Session 6 - Diseases of the ear

Question 1

What is an auricular haematoma?

Answer 1

Trauma resulting in bleeding within the auricle may produce an Auricular Haematoma. A localised collection of blood forms between the Perichondrium and the Auricular Cartilage, causing distortion of the contours of the auricle.

If the blood is not aspirated, fibrosis develops in the overlying skin, forming a deformed auricle (Cauliflower or Boxer’s ear).

Question 2

Name four congenital pinna deformities

Answer 2

o Antihelix deformity
o Pinna malformation
o Pre-auricular pit
o Pre-auricular skin tag

Question 3

What is acute otitis externa?

Answer 3

o Infection / Inflammation of the external acoustic meatus

Question 4

Who does otitis externa usually effect?

Answer 4

o Often develops in swimmers who do not dry their meatus after swimming
o Itching and pain in the external ear
 Pulling the auricle or applying pressure on the tragus increases pain

Question 5

What is otitis media?

Answer 5

Infection of the middle ear

Question 6

What is otitis media often caused by?

Answer 6

Respiratory infection via the eustachian tube

Question 7

Why is otitis media more common in children?

Answer 7

their Eustachian tube is shorter and more horizontal, making it easier for organisms to travel up it and harder for fluid to drain away from the middle ear

Question 8

What are the major symptoms of otitis media?

Answer 8

o Earache and bulging red tympanic membrane

 Pus or fluid in the middle ear

Question 9

What could inflammation of the mucous membrane lining the tympanic cavity cause in otitis media?

Answer 9

Partial or complete blockage of the eustachian tube

Question 10

What can cause perforation of tympanic membrane?

Answer 10

otitis media, the insertion of foreign bodies, trauma, excessive pressure

Question 11

What is mastoiditis?

Answer 11

o Infections of the mastoid antrum and mastoid air cells

Question 12

What causes mastoiditis?

Answer 12

Otitis media

Question 13

What does mastoiditis cause?

Answer 13

o Causes inflammation of the mastoid process
 Swelling behind the ear
o Infection may spread superiorly into the middle cranial fossa through the petrosquamous fissure in children
 Osteomyelitis

Question 14

What can cause blockage of eustachian tube?

Answer 14

mild infections, e.g. a cold as walls of its cartilaginous part are normally already in apposition

Question 15

What happens when eustachian tube is blocked?

Answer 15

residual air in the tympanic cavity is absorbed into mucosal blood vessels
 Lower pressure in the tympanic cavity
 Retraction of the Tympanic Membrane
o Interference with the free movement of the tympanic membrane (its retraction) affects hearing
o Adenoidal hypertrophy can block the opening to

Question 16

What is a major viral cause of eustachian tube blockage?

Answer 16

o Adenoidal hypertrophy can block the opening to the tube in the Nasopharynx
 Children 3-8
 Epstein-Barr Virus (EBV)

Question 17

What does paralysis of stapedius cause?

Answer 17

o Loss of protective action against loud noises

o Hyperacusis or Hyperacusia

Question 18

What is motion sickness?

Answer 18

o Discordance between vestibular and visual stimulation

Question 19

What is the major cause of dizziness and hearing loss?

Answer 19

Injuries of the peripheral auditory system

Question 20

What are the big symptoms of peripheral auditory damage?

Answer 20

Hearing loss
Vertigo
Tinnitus

Question 21

What is a major cause of conductive hearing loss?

Answer 21

o Results from anything in the external or middle ear that interferes with the conduction of sound or movement of the oval or round windows.
o People with this type of hearing loss often speak with a soft voice
 To them, their own voices sound louder than background sounds
o May be improved surgically or by use of a hearing device

Question 22

What causes sensorineural hearing loss?

Answer 22

o Results from defects in the pathway from cochlea to brain
 Defects of cochlea
 Defects of cochlea nerve
 Defects of brainstem

Question 23

What is a treatment for sensorineural hearing loss?

Answer 23

o Cochlear implants can restore hearing
 External microphone transmitting to an implanted receiver that sends electrical impulses to the cochlea, stimulating the cochlear nerve

Question 24

What is meniere syndrome?

Answer 24

o Blockage of the cochlear aqueduct
o Recurrent attacks of tinnitus, hearing loss and vertigo
o Accompanied by a sense of pressure in the ear, distortion of sounds and sensitivity to noise

Question 25

What is a colesteatoma?

Answer 25

o Blockage of the Eustachian tube leads to negative middle ear pressure
o Negative pressure leads to retraction pockets
o Dead skin cells accumulate in the pockets
o Necrotic mass of dead skin
 Colesteatoma
o Erosion of middle ear structures and bone via lytic enzymes

Question 26

What is otalgia?

Answer 26

o Ear pain
o Infection / inflammation around the ear
o Pain from teeth, pharynx or cervical spine commonly referred to the ear

Question 27

What is pruritus?

Answer 27

o Itching

o May result from primary disorder of the external ear, or middle ear discharge

Question 28

What is otorrhea?

Answer 28

o Discharge from the ear
o Indicates acute or chronic infection
o Blood / CSF discharge associated with skull fracture