4th Year Ear Additions

Question 1

what is an important differential in SNHL in the elderly?

Answer 1

dementia

Question 2

does hearing loss increase your risk of dementia?

Answer 2

yes, but treating can reduce the risk

Question 3

medications that cause SNHL

Answer 3

loop diuretics (furosemide)
aminoglycosides (gentamicin)
chemotherapy (cisplatin)

Question 4

what movement do the semi-circular canals detect?

Answer 4

rotational

Question 5

what movement do the otolith organs detect?

Answer 5

linear

Question 6

what is the role of the vestibular nerve?

Answer 6

balance

Question 7

what is the role of the cochlear nerve?

Answer 7

hearing

Question 8

what are not features of vestibular neuronitis?

Answer 8

tinnitus and hearing loss as this is inflammation of only the vestibular nerve

if these are present consider labyrinthitis

Question 9

short-term acute management options for peripheral vertigo

Answer 9

prochlorperazine

antihistamines

Question 10

what does prolonged use of prochlorperazine and antihistamines cause?

Answer 10

can slow recovery

Question 11

what condition is bilateral acoustic neuromas associated with?

Answer 11

NF 2

Question 12

what can acoustic neuromas damage if they grow large enough?

Answer 12

vestibulocochlear and facial nerve

Question 13

where does the facial nerve exit the brainstem?

Answer 13

cerebellopontine angle

Question 14

what does the facial nerve pass through?

Answer 14

temporal bone

parotid gland

Question 15

branches of the facial nerve

Answer 15

5 branches:

• temporal
• zygomatic
• buccal
• marginal mandibular
• cervical

Question 16

what does UMN facial palsy suggest?

Answer 16

stroke

forehead spared

Question 17

does LMN have forehead sparing?

Answer 17

no

Question 18

management of Bell’s palsy

Answer 18

prednisolone
lubricating eyedrops (exposure keratopathy)

Question 19

where is the bony labyrinth located?

Answer 19

petrous part of the temporal bone with perilymph

Question 20

what does the bony labyrinth consist of?

Answer 20

cochlea
vestibule
three semi-circular canals

Question 21

where is the membranous labyrinth?

Answer 21

within the bony labyrinth

Question 22

what does the membranous labyrinth consist of?

Answer 22

cochlear duct
semi-circular ducts
utricle
saccule

filled with endolymph

Question 23

congenital causes of SNHL

Answer 23

Connexin 26 GJB2
Waardenburg's (AD)
Jervell and Lange-Nielsen
Stickler (AD)
Usher's (AR)
Pendred's (AR)

Question 24

RF for congenital SNHL

Answer 24

FH
maternal infection
craniofacial abnormalities
LBW
hyperbilirubinaemia
ototoxic medication
meningitis
low APGAR

Question 25

pathway for testing SNHL in children

Answer 25

new-born screening objective audiometry auditory brainstem response audiogram

Question 26

non-genetic causes of SNHL

Answer 26

``` maternal infections (rubella, chickenpox, CMV, HIV, strep) alcohol/ drug misuse inflammatory (meningitis, labyrinthitis) AI (sarcoidosis, RA, GPA) ```

Question 27

noise-induced hearing loss prolonged exposure length?

Answer 27

10+ years 8 hours a day

Question 28

what conditions is pulsatile tinnitus associated with?

Answer 28

GCA | IIH

Question 29

grading for facial palsy

Answer 29

House-Brackmann (normal is 1 and paralysis is 6)

Question 30

causes of facial palsy

Answer 30

``` stroke vestibular schwannoma Bell's palsy herpes zoster parotid tumour surgery Lyme disease sarcoidosis ```

Question 31

most common procedure that risks facial nerve injury?

Answer 31

parotidectomy when nerve is traumatised but thought to be intact then systemic steroids are used

Question 32

what is a myringotomy?

Answer 32

cut to relieve pressure of the eardrum

Question 33

what does sudden SNHL require for diagnosis?

Answer 33

at least 30dB lost in three consecutive frequencies

Question 34

what does acute release of pain in acute otitis media indicate?

Answer 34

tympanic membrane perforation

Question 35

what to consider in unilateral glue ear in adults?

Answer 35

nasopharyngeal cancer and eustachian tube obstruction | especially in smokers and people of Chinese or South East Asia origin

Question 36

OTC device for eustachian tube dysfunction?

Answer 36

otovent (patient blows into balloon using a single nostril)

Question 37

what is betahistine?

Answer 37

labyrinthine vasodilator

Question 38

risk in pinna haematoma?

Answer 38

cauliflower ear

Question 39

how can the teeth refer pain to the ear?

Answer 39

auriculo-temporal brach of the trigeminal nerve

Question 40

how can the larynx cause ear pain?

Answer 40

auricular branch of the vagus

Question 41

how can the throat cause ear pain?

Answer 41

tympanic branch of glossopharyngeal