EAR

Question 1

Bones of the ear in order from closest to tympanic membrane

Answer 1

Malleus, incus, stapes

Question 2

Three main types of hearing loss

Answer 2

Conductive
Sensorineural
Mixed

Question 3

What type of hearing loss is associated with the outer and middle ear?

Answer 3

Conductive hearing loss

Question 4

What type of hearing loss is associated with the inner ear?

Answer 4

Sensorineural hearing loss

Question 5

What is the most common type of hearing loss?

Answer 5

Sensorineural hearing loss - 90%

Question 6

What is mixed hearing loss?

Answer 6

Both conductive and sensorineural hearing loss

Question 7

What is a Rinne’s positive result?

Answer 7

Air conduction > bone conduction

Question 8

If a person is Rinne’s positive but hearing has reduced equally for both bone and air conduction, what type of hearing loss do they have?

Answer 8

Sensorineural hearing loss

Question 9

If a person is Rinne’s negative, what kind of hearing loss do they have? HINT: 2 potential types

Answer 9

Conductive hearing loss or severe sensorineural hearing loss

Question 10

What conduction is heard better in a Rinne’s negative test?

Answer 10

Bone > air conduction

Question 11

What is a normal Weber’s test result?

Answer 11

Sound heard equally in both ears

Question 12

In Weber’s test, if the sound is heard louder on the side of intact ear, what is the likely hearing loss?

Answer 12

Sensorineural

Question 13

In Weber’s test, if the sound is heard louder on the side of the affected ear, what is the likely hearing loss?

Answer 13

Conductive

Question 14

What is pure tone audiometry?

Answer 14

Measures quietest sounds a person can hear at different frequencies (pitch) in each ear. Results plotted in pure tone audiogram

Question 15

Four degrees of hearing loss severity

Answer 15

Mild, moderate, severe , profound

Question 16

Describe tympanometry

Answer 16

Test of middle ear functioning. Looks at compliance of eardrum to changing air pressures, indicating how effectively sound is transmitted into middle ear

Question 17

Number of people in UK severe or profoundly deaf

Answer 17

> 900,000

Question 18

What is a common cause of temporary hearing loss?

Answer 18

Wax

Question 19

List 4 problems with the outer ear that can cause hearing loss

Answer 19

Congenital malformations of the ear
Wax
Infection
Exostosis

Question 20

What is exostosis (surfer’s ear)?

Answer 20

Abnormal bone growth within the ear canal

Question 21

What causes exostosis?

Answer 21

Irritation from cold wind and water exposure causes bone surrounding ear canal to develop lumps of new bony growth which constrict ear canal. Where canal is blocked, water and wax become trapped and cause infection

Question 22

Three causes of hearing loss caused by the middle ear

Answer 22

Perforated ear drum
Otitis media with effusion
Otosclerosis

Question 23

What is otosclerosis?

Answer 23

Abnormal growth of bone of middle ear. Prevents structures from working properly, causes hearing loss. For some, this may become severe

Question 24

Describe chronic suppurative otitis media (CSOM)

Answer 24

Inflammation of middle ear and mastoid cavity
Characterised by discharge from middle ear through a perforated tympanic membrane
At least 6 weeks

Question 25

After which condition can chronic suppurarive otitis media occur?

Answer 25

Following an URTI that has led to acute otitis media

Question 26

Five problems with the inner ear that can cause hearing loss

Answer 26

``` Presbyacusis Noise exposure Genetic Ototoxicity Vestibular schwannoma ```

Question 27

What is the most common type of sensorineural hearing loss, caused by aging of auditory system? It occurs gradually and initially affects the ability to hear higher pitched sounds

Answer 27

Presbycusis | Pronounced prezbikusis

Question 28

Hallmark of presbycusis

Answer 28

Progressive, symmetrical loss of high-frequency hearing over many years

Question 29

What factors influence the onset and severity of presbycusis?

Answer 29

Genetic predisposition, socioeconomic status, noise exposure, smoking, hypertension, diabetes, vascular disease

Question 30

Approximatly how many decibels is a whisper?

Answer 30

30

Question 31

Approximatly how many decibels is a jackhammer?

Answer 31

130

Question 32

Give an example of a drug that causes tinnitus

Answer 32

NSAIDs

Question 33

Give 2 examples of drugs that cause temporary hearing loss

Answer 33

Loop diuretics | Macrolides

Question 34

Give an example of a drug that causes permenant hearing loss and/or vestibular damage

Answer 34

Aminoglycosides

Question 35

Benign, usually slow growing tumour from an overproduction of Schwann cells

Answer 35

Vestibular schwannoma (acoustic neuroma)

Question 36

Typical vestibular schwannoma presentation

Answer 36

Asymmetrical hearing loss, tinnitus, dizziness. CN VII symptoms if large

Question 37

How is vestibular schwannoma diagnosed?

Answer 37

MRI of internal acoustic meatus

Question 38

Managment of vestibular schwannoma

Answer 38

Dependent on size & symptoms Monitoring Radiotherapy Surgery

Question 39

Two central causes of hearing loss

Answer 39

Dementia, depression

Question 40

Mechanism of hearing

Answer 40

Sound waves travel via external canal to tympanic membrane, causing it and attached chain of ossicles to vibrate. Motion of stapes against oval window sets up waves in fluids of cochlea, causing basilar membrane to vibrate. This stimulates organ of Corti to send nerve impulses to brain

Question 41

What proportion of people with tinnitus also experience hearing loss?

Answer 41

2/3

Question 42

Two examinations that should be done for tinnitus

Answer 42

Otoscopy | Blood pressure

Question 43

Causes of tinnitus - 12 listed

Answer 43

``` Hearing loss Loud noise Stress + anxiety Ear infections Wax Ménière's disease Glue ear Otosclerosis Perforated eardrum Hypertension Neuroma Diabetes ```

Question 44

Managment options for tinnitus

Answer 44

``` Hearing aid Relaxation CBT Using sound Addressing sleep problems ```