otology Flashcards
what are the kind of symptoms someone with ear problems could present with?
hearing loss tinnitus vertigo otalgia ottorrhoea facial weakness
what instrument would you use examining the ear
otoscopy
in a rinne’s test, what would give a negative result?
bone conduction is greater than air conduction- this is a sign of conductive hearing loss
in a rinne’s test what would give positive results
air conduction is greater than bone production- this can either lead to normal ear or sensorineural hearing loss
management of auricular haematoma
incision and drainage
pressure dressing
antibiotics
complications of auricular haematoma
cauliflower ear
management of foreign body in ear
removal
definition of otitis externa
inflammation of external auditory meatus
management of otitis externa
antibiotic/steroid ear drops
+/- suction under microscope
prevention of otitis externa
no water or cotton buds
definiton of malignant otitis externa
osteomyelitis of temporal bone
presentation of malignant otitis externa
severe pain in elderly diabetic
granulations in external auditory meatus
+/- cranial nerve palsies
management of malignant otitis externa
antibiotics for weeks or months
definition of otitis media with effusion
sterile fluid in middle ear “glue ear”
presentation of otitis media with effusion
hearing loss
speech delay
management of otitis media with effusion
observation for 3 months
Otovent
grommet
definition of acute suppurative otitis media
pus in middle ear
presentation of acute suppurative otitis media
otalgia +/- otorrhoea
management of acute suppurative otitis media
observation
amoxicillin
definition of tympanosclerosis
calcification in tympanic membrane +/- middle ear
presentation of tympanosclerosis
asymptomatic
management of tympanosclerosis
none
pathology of chronic suppurative otitis media
perforated tympanic membrane
or
cholesteatoma
(skin in middle ear +/- mastoid bone)
complications of chronic suppurative otitis media
“dead ear”
facial palsy
meningitis
brain abscess
causes of perforation of tympanic membrane
infection
trauma
grommet
perforation of tympanic membrane presentation
recurrent infections
hearing loss
perforation of tympanic membrane management
water precautions
+/- myringoplasty
causes of cholesteatoma
Eustachian tube dysfunction
impaired skin migration
presentation of cholesteatoma
persistent offensive otorrohoea
management of cholesteatoma
mastoidectomy
presentation of otosclerosis
conductive hearing loss
normal tympanic membrane
pathology of otosclerosis
fixation of stapes by extra bone
management of otosclerosis
hearing aid
or
stapedectomy
causes of sensineural hearing loss
presbyacusis noise exposure head injury ootoxic medication viral infections acoustic neuroma
management of sensineural hearing loss
hearing aids
definnition of tinnitus
any perception of sound
investigation of tinnitus
unilateral
pulsatile
management of tinnitus
treat underlying cause (if possible)
sound enrichment
stress management
definition of vertigo
any perception of movement
differential diagnosis of vertigo
benign positional vertigo
Ménières disease
vestibular neuritis / labyrinthitis
migraine
pathology og benign positional vertigo
otoconia in semicircular canals
clinical features of benign positional vertigo
vertigo precipitated by specific changes in head position
duration: seconds
no associated symptoms
nystagmus: positional and rotatory
investigation of benign positional vertigo
Dix-Hallpike test
management of benign positional vertigo
epley manoeuvre
pathology of vestibular neuritis/ labrynthistis
reactivation of latent HSV infection of vestibular ganglion
clinical features of Vestibular neuritis / labyrinthitis
spontaneous vertigo
associated unilateral hearing loss (labyrinthitis)
duration: days
nystagmus: horizontal, towards affected ear
management of Vestibular neuritis / labyrinthitis
acute: vestibular sedatives
chronic: vestibular rehabilitation
pathology of Ménière’s disease
endolymphatic hydrops
clinical features of Ménière’s disease
spontaneous vertigo
associated unilateral hearing loss / tinnitus / aural fullness
duration: hours
management of Ménière’s disease
bendroflumethazide
intratympanic dexamethasone
intratympanic gentamicin
pathology of migraine
vascular ? neural
clinical features of migraine
spontaneous vertigo duration: variable ± headache, sensory sensitivity ± precipitated by migraine triggers ± past history of migraine
management of migraine
avoid migraine triggers
prophylactic medication
clinical feature of facial nerve palsy
lower motor neuron facial palsy
forehead involved
differential diagnosis of facial nerve palsy
intratemporal eg cholesteatoma
extratemporal eg parotid tumour
idiopathic = Bell’s palsy
management of facial nerve palsy
treat underlying cause (if possible)
steroids
eye care
