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In service Prep > Otology > Flashcards

Otology Flashcards

1
Q

How many hours of 85 dB noise can someone experience at the workplace?

A

16

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2
Q

How many hours of 90 dB noise can someone experience at workplace?

A

8

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3
Q

How many hours of 92 dB noise can someone experience at workplace?

A

6

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4
Q

How many hours of 95 dB noise can someone experience at workplace?

A

4

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5
Q

How many hours of 100 dB noise can someone experience at workplace?

A

2

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6
Q

How many hours of 105 dB noise can someone experience at workplace?

A

1

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7
Q

How many hours of 110 dB noise can someone experience at workplace?

A

.5

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8
Q

How many hours of 115 dB noise can someone experience at workplace?

A

.25

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9
Q

At what age can u get an ABI

A

12

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10
Q

What chromosome is the NF1 gene located on

A

17

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11
Q

What chromosome is NF2 located on

A

22

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12
Q

What portion of bony labyrinth is taken up by membranous labyrinth?

A

25%

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13
Q

Carboplatinum is toxic to which structure in ear

A

Inner hair cells

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14
Q

Cisplatin is toxic where?

A

Stria vascularis Spiral ganglion cells Outer hair cells

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15
Q

What is Alexander aplasia

A

Cochlear duct differentiation at the level of the nasal coil is limited leading to effects on organ of Corti and ganglion cells

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16
Q

Mondini aplasia

A

Only basal coil of cochlea can be identified

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17
Q

What is scheibe aplasia

A

Malformation of membranous labyrinth in cochlea and saccule

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18
Q

Michel aplasia

A

Complete age new is of petrified portion of temporal bone

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19
Q

Which ear is more commonly affected in microtia

A

Right

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20
Q

What structure receives the crura of the semicircular canals

A

Utricle

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21
Q

What is the jahrsdoerfer scoring system

A

Scoring of how good a candidate is for aural atresia repair. 6-8 poor candidate, 8-10 moderate, 10 and up great candidate

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22
Q

What is the most common complication of Cholesteatoma

A

Labyrinthine fistula

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23
Q

Which nerve supplies sensory innervation to the conchal bowl?

A

Nervus intermedius, branch of facial

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24
Q

What percent of cochlear afferents originate from outer hair cells

A

5-10%

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25
Q

What percent of cochlear afferents originate from inner hair cells

A

90-95%

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26
Q

What is the olivocochlear bundle

A

Carries deferents that regulate cochlear gain and frequency selectivity of the outer hair cells

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27
Q

What inner ear structure terminates at the round window?

A

Scala tympani

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28
Q

What is dorello’s canal

A

between the petrous tip and the sphenoid bone. It is the groove for the VI nerve, why you get abducens palsy and pain behind the eye in gradenigo syndrome

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29
Q

What is one way that otosclerosis can cause SNHL within cochlea?

A

Hyalinization of the stria vascularis causing difficulty with recycling potassium ions

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30
Q

What is the difference between an osteoma and an exostosis?

A

osteoma -> narrow base, easy to remove exostosis -> broad base, lamellar bone formation, must be drilled

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31
Q

What decibel gain does the tortuosity of the EAC provide?

A

10-15 dB

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32
Q

What is the dB gain of the middle ear?

A

27.5 dB (gain from ossicular chain (2.5) and TM (25), added together)

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33
Q

What is the ratio of the length of the manubrium to long process of incus and what does this add to the gain?

A

1.3: 1 -> 2.5 dB

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34
Q

What is the ratio of the area of the pars tensa to the size of the oval window and what does this add to the gain?

A

55 mm: 3.2 mm, or 17:1 resulting in 25 dB gain

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35
Q

Up to what size of vestibular schwannoma can you use gamma knife radiation?

A

UP to 3 cm, larger than that and the tumor can swell causing hydrocephalus

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36
Q

what does cVEMP test?

A

The saccule and subsequently inferior vestibular nerve

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37
Q

oVEMP tests what?

A

The utricle, or superior vestibular nerve

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38
Q

which is the most vestibulotoxic antibiotic?

A

streptomycin, then gentamicin

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39
Q

For what age are ABIs approved in children?

A

12

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40
Q

What percent ototoxicity is aminoglycosides

A

10%

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41
Q

what kind of granuloma forms in langherhans hictiocytosis

A

eosinophilic

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42
Q

What age range do you do behavioral observational audiometry?

A

0-6 months

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43
Q

What age range do you do visual reinforcement audiometry?

