What do you treat otitis media with?
Oral Amoxycillin, 15mg/kg, 8 hourly
Cefuroxime if allergic
When are antibiotics given in otitis media?
It is the only hearing ear
Complications - mastoiditis, facial paralysis
Explain Weber's test and how it is interrupted?
A vibrating tuning fork is placed on a boney prominence, equidistant from both ears
Patient reports where they hear the buzzing
If there is a conductive hearing loss then the sound will be louder in the effected ear as bone conduction will compensate
If there is sensorineural loss then it will be heard in the unaffected ear
What pitch is worse heard with sensorineural hearing loss?
How is chronic suppurative otitis media characterised?
Tubotympanic disease - "safe"
Atticoantral disease - "unsafe"
What are some complications from cholesteatomas?
Conductive or sensorineural hearing loss
How is Ramsay-Hunt mananged?
Acyclovir if within 3 days
Eye patch and artificial tears if facial nerve involvement
What is a cholesteatoma?
A squamous epithelium trapped in the temporal bone that can be congenital or secondary to tympanic membrane pathology
What structures can refer pain to the ear?
What is Rinne's test? How is it interrupted?
Place the vibrating fork on the mastoid process
If bone conduction is better than air then there is conductive hearing loss
What symptoms do you get with vestibular neuritis?
Persistent vertigo following an acute infection
No hearing loss or tinnitus
What manoeuvres are used in BPPV? What is the function of each one?
The Dix-Hallpike - Diagnosis
Epley - Treatment
How is Meniere's treated?
Diazepam or prochlorperazine for acute attacks
Low salt diet
Thiazide diuretic or betahistine
What is the pathophysiology of BPPV?
Otoliths from the utricle become loose and lodge in the posterior semicircular canal
Which symptoms do you get with meniere's disease?
Intermittent vertigo - >30 minutes but <1 day
Fullness in the ear
What is a potential complications of acute otitis media?
Chronic otitis media
What are some common causative agents of otitis media?
What is chronic suppurative otitis media? What symptoms do patients get?
Recurrent or persistent bacterial infection that causes irreversible damage to the tympanic membrane and some the ossicles resulting in conductive hearing loss
What is Ramsay-Hunt syndrome? What are the symptoms?
Reactivation of herpes-zoster in the facial nerve ganglion
Who should get middle ear ventilatory tubes?
OME for 4 months with other symptoms
Recurrent OME in an at risk group
OME and structure damage to the tympanic membrane
Which part of the brain controls hearing?
Temporal lobe of the cerebral cortex