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Flashcards in Ear disease Deck (39):
1

What type of tuning fork is used to test hearing?

512 Htz

2

Where is the tuning fork placed in rinnes test? What about in webers test?

Rinnes - base of tuning fork is placed on mastoid process
Webers - base of tuning fork is placed on bony prominence of the head

3

What is a pure tone audiogram used for?

Detecting hearing loss and differentiating between high/low frequency and conductive/sensorineural loss

4

How are the left and right ears denoted on an audiogram respectively?

Left - crosses
Right - circles

5

How is bone conduction denoted on an audiogram?

Square bracket

6

What is a tympanogram?

Test of pressure within the patients ear (air forced into ear)

7

What type of scope is used to examine the ear?

Otoscope

8

How can the common symptoms of ear disease be remembered?

6 D's -

Deafness
Discomfort
Discharge
Dizziness
Din din (tinnitus)
Defective facial movement (paralysis)

9

What classifications of deafness are there?

Conductive
Sensorineural
Mixed
Central

10

Where is the pathology in conductive deafness?

External or middle ear

11

Where is the pathology in sensorineural deafness?

Sensory - cochlea
Neural - auditory nerve

12

Where is the pathology in mixed deafness?

External/middle ear + Cochlea/auditory nerve

13

Where is the pathology in central deafness?

Brain

14

Which nerves can be involved in ear discomfort (earache)?

Trigeminal (maxillary and mandibular branches)
Facial
Glossopharyngeal
Vagus

Nb - remember pain is often referred

15

What pathologies can cause discharge to come from the ear?

Acute otits media
Chronic otitis media
Skull fractures (cerebrospinal fluid)
Iatrogenic (surgery)

16

Into which two broad categories can dizziness be classified?

Central (brain)
Peripheral (ear pathology - with/without hearing loss)

17

How may dizziness induced by central pathology present?

Dizziness + acute lisp

18

What is tinnitus?

An abnormal sound not coming from an external source - normal in silence but abnormal when there is ambient noise

19

What type of tinnitus should always be investigated?

Unilateral tinnitus

20

How is tinnitus treated?

Adaptation strategies/techniques
Hearing aids

21

Are facial palsies relating to the ear upper or lower motor neurone pathologies?

Lower most often

22

How can lower and upper motor neurone pathologies be clinically differentiated?

Upper - bilateral palsy
Lower - unilateral palsy

23

Is itch a feature of otitis externa?

Often

24

What are rare complications of acute otitis media?

Brain abscess
Mastoiditis

25

How is non-resolving otitis media with effusion treated?

Grommet insertion
Hearing aid

26

Which two types of patients often get otitis media with effusion?

Children with cleft palate
Children with down's syndrome

27

How is chronic otitis media managed?

Antibiotics + myringoplasty

28

What type of hearing loss does ear drum perforation cause?

Conductive (should resolve as ear drum heals)

29

What is a cholesteatoma?

Keratinised squamous cell epithelium within the middle ear

30

What is primary acquired cholesteatoma?

Cholesteatoma which arises due to perforation of the tympanic membrane (chronic otitis media)

31

Why does the ear drum retract/perforate in otitis media with effusion?

Due to the negative pressure within the ear

32

What are the types of cholesteatoma?

Congenital/Derlacki - SC epithelium trapped in mastoid bone during embryogenesis (conductive hearing loss as it expands, ear drum will be intact)

Primary acquired - chronic negative airway pressure causes retraction and perforation of tympanic membrane causing abnormal placement of SC

Secondary acquired - insult to the tympanic membrane (AOM, trauma, surgery, etc) causes abnormal placement of SC

33

How is cholesteatoma investigated?

CT of temporal bone

34

How is cholesteatoma managed?

Surgical removal

35

What are the possible complications of otitis media?

Abscess
Facial paralysis
Thrombophlebitis
Mastoiditis

36

What is a bezoids abscess?

Abscess in sternocledomastoid

37

Cholesteatoma is locally destructive but not malignant. T/F

True

38

Define acute otitis media, otitis media with effusion and chronic otitis media

AOM - acute inflammation of the middle ear

OME/glue ear - effusion in middle ear caused by negative pressure due to eustachian tube dysfunction (precede OR follow AOM)

COM - mucosal (perforation of tympanic membrane) or squamous (tympanic membrane retraction +/- cholesteatoma)

39

What is otitis media with effusion associated with?

Parental smoking
Early entry into child care
Not breastfeeding
Feeding infants while lying down

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