3 - ENT - Otology - Conductive deafness - Cholesteatoma, Retraction pockets, Tympanosclerosis, Otosclerosis

Question 1

Cholesteatoma - what is it?

Answer 1

sac of squamous epithelium forms from TM ( usually pars flaccida - attic) and enlarges

Question 2

Cholesteatoma - what is frequent? leading to? sac fills with? not a tumour, but is what?

Answer 2

infection - leading to foul smelling discharge
sac becomes filled with keratin
locally invasive

Question 3

cholesteatoma - complications include erosion into….

Answer 3

ossicles - conductive deafness
lateral semicircular canal - vertigo
facial nerve - palsy
cochlear causing sensorineural deafness
through rood of middle ear (tegmen) - intracranial abscess/sepsis
sigmoid venous sinus - thrombosis

Question 4

mgmt of cholesteatoma

Answer 4

mastoid surgery to remove sac

Question 5

retraction pockets - what is it? normally does what?

Answer 5

indrawing of TM - eustachian tube dysfunction

normally self cleaning and resolves naturally

Question 6

what makes a retraction pocket a cholesteatoma?

Answer 6

if keratineous debris accumulates in pocket

Question 7

Tympanosclerosis - what? resulting from?

Answer 7

calcification of scar tissue on TM - results from previous trauma/infection

Question 8

Tympanosclerosis - Sx?

Answer 8

may be aSx, or cause significant deafness

Question 9

Otosclerosis - heritibility? what happens?

Answer 9

familial dominant condition

spongy bone formation around oval window –> fusion with stapes and conductive deafness

Question 10

otosclerosis - characteristic point of hearing loss? mgmt?

Answer 10

dip in hearing at 2k Hz
mgmt = replacement of stapedius (stapedectomy)
hearing aid