Week 208 - Hearing and Balance Flashcards
Where does Chorda Tympani pass and what does it supply?
Passes medial to malleus and lateral to incus
Carries taste fibres from anterior 2/3 of tongue
Name some drugs that cause Ototoxicity
Gentamycin Cisplatin Furosemide (IV) Aspirin Quinine
What changes do you expect to see in someone with Meniere’s disease?
Vertigo (lasting Hours)
Hearing Loss
Tinnitus
What are the possible causes of Central Vertigo?
Hours- Migrane
Days to weeks - MS
Long term - Cerebro vascular disease
What does tenderness on palpation of tragus suggest?
Infection of EAM or temporomandibular joint
What is Tympanosclerosis?
White patches on the tympanic membrane - form of scarring
What is the Dix-Hallpike positional test for?
Benign Paroxysmal Positional Vertigo
How is the nose divided into two?
By septal cartilage
What is the most common cause of Hyperthyroidism?
Graves disease
TSH receptor binding and stimulating antibodies
What is the treatment for Hyperthyroidism?
Carbimazole (12-18 months)
Propylthiouracil (alternative for pregnant/breast-feeding)
What is a Cholesteatoma?
A keratinizing squamous epithelium within middle ear cleft
Locally destructive
Foul-smelling otorrhoea (superior+posterior)
What are the possible treatments for Glue Ear?
Watch and wait
Grommets
Grommets and adenoidectomy
Hearing aid
What is Presbyacusis?
Age associated hearing loss
Congenital
Iatrogenic (aminoglycosides, loop diuretics, chemo)
High freq freq loos + background low freq = hard to hear
What is the treatment for Otitis Media?
Wait for 72hrs
If not, systemic Abx (e.g. amoxicillin)
What are complications that can follow Otitis Media?
Mastoiditis (commonest)
Labyrinthitis
VII paralysis
Meningitis & Brain Abscess
What artery supplies the Cochlea?
Labyrinthine Artery
What is the Epley manoeuvre used for?
Curing BPPV, 30% will come back
What will Vestibular Neuritis present with?
SEVERE Vertigo, Nausea, Vomiting (few days)
Affects vestibular nerve only (no cochlear symptoms)
What will Labyrinthitis present with?
SEVERE Vertigo, Nausea, Vomiting + Cochlear Symptoms
Permanent changes in hearing and tinnitus
Caused by viral infection
What is treatment for Meniere’s Disease?
Reduce Salt Give beta-histine Cinnarizine ( vestibular sedative) Grommets, Chemical Labyrithectomy Avoid caffeine
What detects LINEAR movements in the middle ear?
Maculae within the utricle and saccule
What detects ANGULAR movements in the middle ear?
Semicircular canals
When the cilia in the vestibular apparatus are disturbed TOWARDS the kinocillium, what happens?
Depolarisation -> INCREASE FIRING
What are the positive and negative findings for Rinne’s Test?
AC>BC - positive result (normal or sensory deafness)
BC>AC - negative result (conductive deafness)
What nerves supply the middle ear?
Superior Vestibular Nerve
Inferior Vestibular Nerve
Cochlear Nerve
What Structures can present with OTALGIA?
Tonsil - Tonsilitis, Tonsil carcinoma Tongue - Tongue carcinoma Teeth - Tooth Abscess TMJ - TMJ dysfunction Throat - Carcinomas in larynx and pharynx The Neck - Arthritis
What are the possible causes of Facial Palsy?
Bell’s Palsy (1/2 of cases; ?HSV1)
Ramsay Hunt Syndrome (Herpetic rash on pinna or soft palate + the palsy)
Trauma (surgical parotidectomy)
Tumour (facial and vestibular schwannomas)
Infections (otitis media, cholesteatoma)
What facial changes would you expect to see with a LMN lesion in the face?
All face weak (inc. forehead)
Which muscle is responsible for smiling?
Zygomaticus
Which muscle is responsible for puffing out cheeks?
Buccinator
Which muscle is responsible for creasing the forehead?
Frontalis
