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Head and Neck > Otology > Flashcards

Otology Flashcards

1
Q

What are some symptoms of otological disorders?

A
  • Hearing loss
  • Tinnitus
  • Vertigo
  • Otalgia
  • Otorrhoea (discharge from the ear)
  • Facial weakness
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2
Q

What are some methods of physical examination that can be useful in diagnosing otological disorders?

A
  • Otoscopy
  • Rinne’s test
  • Weber’s test
  • Whispered voice test
  • Pure tone audiogram (identify hearing threshold levels)
  • Tympanogram
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3
Q

What types of hearing loss do the Webers and Rinne’s hearing tests attempt to diagnose?

A
  • Conductive hearing loss

- Sensorineural hearing loss

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4
Q

What is the threshold for normal hearing on a pure tone audiogram? How are conductive and sensorineural hearing loss diagnosed?

A
  • Normal hearing: better than 20dB
  • Conductive hearing loss: bone conduction better than air conduction
  • Sensorineural hearing loss: bone conduction the same as air conduction
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5
Q

What is a tympanogram?

A
  • Graphic representation of how the eardrum moves in response to the air pressure in the ear canal
  • Create variations of air pressure in the tympanic canal and measure the compliance of the TM and mobility of ossicles
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6
Q

What are the possible results from a tympanogram test?

A
  • type A: normal middle ear pressure and
    compliance
  • type B: low middle ear compliance
  • type C: low middle ear pressure
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7
Q

What is an auricular haematoma? What is a complication of untreated auricular haematoma?

A
  • A haematoma in the auricle (outer part) of the ear

- Cauliflower ear

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8
Q

How is an auricular haematoma treated?

A
  • incision and drainage
  • pressure dressing
  • antibiotics
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9
Q

What is otitis externa? How is it treated?

A
  • Inflammation of the external auditory meatus

Management:

  • antibiotic/steroid ear drops
  • +/- suction under microscope
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10
Q

What is malignant otitis externa? How is it treated?

A
  • Osteomyelitis (infection of bone) in the temporal bone

- Antibiotics (cycle tends to be weeks/months long)

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11
Q

How does malignant otitis externa tend to present?

A
  • pain (severe in elderly diabetic especially)
  • Granulation tissue in external auditory meatus

+/- cranial nerve palsies

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12
Q

What is otitis media with effusion? What is it commonly known as?

A
  • Effusion of fluid in the middle ear

- Commonly knowns as “glue ear”

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13
Q

How does otitis media with effusion tend to present? How is it treated?

A
  • Hearing loss
  • Speech delay

Management:

  • Observation at first (should spontaneously resolve)
  • Otovent: pressurized balloon used to open eustachian tubes to allow fluid to drain
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14
Q

What is acute suppurative otitis media? How does it tend to present? How is it treated?

A
  • Otitis media with accumulation of pus in middle ear
  • Otalgia +/- otorrhoea
  • Management: observation +/- antibiotics (amoxicillin)
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15
Q

What is otitis media?

A

Inflammation of the middle ear

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16
Q

What is tympanosclerosis? How does it tend to present? How is it managed?

A
  • Calcification in tympanic membrane +/- middle ear
  • Usually asymptomatic
  • Usually no treatment required
17
Q

What causes chronic suppurative otitis media?

A
  • Perforated tympanic membrane

- cholesteatoma (growth in middle ear - often a cyst or sac)

18
Q

What are some complications of chronic suppurative otitis media?

A
  • “dead ear” (hearing loss in one ear)
  • facial palsy
  • meningitis
  • brain abscess
19
Q

What are some causes of perforated tympanic membrane? How does it tend to present?

A
  • Infection
  • Trauma
  • Tympanostomy tube (“grommet”)
  • Recurrent infections
  • Hearing loss
20
Q

How are perforated tympanic membranes treated?

A
  • Water precautions
  • Should heal spontaneously
  • myringoplasty if needed (closure of the perforation of pars tensa of the tympanic membrane)
21
Q

What are some causes of cholesteatomas? How do they tend to present? Management?

A
  • Eustachian tube dysfunction
  • Impaired skin migration
  • presentation: persistent offensive otorrohoea
  • management: mastoidectomy (removal of diseased mastoid air cells)
22
Q

What is otosclerosis? How does it tend to present?

A
  • Fixation of the stapes bone by the inappropriate proliferation of extra spongy bone
  • Conductive hearing loss
  • Normal tympanic membrane
23
Q

How is otosclerosis usually managed?

A
  • Hearing aid

- Stapedectomy (removal of stapes and replacement with a prosthetic)

24
Q

What is sensorineural hearing loss? What is conductive hearing loss?

A
  • Sensorineural hearing loss: permanent hearing loss that occurs when there is damage to either the cilia of the inner ear or the auditory nerve
  • Conductive hearing loss: obstruction or damage to the outer or middle ear that prevents sound from being conducted to the inner ear
25
Q

What are some causes of sensorineural hearing loss?

A
  • presbyacusis (hearing loss w old age)
  • Head injury / noise exposure
  • Viral infections
  • Acoustic neuroma
  • Ototoxic medications
26
Q

How is sensorineural hearing loss managed?

A
  • Hearing aids
27
Q

What are some causes of vertigo?

A
  • benign positional vertigo
  • Ménières disease
  • vestibular neuritis / labyrinthitis
  • migraine
28
Q

Describe the pathophysiology and presentation of Benign positional vertigo?

A
  • otoconia (otoliths) in semicircular canals
  • vertigo precipitated by specific changes in head position
    duration: seconds
  • no associated symptoms
  • nystagmus: positional and rotatory
29
Q

How is Benign positional vertigo diagnosed? How is it managed?

A
  • Dix-Hallpike test

- Epley manoeuvre

30
Q

Describe the pathophysiology and presentation of Vestibular neuritis / labyrinthitis?

A
  • reactivation of latent HSV infection of vestibular ganglion
  • spontaneous vertigo
  • associated unilateral hearing loss (labyrinthitis)
  • duration: days
  • nystagmus: horizontal, towards affected ear
31
Q

How is Vestibular neuritis / labyrinthitis treated?

A
  • acute: vestibular sedatives

- chronic: vestibular rehabilitation

32
Q

What is the pathophysiology of Ménière’s disease? Clinical features?

A
  • Fluid builds up in the labyrinth of the ear (cause unk.)
  • spontaneous vertigo
  • associated unilateral hearing loss / tinnitus / aural fullness
  • duration: hours
33
Q

how is Ménière’s disease treated?

A
  • bendroflumethazide
  • intratympanic dexamethasone
  • intratympanic gentamicin

Head and Neck (15 decks)

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