A

6 months to 2 years

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44
Q

What age range do you do conditioned play audiometry?

A

2 - 6 years

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45
Q

Describe what weeks different cochlear anomalies arise

A

Cochlear anomalies ° Common cavity: fourth week ° Cochlear aplasia: fifth week ° Cochlear hypoplasia: sixth week ° Incomplete cochlear partitions (“Mondini malformation”): seventh week

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46
Q

Which SCC develops last and thus displays the most anomalies

A

LSCC

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47
Q

What space is located anterior to the cog in the middle ear?

A

supratubal recess

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48
Q

pathway of Vemp testing

A

acoustic stimulus -> saccule -> inferior vestibular nerve -> brainstem vestibular nucleus -> spinal tract -> scm

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49
Q

What is this a picture of

A

cvemp

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50
Q

Why is VEMP testing useful in vestibular schwannomas?

A

If VEMP absent, then likely tumor is arising from the inferior vestibular nerve, which is closest to the cochlear nerve, therefore hearing preseration is LESS likely with surgery

51
Q

What is calorics testing?

A

Horizontal/lateral canal, innervated by the superior vestibular nerve

52
Q

what is depicted in this image

A

Calorics, Weakness in left lateral SCC (superior vestibular nerve)

53
Q

Abnormalities in saccadic testing are indications of what kind of problems?

A

CEntral problems, like neurodegenerative not peripheral vestibular system

54
Q

What does it mean when the tracking tests are abnormal

A

CNS issue

55
Q

What 3 components are the rotary chair tests testing?

What is it useful for checking?

A

Phase, Gain, Asymmetry

Confirmation of caloric testing

Checking for compensation

Checking bilateral losses

56
Q

What is displayed in this image

A

Rotary chair testing, normal

57
Q

What are the two components of posturography testing

A

Sensory organization test

Movement coordination test

58
Q

What is the normal interaural attenuation for bone conduction?

A

0dB

59
Q

What does the utricle sense

A

Horizontal linear acceleration

60
Q

What does the saccule sense

A

vertical linear acceleration

61
Q
A
62
Q

What is Ewald’s law

A

Describes the push pull system of the vestibular system

63
Q

How are the kinocilia oriented in the lateral canal?

A

Kinocilia oriented in such a way that ampulopedal flow stimulates

64
Q

How are kinocilia oriented in the superior and posterior canals

A

Kinocilia oriented in such a way that ampullofugal flow stimulates

65
Q

What do you see on the ECOG in menieres?

A

Increased sp/ap ratio (>0.4)

66
Q

Where is the dehiscence of SSCD located

A

anterior an opposite to superior petrosal sinus

67
Q

How does cholesteatoma get from epitympanum to mesotympanum if it is of epitympanic origin

A

Extends through the posterior pouch of Von Trolsch

68
Q

What is the most common locations of cholesteatoma to form from most common to least (3)

A
  1. posterior epitympanum
  2. Posterior mesotympanum
  3. Anterior epitympanum
69
Q

Where is the most common location for residual cholesteatoma to hide

A

sinus tympani

70
Q

How can you check if youve buried epithelium after CWD mastoidectomy?

A

DWI mri

71
Q

What is the smallest size cholesteatoma that DWI MRI can detect

A

3 mm, thats why you want to wait a little before doing it

72
Q

What is Gallium scan useful for in malignant OE?

A

To decide when to stop IV abx, every 6 weeks

73
Q

What type of microbe is most commonly responsible for bullous myringitis

A

Virus, sometimes mycoplasma

74
Q

What is the most common malignant tumor of the external ear (pinna)

A

basal cell carcinoma

75
Q

Most common malignant tumor of the ear CANAL

A

squamous cell carcinoma

76
Q

What is the 5 year survival of T1 and T2 EAC SCC?

A

90%

77
Q

What is the 5 year survival of EAC SCC T3/T4

A

less than 50%

78
Q

What is the MINIMUM surgery for EAC SCC?

A

Lateral temporal bone resection

79
Q

Where may facial nerve pass that puts it at risk during canaloplasty surgery?

A

Lateral to the annulus at the posterior/inferior level (2% of cases)

80
Q

What can keratosis obturans be sometimes associated with?

A

Bronchiectasis/chronic pulmonary disease

81
Q

What is the CAUSE of keratosis obturans?

A

Failed epithelial migration

82
Q

what is the CAUSE of EAC cholesteatoma

A

Trapped epithelium in bony canal

83
Q

What glands does the facial nerve give postganglionic parasympathetics to?

