Ear disease (covered in previous set so pie)

Question 1

What are the 5 D’s which are signs of ear disease ?

Answer 1

• Deafness
• Discomfort
• Discharge
• Dizziness
• Din Din – tinnitus

Question 2

What nerve is the most common caue of ear discomfort and why?

Answer 2

• CN IX
• Due to referred pain from the throat as its the main nerve which supplies there but it also supplies some of the ear

Question 3

What is tinnitus ?

Answer 3

Often described as rinning in your ears (basically hearing sound that comes from inside your body rather than outside)

Can also be described as:

• Buzzing
• Humming
• Grinding
• Hissing
• Whistling

Question 4

What is ottitis externa ?

Answer 4

A condition that causes inflammation (redness and swelling) of the external ear canal

Question 5

What are the symptoms of ottitis externa ?

Answer 5

• Ear pain
• Itchiness in the ear canal
• Discharge of liquid or pus from the ear
• Some degree of temporary hearing loss

Question 6

What are the different types of discharge that can come from the ear and what are they associated with ?

Answer 6

• External ear produces a scanty watery discharge
• Middle ear - produces a mucous discharge
• CSF can also leak out of the ear following trauma, suspect this if you see halo sign on filter paper, or high glucose levels

Question 7

What is acute otitis media and what are the signs of it ?

Answer 7

Acute inflammation of the middle ear

Signs:

• Pain
• Conductive hearing loss - due to fluid in middle ear
• Fever
• Irritability
• Often occurs after an upper resp tract infection
• Discharge (if tympanic membrane ruptures)

Question 8

What is chronic otitis media ?

Answer 8

It is essentially inflammation with middle ear fluid of several months duration

Question 9

What are the signs of chronic otitis media ?

Answer 9

• Discharge
• Decreased hearing
• But little pain
• The tympanic membrane has been ruptured and not fully healed hence the discharge

Question 10

What is otitis media with effusions (glue ear)?

Answer 10

It is the main cause of hearing loss in kids, it is essentially when fluid cannot be drained out of the eustachian tube resulting in a build up of fluid in the middle ear

Question 11

What is a complication seen in kids due to OME ?

Answer 11

Learning problems due to hearing loss

Question 12

What are the signs of OME ?

Answer 12

• Retracted or bulging tympanic membrane
• Tympanic membrane can also look, dull, grey or yellow
• May be bubbles or a fluid level seen at tympanic membrane
• Decreases tympanic membrane mobility
• Conductive hearing loss

Question 13

What are some of the causes of OME ?

Answer 13

• Upper resp tract infections
• Overised adenoids

Question 14

What is the treatment of OME ?

Answer 14

• 1st line - explanation and reassurance - Usually resolves by itself
• 2nd line - if perisiting longer than 3 months with notable hearing loss/ or learning problems due to it, then myringotomy and insertion of grommet

Question 15

What is a cholesteatoma ?

Answer 15

The presence of keratinising squamous epithelium within the middle ear, or in other pneumatised areas of the temporal bone.

Question 16

What are some of the more common complications of cholesteatomas ?

Answer 16

• Ear infection, causing discharge from the ear
• Hearing loss, which can be permanent
• Vertigo (the sensation that you, or the world around you, is spinning)
• Tinnitus
• Damage to facial nerve

Question 17

What are the 2 very rare but very serious complications of cholesteatomas ?

Answer 17

Brain abscess or meningitis

Question 18

What is the treatment of cholesteatomas ?

Answer 18

Mastoid surgery to remove the disease

Question 19

How is cholesteatomas diagnosed ?

Answer 19

CT scan and audiogram

(diffusion weighted MRI meant to be replacing for diagnosing it)