Otology Flashcards by Liam Lennox

What is otology?

The study of anatomy and diseases of the ear

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What are some examples of some symptoms related to otology?

Hearing loss

Tinnitus

Vertigo

Otalgia

Otorrhoea

Facial weakness

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What is hearing a sound in the absence of external sounds called?

Tinnitus

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What is a sense of spinning dizziness called?

Otalgia

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What is discharge from the ear called?

Otorrhoea

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What is ear pain called?

Otalgia

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What are some different methods of ear examination?

Otoscopy

Microscopy

Rinne’s test

Weber’s test

Whispered voice test

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What are the 3 possible outcomes from the Rinne’s test?

A (normal ear, air > bone so test is positive)

B (conductive hearing loss, bone > air so test is negative)

C (sensorineural hearing loss, air > bone so test is positive)

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What are the 3 possible outcomes of the Weber’s test?

A (normal hearing in both ears, left=right so test is central)

B (sensorineural hearing loss in right ear, left>right so test lateralises to the left)

C (conductive hearing loss right ear, right>left so test lateralises to the right)

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What is the Whispered voice test?

Whispered voice at 60cm with the other ear masked and no lip reading

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What are different methods of ear investigations?

Pure tone audiogram

Tympanogram

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What are the 3 outcomes of pure tone audiogram?

A (normal hearing, better than 20dB)

B (conductive hearing loss, bone conduction better than air condiction)

C (sensorineural hearing loss, bone conduction the same as air conduction)

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What are the 3 outcomes of tympanogram?

A (normal middle ear pressure and compliance)

B (low middle ear compliance)

C (low middle ear pressure)

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What is pure tone audiogram?

Test to identify hearing thresholds of someone

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What is a tympanogram?

Graphic representation of the relationship between air pressure in the ear canal and the movement of the tympanic membrane

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What is the tympanic membrane also known as?

Ear drum

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What are examples of disorders of the ear?

Auricular haematoma

Forign body

Otitis externa

Malignant otitis externa

Otitis media with effusion

Acute suppurative otitis media

Tympanosclerosis

Chronic suppurative otitis media

Perforation of tympanic membrane

Cholesteatoma

Otosclerosis

Sensineural hearing loss

Tinnitus

Vertigo

Benign positional vertigo

Vestibular neuritis/labyrinthitis

Meniere’s disease

Migraine

Facial nerve palsy

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What is auricular haematoma?

Collection of blood underneath the perichondrium of the ear

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What is the management of auricular haematoma?

Incision and drainage

Pressure dressing

Antibiotics

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What is a possible complication of auricular haematoma?

Cauliflower ear

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What is the management of a forign body in the ear?

Removal

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Explain the order of urgency for different kinds of forign bodies in the ear?

Button battery > organic > inorganic

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What is otitis externa?

Inflammation of external auditory meatus

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What is the management of otitis externa?

Antibiotic/steroid ear drops with or without suction under microscopy

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What is the prevention of otitis externa?

No water or cotton buds to be used in the ear

What is malignant otisis externa?

Osteomyelitis of temporal bone

What is the presentation of malignant otitis externa?

Severe pain in elderly diabetic Granulations in external auditory meatus with or without cranial nerve palsies

What is the management of malignant otitis externa?

Antibiotics for weeks or months

What is otitis media?

Inflammation of the middle ear

What is otitis media with effusion also known as?

Glue ear

What is the presentation of otitis media?

Hearing loss Speech delay

What is the management of otitis media with effusion?

Observation for 3 months Otovent Grommet

What is an otovent?

Autoinflation device used to open up the euchachian tubes

What is grommet?

Tiny tube to be entered into the ear

What is acute suppurative otitis media?

Inflammation of middle ear and mastoid cavity that is characterised by pus in the ear

What is the presentation of acute suppurative otitis media?

Otalgia with or without otorrhoea

What is the management of acute suppurative otitis media?

Observation Amoxicillin

What is tympanosclerosis?

Calcification in tympanic membrane with or without middle ear involvement

What is the presentation of tympanosclerosis?

Usually asymptomatic

What is the management of tympanosclerosis?

Usually none

What is the pathology of chronic suppurative otitis media?

Perforated tympanic membrane or cholesteatoma (skin in middle ear with or without mastoid bone involvement)

What are possible complications of chronic suppurative otitis media?

Dead ear Facial palsy Meningitis Brain abscess

What are potential causes of perforation of tympanic membrane?

