

pseudomonas aeruginosa

Question 50

what causative organism is responsible for otitis media?

Answer 50

strep. pneumonia h. influenzar mortadella catahharis