pathology of ear Flashcards
what is the other name for swimmers ear
otitis externa
what are the causes of otitis externa
infectious, allergic or dermatologic
normally colonized with gram positive organisms (S. aureus or epidermidis)
what is the presentation of otitis externa
otalgia, pruritis, discharge
may have diminished hearing secondary to partial occlusion
may have pain with external manipulation of the ear
what increases kids risk of inner ear infection
eustachian tube anatomy (more horizontal)
what is the most common cause of otitis media (AOM)
viral pathogens - RSV, rhinovirus, enterovirus, coronavirus, influenza, adenovirus
bacterial: S. pneumonia, H. influenzae (M/c)
what is the most common cause of AOM in kids < 6 months
chlamydia trachomatis
what can suppurative AOM lead to
ruptured tympanic membrane
what are the common causes of ruptured TM
suppurative AOM
barotrauma and blunt trauma
what is mastoiditis
suppurative infection of mastoid air cells
complication of AOM
purulent fluid within the mastoid will cause possible abscess
causes bone restoration
concern that infection increases risk of spread to CN, temporal and CNS
what is the presentation of mastoiditis
AOM that has worsened
pain over mastoid process
fever/chills
otalgia
post-auricular erythema and tenderness
at what age are the eustacian tubes adult sized
age 6
what does the eustachian tube allow for
drainage and ventilation of the middle ear
what is Eustachian tube dysfunction (ETD) associated with
inability to regular pressure
decreased protection: reflux of nasopharyngeal pathogens
decreased clearance
what is the presentation of ETD
otalgia
retracted TM
effusion
decreased pneumatic changes
hearing diminished
what is otalgia
ear pain/ache
what makes up the inner ear
semicicular canals
oval window
facial nerve
vestibulocochlear nerve
cochlea
what is acoustic neuroma
benign tumors of Schwann cells of the vesticulochochlear nerve (CN8) - m/c occurs at the porus acusticus ( where cells transition from CNS to PNS)
very slow growing if tumor grows at all
what is the concern if a pediatric patient presents with acoustic neuroma
concerning for neurofibromatosis type 2 (NF2)
typically presents with bilateral tumors
affects chromosome 22
leads to defect in tumor suppressor gene within Schwann cells
What is the presentation of acoustic neuromas
associated with mass affect on VN, cerebellar compression..
if cochlear nerve involved - decreased hearing, tinnitus
vestibular nerve - gait instability
compression of CN5 - facial paresthesias, pain
CN7 - change in taste, facial paralysis, xerostomia
can compress on cerebellum/brainstem = ataxia
what are the different types of vertigo
peripheral (semicircular canals, vestibule, vestibular nerve)
central (cerebellum/brainstem)
what causes BPPV
calcium debris in the semicircular canal
-canalithiasis - m/c in posterior canal
causes false activation of hair cells similar to that of endolymph moving when there was a real stimuli
false sense of spinning
what is labrythinitis and vestibular neuritis
vestibular neuritis is inflammation of vestibular branch of CN8
labrythitis is inflammation of labyrinth
both typically associated with viral or post viral inflammation
what does labrynthitis and vestibular neuritis result in
peripheral vertigo
N/V, instability
unidirectional horizontal nystagmus
what diseases can causes peripheral vertigo
menieres
vestibular neuritis
labrynthisis
acoustic neuroma
BPPV
what is the perception of sound that are not related to external stimuli
tinnitus
what are tinnitus inducing medications
loop diuretics (furosemide)
salicylates
NSAIDS
Quinine
ABX (aminoglycosides, erythromycin, vancomycin)
chemo
topical (propylene glycol, antiseptic, ethanol, polymixinB, neomycin)
what is conductive hearing loss
unable to conduct the sound waves from external ear to inner ear (disorder within the external or middle ear)
what can be associated with conductive hearing loss
edema/inflammation
otitis media/externa
ETD
Trauma of TM
middle ear barotrauma
cerumen build up
tumor
psoriasis
malformation
cholesteotoma
otosclerosis
what is sensorineural hearing deficit
hearing deficit due to pathology within the INNER ear
what are non-hereditary causes of sensorinueral hearing deficit
infection during cochlear development. -CMV, hepatitis, rubella, toxoplasmosis, HIV, syphilis, meningitis
teratogenic meds, drugs, ETOH
what are the hereditary causes of sensorineural hearing deficit
autosomal dominant or recessive
m/c associated with abnormal connexin 26 (protein needed to help with cellular communication)
may present initially or progress throughout life
may also have congenital malformation with atresia of cochlea
what is age related hearing loss called
presbycusis
what are ototoxic drugs that can lead to sensorineural hearing deficit
aminoglycosides
vancymycin
erythromycin
loop diuretics
antimalarials
sildenafil
cocaine
what autoimmune disesase can affect sesorinueral hearing deficit
SLE
RA
Sjogrens syndrome
Kawasaki disease
temporal arteritis
what vascular diseases can affect sesorinueral hearing deficit
CVA
TIA
cerebellar infarct
inner ear hemorrhage
what causes menieres disease
endolympathic hydrops
episodic vertigo, unilateral tinnitus and hearing loss
what can cause endolymphatic hydrops
trauma
chronic OM
congenital hearing deficit
labyrinthine concussion
leukemic infiltrates
otosclerosis
paget disease
post surgical complications
syphilis
viral labrythitis