Infection Trauma Grommet

What is the presentation of perforation of tympanic membrane?

Recurrent infections Hearing loss

What is the management of perforation of tympanic membrane?

Water precautions With or without myrinoplasy

What is myrinoplasy?

Operation to repair a perforation of the tympanic membrane

What is cholesteatoma?

Abnormal, non-cancerous skin growth in the middle ear

What are possible causes of cholesteatoma?

Eustachian tube dysfunction Impaired skin migration

What is the presentation of cholesteatoma?

Perisistent offensive otorrhoea

What is the management of cholesteatoma?

Mastoidectomy

What is a mastoidectomy?

Surgical procedure to remove diseased mastoid air calls

What is otosclerosis?

One of staples in middle ear gets stuck in place

What is the presentation of otosclerosis?

Conductive hearing loss Normal tympanic membrane

What is the pathology of otosclerosis?

Fixation of stapes by extra bone

What is the management of otosclerosis?

Heading aid or stapedectomy?

What is a stapedectomy?

Procedure in middle ear where stape is removed

What is sensorineural hearing loss?

Type of hearing loss where the root cause lies in the inner ear or sensory organ (cochlea and associated structures) or the vestibulocochlear nerve (CN VIII)

What are possible causes of sensorineural hearing loss?

Presbyacusis Head injury Viral infections Noise exposure Ototoxic medications Acoustic neuroma

What is the management of sensorineural hearing loss?

Hearing aids

What is tinnitus?

Sensation of hearing a sound in the absence of external sounds

What should be investigated with tinnitus?

Unilateral Pulsatile (pulsating)

What is the management of tinnitus?

Treat underlying cause Soud enrichment Stress management

What is vertigo?

Sense of spinning dizziness

What are the differential diagnosis of vertigo?

Benign positional vertigo Menieres disease Vestibular neuritis/labyrinthitis Migraine

What is benign positional vertigo?

Sudden sensation of spinning, feels like from the inside of your head

What is the pathoogy of benign positional vertigo?

Otoconia in semi-circular canals

What are otoconia?

Bio-crystals which couple mechanical forces to the sensory hair cells in the utricle and saccule

What are the clinical features of beign positional vertigo?

Vertigo precipitated by specific changes in head position Duration in seconds No associated symptoms Nystagmus is positional and rotatory

What is Nystagmus?

Vision condition where the eyes make repetative, uncontrolled movements

What investigation is done for benign positional vertigo?

Dix-Hallpike test

What is the management of benign positional vertigo?

Epley manoeuvre

What is vestibular neuritis?

Inflammation of vestibular nerve

What is the pathology of vestibular neuritis/labyrinthitis?

Reactivation of latent HSV infection of vestibular ganglion

What are the clinical features of vestibular neuritis?

Spontaneous vertigo Associated underlateral hearing loss (labyrinthitis) Duration is days Nystagmus is horizontal towards the affected ear

What is the management of vestibular neuritis/labyrinthitis?

Management of acute is vestibular sedatives Management of chronic is vestibular rehabilitation

What is Maniere's disease?

Disorder of inner ear that leads to dizziness and hearing loss

What is the pathology of Maniere's disease?

Endolymphatic hydrops

What are the clinical features of Maniere's disease?

Spontaneous vertigo Associated unilateral hearing loss/tinnitus/aural fullness Duration is hours

What is the management of Maniere's disease?

Bendoflumethazide Intratympanic dexamethasone Intratympanic gentamicin

What is a migraine?

Moderate to severe headache felt as throbbing pain on one side of the head

What is the pathology of a migraine?

Possibly vascular or neural, but is unknown

What are the clinical features of a migraine?

Spontaneous vertigo Duration is variable With or without headache, sensory sensitivity With or without precipitated migraine triggers With or without past history of migraine

What is the management of migraine?

Avoid migraine triggers Prophylactic medication

What is facial nerve palsy?

Function of the facial nerve (CN VII) is partly or completely lost

What are the clinical features of facial nerve palsy?

Lower motor neuron facial palsy (forehead involved)

What is the differential diagnosis of facial palsy?

Intratemporal such as cholesteatoma Extratemporal such as parotid tumour Idiopathic is called Bell's palsy

What is idiopathic facial palsy called?

Bell's palsy

What is the management of facial nerve palsy?

Treat underlying cause (if possible) Steroids Eye care