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Head and Neck - Year 2 > Otology > Flashcards

Otology Flashcards

1
Q

What are some otology symptoms?

A 
Hearing loss
Tinnitus
Vertigo
Otalgia
Otorrhoea
Facial weakness
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2
Q

What happens in Rinne’s test for a normal ear?

A

Air > bone

Test = positive

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3
Q

What happens in Rinne’s test for conductive hearing loss?

A

Bone > air

Test = negative

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4
Q

What happens in Rinne’s test for sensorineural hearing loss?

A

Air > bone

Test = positive

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5
Q

What happens in Weber’s test for normal hearing in both ears?

A 
Left = right 
Test = central
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6
Q

What happens in Weber’s test for sensorineural hearing loss in right ear?

A

Left > right

Test = lateralises to left

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7
Q

What happens in Weber’s test for conductive hearing loss in right ear?

A

Right > left

Test = lateralises to right

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8
Q

What is involved in the whispered voice test?

A

Whispered voice at 60cm
Mask other ear
No lip reading

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9
Q

What happens in a pure tone audiogram for normal hearing?

A

Better than 20dB

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10
Q

What happens in a pure tone audiogram for conductive hearing loss?

A

Bone conduction better than air conduction

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11
Q

What happens in a pure tone audiogram for sensorineural hearing loss?

A

Bone conduction the same as air conduction

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12
Q

What is type A in a tympanogram?

A

Normal middle ear pressure and compliance

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13
Q

What is type B in a tympanogram?

A

Low middle ear compliance

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14
Q

What is type C in a tympanogram?

A

Low middle ear pressure

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15
Q

What is responsible for equalising pressure around the ear drum?

A

Eustachian tube

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16
Q

What is the management for auricular haematoma?

A

Incision and drainage
Pressure dressing
Antibiotics

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17
Q

What is a complication of auricular haematoma?

A

Cauliflower ear

Blood becomes infected and destroys connective tissue in pinna

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18
Q

What is the management for a foreign body in the ear?

A

Removal

Urgent if button battery > organic > inorganic

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19
Q

What is otitis externa?

A

Inflammation of external auditory meatus

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20
Q

What is the management for otitis externa?

A

Antibiotic/steroid ear drops

+/- suction under microscope (required if ear canal obstructed as ear drops won’t work

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21
Q

How do you prevent otitis externa?

A

No water or cotton buds

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22
Q

What is malignant otitis externa?

A

Osteomyelitis of temporal bone

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23
Q

What is the presentation of malignant otitis externa?

A

Severe pain in elderly diabetic
Granulations in external auditory meatus
+/- cranial nerve palsies

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24
Q

What is the management for malignant otitis externa?

A

Antibiotics for weeks or months

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25
Q

What is otitis media with effusion?

A

Sterile fluid in middle ear

Caused by eustachian tube blockage - pressure builds around ear drum

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26
Q

What is the presentation for otitis media with effusion?

A

Hearing loss

Speech delay

27
Q

What is the management for otitis media with effusion?

A

Observe for 3 months
Otovent
GROMMET

28
Q

What is acute suppurative otitis media?

A

Pus in middle ear

29
Q

What is the presentation for acute suppurative otitis media?

A

Otalgia +/- otorrhoea

Painful and discharge if ear drum ruptures

30
Q

What is the management for acute suppurative otitis media?

A

Observation

Amoxicillin (only if persistent)

31
Q

What is tympanosclerosis?

A

Calcification in tympanic membrane +/- middle ear

32
Q

What is the presentation for tympanosclerosis?

A

Usually asymptomatic

33
Q

What is the management for tympanosclerosis?

A

Usually none

34
Q

What are the complications of chronic suppurative otitis media?

A

‘Dead ear’ - complete loss of hearing
Facial palsy
Meningitis
Brain abscess

35
Q

What are the causes of a perforation of the tympanic membrane?

A

Infection
Trauma
GROMMET

36
Q

What is the presentation of a perforated tympanic membrane?

A

Recurrent infections

Hearing loss

37
Q

What is the management for perforation of the tympanic membrane?

A

Water precautions +/- myringoplasty

Myringoplasty - operation to repair hole in eardrum

38
Q

What are the causes of cholesteatoma?

A

Eustachian tube dysfunction

Impaired skin migration

39
Q

What is the presentation for cholesteatoma?

A

Persistent offensive otorrhoea

40
Q

What is the management for cholesteatoma?

A

Mastoidectomy

41
Q

What is the presentation for otosclerosis?

A

Conductive hearing loss

Normal tympanic membrane

42
Q

What is the pathology for otosclerosis?

A

Fixation of stapes by extra bone

43
Q

What is the management for otosclerosis?

A

Hearing aid or stapedectomy

44
Q

What are the causes for sensorineural hearing loss?

A 
Presbyacusis
Head injury
Viral infections
Noise exposure
Ototoxic medications
Acoustic neuroma
45
Q

What is the management for sensorineural hearing loss?

A

Hearing aids

46
Q

What occurs in investigation of tinnitus?

A

Unilateral

Pulsatile

47
Q

What is the management for tinnitus?

A

Treat underlying cause
Sound enrichment
Stress management

48
Q

What is the differential diagnosis for vertigo?

A

Benign positional vertigo
Meniere’s disease
Vestibular neuritis/labyrinthitis
Migraine

49
Q

What is the pathology of benign positional vertigo?

A

Otoconia in semicircular canals

50
Q

What are the clinical features of benign positional vertigo?

A

Precipitated by specific changes in head position
Lasts seconds
No associated symptoms
Nystagmus: positional and rotatory

51
Q

What is the investigation for benign positional vertigo?

A

Dix-Hallpike test

52
Q

What is the management for benign positional vertigo?

A

Epley manoeuvre

53
Q

What is the pathology for vestibular neuritis?

A

Reactivation of latent HSV infection of vestibular ganglion

54
Q

What are the clinical features of vestibular neuritis?

A

Spontaneous vertigo
Associated unilateral hearing loss
Lasts days
Nystagmus - horizontal, towards affected ear

55
Q

What is the management for vestibular neuritis?

A 
Acute = vestibular sedatives
Chronic = vestibular rehabilitation
56
Q

What is the pathology for meniere’s disease?

A

Endolymphatic hydrops

57
Q

What are the clinical features of meniere’s disease?

A

Spontaneous vertigo
Associated unlateral hearing loss/tinnitus/aural fullness
Lasts hours

58
Q

What is the management for meniere’s disease?

A

Bendroflumethazide
Intratympanic dexamethasone
Intratympanic gentamicin

59
Q

What are the clinical features of migraine?

A 
Spontaneous vertigo
variable duration
\+/- headache, sensory sensitivity
\+/- precipitated by migraine triggers
\+/- past history of migraine
60
Q

What is the management for migraines?

A

Avoid migraine triggers

Prophylactic medication

61
Q

What are the clinical features of facial nerve palsy?

A

Lower motor neuron facial palsy

Forehead involved

62
Q

What is the differential diagnosis for facial nerve palsy?

A

Intratemporal (e.g. cholesteatoma)
Extratemporal (e.g. parotid tumour)
Idiopathic = Bell’s palsy

63
Q

What is the management for facial nerve palsy?

A

Treat underlying cause
Steroids
Eye care

Head and Neck - Year 2 (14 decks)

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