Outer and Middle Ear Flashcards

1
Q

When may auricular haematoma occur?

A

After trauma to the auricle

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2
Q

How is auricular haematoma treated?

A

Incision and drainage
Pressure dressing
Antibiotics

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3
Q

Why would a pressure dressing be required for treatment of auricular haematoma?

A

To prevent reoccurence

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4
Q

What is a potential complication for auricular haematoma?

A

Cauliflower ears

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5
Q

What happens in cauliflower ears?

A

Necrosis of auricle cartilage leading to deformity

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6
Q

What happens in the case of a foreign body in the ear?

A

Removal of FB

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7
Q

When may a FB not be removed from the ear?

A

If it’s small and unharmful as will work it’s way out with wax

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8
Q

One example of a FB in the ear is a button battery. Why would this need to be removed within a few hours?

A

May cause permanent damage through corrosion.

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9
Q

If a FB is of organic origin, it would need to be removed within a couple of days. What would happen if it wasn’t removed?

A

May become infected

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10
Q

What is ottitus externa?

A

Inflammation of the external auditory meatus.

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11
Q

What can cause otitis media?

A

Infection, but not always the case

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12
Q

What is the treatment for otitis externa?

A

Antibiotics/ steroid ear drops
+/- suction under microscope

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13
Q

How would otitis externa present?

A

Pain, itchiness of ear, possible hearing loss

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14
Q

How can reoccurrence of otitis externa be reduced?

A

No water in ears
No cotton buds in ears

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15
Q

What is ‘malignant’ otitis externa?

A

Osteomyelitis of temporal bone

-important to note, not malignant in terms of neoplastic but because it can spread

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16
Q

What happens if ‘malignant’ otitis externa spreads?

A

Can spread throughout skull base and cause serious morbidity ort mortality

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17
Q

How does ‘malignant’ otitis externa present?

A

Severe ear pain
Granulomas in external auditory meatus
+/- cranial nerve palsies

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18
Q

Which group of people are more likely to get ‘malignant’ otitis externa?

A

Elderly diabetic patients

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19
Q

What is the treatment for ‘malignant’ otitis externa?

A

Long term antibiotics

-often ciprofloxacin is given

20
Q

What happens in otitis media with effusion?

A

Sterile fluid in the middle ear, glue-like consistency so often referred to as ‘glue ear’.

21
Q

How may otitis media with effusion present?

A

Hearing loss
Speech delay

22
Q

Who is usually affected by otitis media with effusion and why?

A

Children
-their eustachian tube, which connects the nose and middle ear, does not function as well as an adult’s. Gas is absorbed by the lining of the middle ear. If the eustachian tube isn’t working, there will be low pressure as middle ear is still absorbing gas which is not replaced by the gas from the nose. Therefore, the lining of the middle ear secretes fluid.

->v wordy, but read through, makes a lot of sense :)

23
Q

What is the management for otitis media with effusion/ glue ear?

A

Observation in most cases
If persistent, procedures like Grommet or an Otovent balloon may be used

24
Q

What is acute suppurative otitis media?

A

Pus in middle ear

25
Q

How will a patient with acute suppurative otitis media present?

A

Otalgia (ear pain)
+/- otorrhea (bursting of ear drum)

26
Q

What is the management for acute suppurative otitis media?

A

Mostly observation, antibiotics may be given

27
Q

What is Tympanosclerosis?

A

Calcification of tympanic membrane and/or in the middle ear.

(scarring)

28
Q

Why may Tympanosclerosis occur?

A

As a result of previous ear infections
After a grommet insertion

29
Q

How does Tympanosclerosis usually present?

A

Usually asymptomatic
May affect hearing if very extensive

30
Q

What is the treatment for Tympanosclerosis?

A

Usually none

31
Q

What are the two types chronic suppurative otitis media?

A

Perforated tympanic membrane
or
Cholesteatoma (skin in the middle ear +/- mastoid bone)

32
Q

What happens in chronic suppurative otitis media?

A

Long term discharge of the ear

33
Q

What are some of the complications of chronic suppurative otitis media?

A

Complete hearing loss
Facial palsy
Meningitis
Brain abscess

34
Q

What are some of the causes of perforation to the tympanic membrane?

A

Infection
Grommet
Trauma

35
Q

What is the presentation of someone with a perforated tympanic membrane, a type of chronic suppurative otitis media?

A

Recurrent ear infections
Hearing loss

36
Q

What is the management for perforation of tympanic membrane, a type of chronic suppurative otitis media?/

A

Keep water out of ears
Some cases, myringoplasty. For example, if a patient wanted to swim normally without having to prevent water from entering their ears, myringoplasty may be offered.

37
Q

Describe what happens in cholesteatoma.

A

Eustachian tube dysfunction which can lead to retraction of the eardrum and formation of a pocket.
Skin migration out of the ear may not work so skin gets trapped in the eardrum.
This lump of dead skin can spread backwards into the mastoid bone.

38
Q

What is the presentation of cholesteatoma?

A

Persistent offensive discharge (otorrhea)

-red flag symptom, should trigger referral to ENT

39
Q

What is the management of cholesteatoma?

A

Mastoidectomy

40
Q

What is Otosclerosis?

A

Abnormal bone growth around stapes bone which causing conductive hearing loss.

41
Q

How does otosclerosis present

A

Conductive hearing loss w/ a normal tympanic membrane

42
Q

What is the treatment for otosclerosis?

A

Hearing aid
or
Stapedectomy

43
Q

What are the clinical features of a facial nerve palsy?

A

Lower motor neuron face palsy meaning the forehead is involved

44
Q

Many ENT pathologies can cause facial nerve palsy. List a few.

A

Cholesteatoma
Parotid tumour

45
Q

If someone has facial nerve palsy with unknown cause, what will they be diagnosed with?

A

Bell’s palsy- a diagnosis of exclusion

46
Q

What is the treatment for facial nerve palsy?

A

Treat underlying condition if possible
Steroids
Eye care- sometimes patient’s cannot close eye fully so need shots to make sure they don’t dry out

47
Q
A