The Outer Ear Disorders Flashcards
What are the functions of the outer ear?
- It houses the pinna & auditory meatus
- Collects and directs sound waves to tympanic membrane
- Provides directional ques
- Resonance provides increase in sound pressure from 2-7kHz
What part of the outer ear should you know?
- Crus (Helix)
- Tragus
- Lobule
- Concha (Cymba & Cavum)
For the external auditory meatus, describe the outer portion…
It’s made of cartilage, has hairs and its where ear wax is formed
For the external auditory meatus, describe the inner portion…
It’s made of bone and it has no hairs and ear wax is not formed here
Why shouldn’t we use Q-tips?
- Can lead to buildup of earwax in the inner portion
- Slows down cleaning process of the ear
- Can damage eardrum
- Can cause abrasions and leads to infection
Describe the texture of the outer portion of the ear canal
Starts out floppy and becomes more rigid as you age out of childhood and then sags when you get older
When does a collapsed canal form?
As we get older, our ears sag
Define a collapsed canal
It’s when the ears droops and leads to a narrow space and less wax buildup in the outer portion
What happens when we put pressure on a collapsed canal?
It can close since its more floppy
With the devices we’re using during testing, how can it affect someone with a collapsed canal?
If we use a Supra-Aural earphone can cause the ear canal to close off and this creates a conductive hearing loss
For the EAM, what are the two concerns?
- Knowing why Q-tips aren’t effective
- Change in rigidity of cartilage with age
- Collapsed canals
The ____ forms the beginning of the outer ear and the _____ends it?
pinna, TM
How many layers are there for the TM?
3
What is the umbo?
The head of malleus
What is the cone of light?
aka Light Reflex is a reflection of the TM from the otoscope light
What makes up the TM?
- Three layers
- Umbo
- Cone of light
How do we look to see if something is wrong with the ear canal or the eardrum?
By performing an otoscopy
What is an otoscope?
It’s a lighted magnifier to view the ear canal/TM
What are two things you must do when using an Otoscope?
- Must pull up and back on pinna to straighten out the ear canal
- Must brace head to prevent accidental trauma
Why must we pull back on the ear canal?
To see past the bends of our ear canal and to see our TM
What could cause harm to our patient?
Performing an otoscopy
When performing an otoscopy, what are we looking for?
Anything: Wax (too much or not enough), debris, trauma, & signs of infections (behind the eardrum)
What are the 2 functions for our having ear wax in our ears?
- It keeps bugs out
2. Prevents ear canal from getting dry and itchy
If a hearing loss is present and the only problem is in the outer ear what kind of hearing loss is it?
Conductive HL
Define Conductive Hearing Loss
Is when hearing is loss is present when doing AC but hearing is normal when BC is done
If additional problems exist in the cochlea, what kind of hearing loss is present?
Mixed
How else can disorders of the outer ear occur?
From syndromes associated with craniofacial anomalies
State examples of these symptoms
- Down Syndrome
- Treacher Collins
- CHARGE
Does our testing account for the real world benefits the auricle provides?
No
What should we know about disorders that only affect the auricle?
It will not result in a hearing loss on the test
What should we note about our patient that has a disorder of the auricle?
Even though our test did not pick it up, they may face slight difficulties in the real world but it’s not enough to warrant treatment of hearing loss
Define Preauricular tags
It’s a skin tag that’s in front of ear and it’s a sign of incomplete embryological development
Can preauricular tags coexist w/other ear malformations or only in isolation?
Both
When are we worried about preauricular tags?
When there’s less hearing and more aesthetics
Define Microtia/Anotia
Is a small pinna or no pinna
What is a Grade 1 microtia?
- It’s the least severe
- Ear is smaller than normal
- Landmarks will be there to make it a typical pinna
- May have an ear canal
What is Grade 2 microtia?
- Worst
- Fewer features of the ear
- May have an ear canal
What is Grade 3 microtia?
- More severe
- The most typical
- Looks like a flap
- Typically, no ear canal
What is the worst form of microtia?
Anotia
What ear features consist of anotia?
- No pinna presents
- Most severe form
- Lower set hairline
- Can have an ear canal but miss the pinna
What informs us of a hearing loss for Microtia/Anotia?
If an ear canal is missing
T/F: Disruption during development will typically affect pinna and ear canal?
T
What is microtia often accompanied with?
Atresia & Stenosis
Define atresia
It’s the absence of an ear canal
Define stenosis
Ear canal starts out narrow and are normally genetically
Why is using a supra-aural headphone for stenosis okay?
There wouldn’t be a concern of the ear canal closing off vs a pt with a collapsed canal
Which test would be effective for someone with atresia and why?
BC - since the test is not focused on the ear canal, but on the cochlea
Define Cerumen Impaction
Is a temporary hearing loss until ear wax is removed
How do you know when our ear is impacted?
If the entire ear canal is filled with cerumen and the TM cannot be visualized
Can cerumen impaction cause hearing loss? Which one? and how long is last?
Yes, Conductive Hearing Loss & it’s only temporary
Define Otitis Externa
It’s an infection that occurs on the skin of the EAC
What’s another name for Otitis Externa?
Swimmer’s Ear
Otitis externa can be…
Fungal & Bacterial
If a patient has an otitis externa, can an audiological evaluation be done?
No, because swelling and pain/discomfort
Define Exostoses
Bony growth in the inner portion of the ear canal
What’s another name for exostoses?
Surfer’s ear
Do exostoses cause hearing loss?
It typically doesn’t
What causes disorders of the TM?
Infections, Trauma/Injuries, and Increase pressure of the ear canal
T/F: Every perforation results into a HL?
F
For disorders of the TM, what determines a HL?
- Depends on size and location
What size perforation affects the TM from working properly?
The bigger the perforation, it will cover the malleus
When does a spontaneous intervention not occur?
The bigger the perforation
What happens w/o a spontaneous closure?
- All three layers don’t always grow back,
- It may grow back thinner and flopper
- Can lead to a greater risk of perforation reoccurring
What’s the purpose of a myringoplasty?
It’s a surgery where an artificial covering is used to cover the perforation on the TM to give a false eardrum
When does TM thickening occur?
After infection/trauma leads to scarring/thickening of TM
Can a thinning or thickening of the TM occur?
Yes
What’s the name for scarring on the TM?
Calcium plaques
Does thickening or thinning of the TM cause HL
No, it does not cause noticeable HL