A

Lacrimal, sublingual, submandibular

84
Q

What is the distance that the facial nerve traverses from the point that it exits the IAC to when it exits the stylomastoid foramen

A

30 mm

85
Q

What is the most common cause of hemifacial spasm?

A

Due to vascular loops from AICA or PICA

86
Q

Where is the blood supply to the facial nerve located?

A

epineurium

87
Q

What degrees of facial injury is going to have absent enog?

A

Sunderland 3/4/5

88
Q

What is chromatolysis

A

Increased neuronal metabolism in the cell body after nerve injury

89
Q

What is ephaptic transmission

A

Faulty regeneration of facial nerve causing facial spasm

90
Q

Wha is the indicdence of bells palsy in children?

A

1/100,000

91
Q

Where is facial nerve most likely to be injured during vestibular schwannoma surgery?

A

The porus

92
Q

How much length can you get out of the facial nerve if you detach it from the geniculate ganglion?

A

1 cm

93
Q

What is the best facial outcome you can get with grafting after a complete paralysis?

A

HB grade 3

94
Q

What week of development do the incomplete partition defects arise?

A

7

95
Q

What is a good reference point to decide if the Vestibular aqueduct is enlarged?

A

Should be less than the diameter of the posterior SCC

96
Q

What are the two T bone abnormalities with Pendred always seen together??

A

Mondini + Enlarged Vestibular Aqueduct

97
Q

Of the 3 SCC, which one most often has abnormalities?

A

LCC, after that superior, superior forms FIRST

98
Q

What percent of live births/children will test positive for CMV?

A

1%, only 5-10% will have SNHL

99
Q

Which Ion channel affected in jervell-lange-nielsen

A

Potassium

100
Q

What are the autosomal dominant syndromes

A

Wardenburg, treacher-collins, Apert, branchio-oto-renal

101
Q

What syndrome associated with having trapezoid mouth and have stapes fixation?

A

Apert

102
Q

what is type 4 tympanoplasty

A

Shield the round window, exteriorize the footplate

103
Q

How does middle ear space affect hearing with a TM perf

A

The smaller the volume of the middle ear, the worse conductive loss you get with a TM perf, location of perforation has little to no effect

104
Q

In terms of the ossicular chain, the single most important factor that affects hearing is…

A

Presence if malleus manubrium

105
Q

Which gender is aural atresia more common in? Boys or girls

A

Boys, 3:1

106
Q

In what order does atresia plasty and microtia repair occur

A

first stage of microtia repair FIRST, then atresia repair

107
Q

what is most common location for congen cholwsteatoma

A

anterior meso

108
Q

most common congen ossicular abnorm

A

malleus fixation, higher conductive loss at lower freq, caused by anterior nmalleal ligament fixation

109
Q

How many phases of otosclerosis are tehre

A

two, otospongiosis phase, sclerotic phase

110
Q

In which direction is nystagmus in labyrinthitis

A

First irritative (in direction of the ear), then changes direction to hypofunctional, away from that ear

111
Q

What do you need to do if someone with CI needs an MRI

A

They need their magnet removed

112
Q

What type of insertion of CI better for hearing preservation

A

Round Window insertion

113
Q

What are criteria for cochlear implantation for adults

A

profound snhl (70 dB or higher), less than 50% word recognition on open set (40% for medicaid)

114
Q

what pathology predisposes to FN stimulation with electrical signal from a cochlear implant

A

otosclerosis, conduction of the energy through the hardened bone

115
Q

Whats the most common complication of cochlear implants?

A

Flap infection

116
Q

What is the finding on CT that can indicate meningioma?

A

Hyperostosis

117
Q

CP angle mass that is the same as CSF, restricted diffusion?

A

epidermoid

118
Q

GLomus tumor are more common in X

A

Females 3:1

119
Q

How often do you see multiple glomus tumors?

A

10%

120
Q

What artery most commonly supplies glomus tumors?

A

Ascending pharyngeal

121
Q

What is the pathology pictured

A

Glomus jugulare

122
Q

What should you do if you discover a middle ear effusion during cochlear implantation?

A

Irrigate middle ear with saline, apply ofloxacin drops, and place patient on post op ceftriaxone

123
Q

What is the inheretence pattern of mondini dysplasia?

A

autosomal dominant with nons yndromic features (but CAN be seen with BOR and Pendred)

  • would double check this
124
Q

What is more common, NF 1 or NF2?

A

NF1

In service Prep (11 decks)

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