otorrhea

Question 1

what does the term otorrhea refer to ?

Answer 1

ear discharge

Question 2

what are the types of ear discharge ?

Answer 2

wax (physiological)
pus or mucopus
blood
CSF

Question 3

what points are important to cover when analysing otorrhea ?

Answer 3

duration
intermittent or persistent
offensive smelling (cholesteatoma)
earache
fever
hearing loss
history of head trauma (CSF)
FB in children

Question 4

what is the presentation of otitis externa ?

Answer 4

scanty thin watery discharge
meatal narrowing
itching ( especially if due to fungal infection)
tenderness on pulling of the tragus or the auricle

Question 5

when should malignant otitis externa be suspected ?

Answer 5

if treatment has been given for otitis externa but there is no response for more than 2 weeks
patient is immunocompromised e.g diabetic

Question 6

what is the presentation of acute otitis media ?

Answer 6

usually presenting in children
fever
vomiting
otalgia
hearing loss
fever and symptoms of pain decrease once there is a release of the discharge from the middle ear
mucopurulent ear discharge

Question 7

what is the presentation of cholesteatoma ?

Answer 7

purulent offensive discharge
characteristic of cholesteatoma
retraction pocket either posterosuperior or attic
keratinn debris in pocket
adjacent bony erosions
granulations in the mucosa which bleed upon contact
perforated TM if acquired

Question 8

when do we suspect CSF otorrhoea ?

Answer 8

watery clear discharge
history of head trauma
persistent watery discharge following myringoplasty

Question 9

how does CSF otorrhea happen ?

Answer 9

history of head trauma usually due to fracture of tegmen

Question 10

broadly what are the causes of bloody otorrhoea ?

Answer 10

trauma
tumors

Question 11

what kind of trauma can cause bloody otorrhea ?

Answer 11

lacerations of the external auditory canal
traumatic rupture of the tympanic membrane
fracture of the skull base

Question 12

what tumors can cause bloody otorrhea ?

Answer 12

malignant tumors
glomus tumors

Question 13

where do glomus tumors originate from ?

Answer 13

chief cells of the paraganglia

Question 14

where are the sites in which glomus tumors can present/ exist ?

Answer 14

1. carotid body tumor
2. jugular bulb tumor
3. middle ear ( glomus tympanicum)

Question 15

what is the function of a glomus body ?

Answer 15

thermoregulatory function

Question 16

what is thee presentation of a glomus tumor of the middle ear ?

Answer 16

conductive hearing loss
pulsatile tinnitus
ear fullness
bloody otorrhea
bruit
presence of a middle ear mass

Question 17

what is the commonest ear discharge ?

Answer 17

wax

Question 18

which nerve is associated with glomus body tumors of the middle eear ?

Answer 18

jacobsons nerve

Question 19

what is the jacobson’s nerve ?

Answer 19

the tympanic branch of the glossopharyngeal nerve

Question 20

what is the association of a glomus tumor in the jugular bulb to the ear ?

Answer 20

glomus jugulare are found along the jugular bulb and they involve the skull base and may extend in the middle ear