Ear Disease

Question 1

list common symptoms of ear disease

Answer 1

hearing loss 
earache - otalgia 
discarge 
tinnitus
vertigo 
facial weakness/nerve palsy

Question 2

what are the signs of ear disease

Answer 2

external scars 
discarge
swelling 
bleeding masses 
swelling over mastoid 
facial weakness 
hearing loss

Question 3

describe conductive hearing loss

Answer 3

impaired sound transmission via external canal and middle ear ossicles to the foot of stapes

Question 4

describe sensorineural hearing loss

Answer 4

defect is central to the oval window of the cochlea

Question 5

list some causes of conductive hearing loss

Answer 5

otitis externa 
acute otitis media 
perforation of tympanic membrane 
OME 
cholesteatoma 
otosclerosis

Question 6

list some causes of sensorineural hearing loss

Answer 6

presbycusis
noise/drug induced hearing loss
vestibular schwannoma

Question 7

describe what otitis externa is and its presentation

Answer 7

inflammation of the outer ear

presents with discharge, itch, pain, reduction in hearing later on

Question 8

what microorganisms cause otitis externa

Answer 8

bacterial - most commonly pseudomonas or staph aureus
fungal - aspergillus or candida
trauma
swimming pools

Question 9

otitis externa is more common in adults/children

Answer 9

adults, otitis media is more common in children

Question 10

describe the likely mechanism of how someone could develop acute otitis media

Answer 10

previous URTI which has spread to the middle ear via the Eustachian tube

Question 11

what are the most common pathogens associated with acute otitis media

Answer 11

RSV
strep. pneumonia
haemophilus influenza
moraxella

Question 12

what is the clinical presentation of otitis media

Answer 12

otalgia, hearing loss and tympanic membrane perforation - usually resolves spontaneously

Question 13

at what point is otitis media defined as chronic

Answer 13

> 3 months

Question 14

chronic otitis media is associated with what condition and why?

Answer 14

glue ear - usually eustachian tube dysfunction or problems with adenoids

Question 15

chronic otitis media in adults is associated with what conditions

Answer 15

rhinosinusitis
nasopharyngeal carcinoma
nasopharyngeal lymphoma

Question 16

what is the treatment for chronic otitis media

Answer 16

surgery using laryngotomy - slit in ear drum to allow fluid to escape and insert grommet

Question 17

describe cholesteatoma

Answer 17

presence of keratinising squamous epithelium in the middle ear - erodes bone and can spread around body leading to abscesses

Question 18

how does cholesteatoma present

Answer 18

foul smelling discharge
tympanic membrane full of white gunk
possible invasion of ossicles and facial nerve
headache

Question 19

what are the complications of untreated cholesteatoma

Answer 19

meningitis
abscess
mastoiditis
most commonly presents aged 5-15

Question 20

what is otosclerosis

Answer 20

fixation of the stapes footplate causing slowly progressing conductive hearing loss

Question 21

what are the causes of otosclerosis

Answer 21

genetics

linked to oestrogens - progresses more quickly in pregnancy and more common in women

Question 22

how is otosclerosis treated

Answer 22

stapedectomy

Question 23

what is presbycusis

Answer 23

gradual loss of hearing related to age - usually high frequency but rate of hearing loss variable

Question 24

what are the clinical features of presbycusis

Answer 24

slurred speech
difficulty hearing high pitched ‘s’ and ‘h’ sounds
tinnitus

Question 25

what is the management of presbycusis

Answer 25

hearing aids

Question 26

what does noise induced hearing loss present with on audiometry studies

Answer 26

classical dip at 4kHz

Question 27

what drugs are known to cause sensorineural hearing loss

Answer 27

gentamycin chemotherapy eg cisplastin aspirin and NSAIDs when in overdose

Question 28

what is a vestibular schwannoma

Answer 28

benign tumour of vestibular nerve - arising from internal auditory meatus

Question 29

how does vestibular schwannoma present

Answer 29

hearing loss tinnitus imbalance

Question 30

what is the investigations and treatment of vestibular schwannoma

Answer 30

investigate with MRI | management - surgical removal depending on size, otherwise radiation and observation

Question 31

glue ear presents with fluid in the ear with signs of acute inflammation true/false

Answer 31

false - presents with fluid in the middle ear but no acute inflammation

Question 32

does otitis media with effusion present with otalgia or hearing loss

Answer 32

otalgia - no | hearing loss - yes

Question 33

how does the tympanic membrane appear with OME

Answer 33

retracted with reduced motility

Question 34

what is the initial treatment for OME

Answer 34

nothing - wait and see as majority resolve within 3 months

Question 35

if OME has no resolved within 3 months what intervention is done

Answer 35

refer to ENT for grommet insertion, if second intervention is required grommet insertion + adenoidectomy