Outer & Middle Ear

Question 1

Condyle

Answer 1

• Protrusion of the mandible
• Below osseocartilaginous junction
• TMJ if mandible sits incorrectly

Question 2

Microtia

Answer 2

deformity of the outer ear

Down Syndrome
Basal Cell Carcinoma

Question 3

Anotia

Answer 3

pinna is absent

Down Syndrome
Basal Cell Carcinoma

Question 4

Atresia

Answer 4

Lack of ear canal

Treacher collins
CHARGE syndrome
Some because of trauma or burn

Question 5

Stenosis

Answer 5

Narrowing of ear canal

No hearing loss, just excessive cerumen

Question 6

External Otitis

Answer 6

external ear infection

Question 7

Exostoses

Answer 7

bony growth in ear canal

Question 8

Myringitis

Answer 8

inflammation of TM

Question 9

Otomycosis

Answer 9

fungal external ear infection

Question 10

Myringoplasty

Answer 10

surgical repair of TM

Question 11

Tympanosclerosis

Answer 11

thickening of TM

Don’t respond well to surgical treatment

Question 12

Negative Pressure

Answer 12

Middle Ear Disorder
Treated By:
Politzerization – one nostril, MD blows opposite
Valsalva – most common
Toynbee maneuver – close jaw & swallow

Question 13

Otitis Media

Answer 13

Barotrauma
Middle Ear Infection

Types:
Purulent (pus-producing) = bacteria
Suppurative = painful pus, increased body temp
Mastoiditis = pus cannot escape, invade mastoid space
Chronic vs acute
hemotympanum

Antibiotic treatment
Dormant OM
Meniscus – visible through the TM
PE Tubes
Tympanosclerosis 
Mucous OM = glue

Question 14

Cholesteatoma

Subluxation – partial dislocation of ossicular chain

Answer 14

History of ear infections

Continual regrowth

Question 15

Mastoidectomy

Answer 15

Mastoiditis- bone must be scraped clean

Creates large concha bowl in pinna

Question 16

Tympanoplasty

Answer 16

ossicular bones
Myringoplasty- simplest form
Subluxation – partial dislocation of ossicular chain

Question 17

Facial Palsy

Answer 17

Bell’s Palsy

Facial Weakness
Dry Eye
Altered Taste
Hyperacusis

Question 18

Patulous Eustachian Tube (PET)

Answer 18

Eustachian tube is chronically open
Autophony – head in a barrel feeling
Voice is perceived as loud
Chewing and breathing sounds loud
“occlusion effect”
Pregnant / birth control
Working out / body weight changes

Question 19

Otosclerosis

Answer 19

Prominent in white women over 30, during pregnancy or menopause
Bony growth or hardening of stapes footplate
Becomes fixed in the oval window
Conductive hearing loss
Tinnitus
Hear better in background noise
Most common fix: stapedectomy or HAs

Question 20

SISN HL- Sudden Idiopathic Sensorineural HL

Answer 20

30 dB loss at least 3 octaves
Autoimmune, Viral, or other infection
Blood supply
Steroid treatment

Question 21

Menniere’s Disease

Answer 21

Unilateral- fluctuating HL
Many “causes”- mostly undetermined
Biggest impact failure to understand speech
Typically unilateral; tinnitis at lower pitch; fluctuates in “attacks”

Four Questions: 
    Roaring tinnitus, 
    aural fullness 
    dizziness
     trouble with speech recognition

Cochlear hydrops: over secretion and under absorption of endolymph
When fluid builds in cochlear duct, pressure & tinnitus increase
Causes swelling; cause of full feeling; typically no dizziness; otherwise similar to Meniere’s

Hearing aids restore loudness for safety in the environment; understanding is not helped by aids

Question 22

superior olivary complex (SOC) and inferior colliculus

Answer 22

Two important crossovers for auditory impulse/nerve

Question 23

8th Nerve HL - Acoustic neuritis

Answer 23

Inflammation of the 8th nerve

Question 24

8th Nerve HL - Multiple sclerosis (MS)

Answer 24

Disease where immune system eats away the protective covering of the nerve

Question 25

8th Nerve HL - Auditory neuropathy

Answer 25

Normal outer hair cell function in the cochlea, but 8th nerve response fails to synchronize reliably
Some days they can hear, some days they cannot
Information does not smoothly travel from the ear to the brain

Question 26

Central Auditory Processing Disorder

Answer 26

Inability of the central auditory system to organize concurrent auditory input into the correct patterns

“Sound gets to the brain, but the brain doesn’t know what to do with it”

MUST have normal hearing sensitivity

Extremely long test battery

Trouble distinguishing APD vs ADD/ADHD
Play dog test; 11 mins long; presses clicker at every specified word
Analyze correct, missed, erroneous responses to determine btwn APD and ADHD
Can also determine if ADHD meds are needed or are working
504/IEP