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ESA 4 - Head and Neck > Pathology of the Ear > Flashcards

Pathology of the Ear Flashcards

1
Q

Where are conditions affecting the ear found?

A

Both adults and children, and in primary and secondary care

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2
Q

What are the symptoms of ear disease?

A

Varied;

  • Pain (otalgia)
  • Discharge
  • Hearing loss
  • Tinnitus
  • Vertigo
  • Facial palsy
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3
Q

What are the types of hearing loss?

A
  • Conductive
  • Sensorineural
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4
Q

What are the categories of abnormalities of the pinna?

A
  • Congential
  • Inflammatory
  • Traumatic
  • Infective
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5
Q

Give an example of a traumatic abnormality of the pinna?

A

Pinna Haematoma

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6
Q

What causes a pinna haemotoma?

A

Blunt injury to the pinna

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7
Q

Where are pinna haemotomas common?

A

In contact sport

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8
Q

What is a pinna haematoma?

A

Accumulation of blood between cartilage and perichondrium

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9
Q

What results from the accumulation of blood between cartilage and perichondrium in a pinna haemotoma?

A

Deprives the cartilage of its blood supply, and pressure necrosis of the tissue can occur

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10
Q

What does a pinna haemotoma require?

A
  • Prompt drainage
  • Measures to prevent re-accumulation
  • Re-apposition of two layers if necessary
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11
Q

What happens if a pinna haemotoma is untreated, or poorly treated?

A

Leads to fibrosis and new asymmetrical cartilage development - cauliflower ear

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12
Q

Give an example of an infective abnormality of the pinna

A

Ramsey-Hunt palsy

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13
Q

What is Ramsey-Hunt palsy?

A

Facial nerve palsy caused by shingles of the facial nerve

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14
Q

How common is otitis externa?

A

Very common

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15
Q

What is otitis externa?

A

Infection and inflammation of the ear canal

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16
Q

Do you get discharge with otitis externa?

A

May do

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17
Q

How is otitis externa treated?

A
  • Antibiotics
  • Steroid drops
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18
Q

What are the common abnormalities of the tympanic membrane?

A
  • Perforation
  • Bulging and redness secondary to otitis media
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19
Q

What is otitis media with effusion known as?

A

Glue ear

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20
Q

Is glue ear an infection?

A

No

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21
Q

What happens in glue ear?

A

There is a build up of fluid and negative pressure in the middle ear

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22
Q

What is the result of the fluid in glue ear?

A

Means the tympanic membrane doesn’t vibrate as well, and so decreases the mobility of TM and ossicles, thus affecting hearing

23
Q

What is dysfunctional in glue ear?

A

The Eustachian tube

24
Q

What is wrong with the Eustachian tube in glue ear?

A

It stays closed all the time

25
Q

What can glue ear predispose to?

A

Infection

26
Q

Why does glue ear predispose to infection?

A

Due to stagnant fluid in the cavirty

27
Q

How is glue ear managed?

A
  • Most resolve spontaneously within 2-3 months
  • Some may persist, and require grommets
28
Q

What is otitis media?

A

An acute middle ear infection

29
Q

Who is otitis media common in?

A

More common in infants and children in adults

30
Q

What are the symptoms of otitis media?

A
  • Otalgia
  • Other non-specific symptoms, e.g. temperature
  • Red, with or without bulging of the TM and loss of the normal landmarks
31
Q

What are the complications of otitis media?

A
  • Tympanic membrane perforation
  • Facial nerve involvement
  • Mastoiditis
  • Intracranial complications
32
Q

What allows otitis media to cause mastoiditis?

A

The mastoid air cells communicates with the middle ear cavity, which provides a potential route for middle ear infections to spread to the mastoid bone

33
Q

What does mastoiditis require for treatment?

A
  • IV antibiotics
  • Surgery to drain
34
Q

What are the intracranial complications of otitis media?

A
  • Meningitis
  • Sigmoid sinus thrombosis
  • Brain abscess
35
Q

What is the middle ear in important anatomical relationship with?

A

The facial nerve

36
Q

What is the anatomical relationship between the facial nerve and the middle ear?

A

The facial nerve, in particular the chorda tympani branch, runs through the middle ear cavity

37
Q

How is the facial nerve seperated from the middle ear?

A

A very thin bony partition

38
Q

What is the clinical relevance of the anatomical relationship between the middle ear and the facial nerve?

A

A middle ear infection may cause a lesion of the facial nerve

39
Q

What are the pathologies of the vestibular apparatus?

A
  • Vertigo
  • Meniere’s disease
40
Q

What is vertigo?

A

A symptom, rather than a condition itself

Sensation that you, or the environment, is moving or spinning

41
Q

Give a common cause of vertigo

A

Benign paroxysmal positional vertigo

42
Q

What can Meniere’s disease affect?

A

The vestibular and cochlear components of the inner ear

43
Q

What are the symptoms of Meniere’s disease?

A
  • Vertigo
  • Hearing loss
  • Tinnitus
  • Feeling of pressure or fullness in the ear
44
Q

How common is cholesteatoma?

A

Rare

45
Q

What is the clinical feature of cholesteatoma?

A

Painless otorrhea

46
Q

What is cholesteatoma usually secondary to?

A

Chronic/recurring ear infections and blockage of ET

47
Q

What does a blockage of the ET cause?

A

A sucking, negative pressure, drawing the eardrum inwards, producing a retraction pocket at the top of the middle ear cavity

48
Q

What results from the formation of a retraction pocket in the top of the middle ear cavity?

A

Skin cells get trapped, collect, and continue to grow in this small pocket within the middle ear

49
Q

How does cholesteatoma progress?

A

Not malignant, but slowly grows and expands, eroding into structures;

  • Ossicles
  • Mastoid bone
  • Cochlea
50
Q

What is a cholesteatoma initially more likely to grow into?

A

Structures in the middle ear

51
Q

What happens to a cholesteatoma over time?

A

It may grow into and erode structures in the inner ear or into the bone of the skull, then brain

52
Q

How does the pharyngotympanic tube differ in infants?

A

It is shorter and more horizontal

53
Q

What is the result of the pharyngotympanic being shorter and more horizontal in infants?

A
  • Easier passage for infection from the nasopharynx to the middle ear
  • Tube can block more easily
54
Q

What problems does a blockage of the pharyngotympanic tube do?

A

Compromises ventilation and drainage of middle ear, and increases risk of middle ear infection

ESA 4 - Head and Neck (30 decks)

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