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Head and Neck > Otology > Flashcards

Otology Flashcards

1
Q

What is Rinne’s Test?

A

Air vs bone conductive hearing test

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2
Q

What is a Rinne’s positive result?

A

Sound is louder by air than by bone

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3
Q

What is a Rinne’s negative result?

A

Sound is louder by bone than by air

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4
Q

What does a Rinne’s negative result mean?

A

Conductive hearing loss

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5
Q

What does a Rinne’s positive result mean?

A

Hearing normal OR

Sensorineural hearing loss (proportionate loss of both)

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6
Q

What is Weber’s test?

A

Tuning fork placed on midline of skull

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7
Q

If Weber’s test is heard louder in the left ear than the right, it implies what?

A

Sensorineural hearing loss in right ear

Conductive hearing loss in left ear

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8
Q

If Weber’s test is heard louder in the right ear than the left, it implies what?

A

Sensorineural hearing loss in left ear

Conductive hearing loss in right ear

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9
Q

Why is Weber’s test heard louder in the weaker ear?

A

No sound will pass into the ear from outside sources, making it seem louder in that ear

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10
Q

What is normal hearing on a pure tone audiogram?

A

Better than 20dB

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11
Q

How will conductive hearing loss appear on a pure tone audiogram?

A

Bone conduction better than air conduction

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12
Q

How will sensorineural hearing loss appear on a pure tone audiogram?

A

Total reduction in hearing reduced for bone and air conduction?

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13
Q

What is conductive hearing loss?

A

Sound is not reaching past outer/middle ear

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14
Q

What is sensorineural hearing loss?

A

Sound information isnt passed from inner ear

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15
Q

What are the possible tympanogram results?

A

Type A: Normal middle ear pressure/compliance
Type B: Low middle ear compliance
Type C: Low middle ear pressure

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16
Q

How is auricular haematoma managed?

A

Incision and drainage
Pressure dressing
Antibiotics

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17
Q

What is the most common complication of auricular haematoma?

A

Cauliflower ear

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18
Q

What is otitis externa?

A

Inflammation of the external auditory meatus skin

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19
Q

How is otitis externa managed?

A

Antibiotics/steroid ear drops

Suction under microscope

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20
Q

How is otitis externa prevented?

A

No water or cotton buds in ear

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21
Q

What is malignant otitis externa?

A

Osteomyelitis of temporal bone

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22
Q

How does malignant otitis externa present?

A

Severe pain in elderly diabetic
Granulations in external auditory meatus
?cranial nerve palsies

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23
Q

How is malignant otitis externa treated?

A

Antibiotics for weeks/months

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24
Q

What is otitis media with effusion?

A

“glue ear”

Sterile fluid in middle ear

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25
Q

How does otitis media present?

A

Hearing loss

Speech delay

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26
Q

How is otitis media with effusion managed?

A

Observe 3months
Otovent
Grommet

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27
Q

When are grommets indicated for otitis media with effusion?

A

No better after 3 months

Child has hearing loss

28
Q

What is acute suppurative otitis media?

A

Pus in middle ear

29
Q

How does acute suppurative otitis media present?

A

Otalgia
?otorrhoea (if burst)
Red, bulging ear drum

30
Q

How is acute suppurative otitis media managed?

A

Observation

Amoxicillin

31
Q

What is tympanosclerosis?

A

Calcification of tympanic membrane +/- middle ear

32
Q

How does tympanosclerosis present?

A

Asymptomatic

33
Q

How is tympanosclerosis managed?

A

None

34
Q

What causes chronic suppurative otitis media?

A

Perforated tympanic membrane
OR
Cholesteatoma

35
Q

What is cholesteatoma?

A

Excess skin in middle ear +/- mastoid bone

36
Q

What are the complications of chronic suppurative otitis media?

A

Dead ear
Facial palsy
Meningitis
Brain abscess

37
Q

What are the causes of a perforated tympanic membrane?

A

Infection
Trauma
Grommet

38
Q

How does a perforated tympanic membrane present?

A

Recurrent infections

Hearing loss

39
Q

How is perforated tympanic membrane treated?

A

Water precautions

?Myringoplasty

40
Q

What causes cholesteatoma?

A

Eustachian tube dysfunction

Impaired skin migration

41
Q

How does cholesteatoma present?

A

Persistent offensive otorrhoea

42
Q

How is cholesteatoma managed?

A

Mastoidectomy

43
Q

How does otosclerosis present?

A

Conductive hearing loss with a normal tympanic membrane

44
Q

How does otosclerosis cause hearing loss?

A

Fixation of stapes by extra bone

45
Q

How is otosclerosis managed?

A

Hearing aid

Stapedectomy

46
Q

What are the main causes of sensorineural hearing loss?

A 
Presbyacusis
Head injury
Viral infections
Ototoxic medications
Noise exposure
Acoustic neuroma (especially when unilateral)
47
Q

When should tinnitus be investigated?

A

Unilateral - acoustic neuroma?

Pulsatile - vascular?

48
Q

How is tinnitus treated?

A

Treat underlying cause
Sound enrichment
Stress management

49
Q

What is vertigo?

A

Perception of movement

50
Q

What is the DDx for vertigo?

A

Benign positional vertigo
Menieres disease
Vestibular neuritis/labyrinthitis
Migraine

51
Q

What is the cause of benign positional vertigo?

A

Otoconia in semicircular canals

52
Q

How does benign positional vertigo present?

A

Vertigo for seconds causes by changes in head position
No associated symptoms
Positional/rotatory nystagmus

53
Q

How is benign positional vertigo tested?

A

Dix-Hallpike test

54
Q

How is benign positional vertigo treated?

A

Epley manoeuvre

55
Q

What is the cause of vestibular neuritis/labyrinthitis?

A

Reactivation of latent HSV infection of vestibular ganglion

56
Q

How does vestibular neuritis/labyrinthitis present?

A

Spontaneous vertigo for days
Associated unilateral hearing loss
Horizontal nystagmus towards ear

57
Q

How is vestibular neuritis/labyrinthitis managed?

A

Acute: Vestibular sedatives
Chronic: Vestibular rehabilitation

58
Q

What is the cause of Meniere’s disease?

A

Endolymphatic hydrops

59
Q

How does Meniere’s disease present?

A

Spontaneous vertigo for hours

Associated unilateral hearing loss/tinnitis/aural fullness

60
Q

What is the management for Meniere’s disease?

A

Bendroflumethazide
Intratympanic dexamethasone
Intratympanic gentamicin

61
Q

What is the cause of migraine?

A

Vascular, neural

62
Q

How does migraine present?

A

Spontaneous vertigo for variable duration
?headache
?trigger precipitated
?past history of migraine

63
Q

How is migraine managed?

A

Migraine triggers

Prophylaxis

64
Q

How does facial nerve palsy present?

A

Lower motor neuron facial palsy

65
Q

What is the differential diagnosis for facial nerve palsy?

A

Intratemporal (cholesteatoma)
Extratemporal (parotid tumour)
Idiopathic

66
Q

What is Bell’s Palsy?

A

Idiopathic facial nerve palsy

67
Q

How is facial nerve palsy managed?

A

Treat cause
Bell’s: Steroids
Eye care/dryness

Head and Neck (5 decks)

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