Ear Disorders Flashcards by Nicole Quinn

Cerumen Impaction methods of removal

ceruminolytic agents: debrox, hydrogen peroxide, rubbing alcohol
Irrigation
manual removal through scope or under microscope

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Otitis externa is

ear canal infection - swimmers ear

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Otitis externa sx

pain - painful tragus or outer ear
blocked/ full sensation
decreased hearing

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Otitis externa PE findings

painful tragus or outer ear
swollen ear canal
blocked by debris
cant see TM

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Otitis externa bacterial organisms

staph aureus
pseudomonas

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Otitis externa fungal organisms

aspergillus niger
candida albicans
(otomycosis)

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Zoster Oticus: Ramsay Hunt syndrome presents as

severe pain with facial paralysis
hearing loss/ vertigo
vesicular eruption - ear/face/palate

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Zoster Oticus: Ramsay Hunt syndrome treatment

Corticosteroids, HSV antiviral
analgesics, topical abx
eye care

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Treatment of otitis externa

clear ear canal
acidify ear canal - acetic acid, boric acid
place wick if needed to facilitate drops placement
keep water out of ear

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Otitis Externa antibacterial ototopicals

cortisporin or ciprofloxacin

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Otitis Externa anti inflammatory ototopicals

abx combined with steroids to reduce inflammation
VoSol HC
Ciprodex
Cipro HC
Cortisporin

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Otitis Externa Antifungal ototopicals

clotrimazole
nystatin
voraconizole

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Otitis externa fungal infections strongly suggest

EENT for evacuation of canal
expect recurrence ~ 4-6 wks later

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Auricular Hematoma is usually from

trauma - wrestling
shear injury at anterior auricular skin
hematoma between cartilage/ perichondrium

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Auricular Hematoma treatment

needle aspiration - inadequate
I&D recommended
compressive dressing
anti-staph abx

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Auricular Hematoma complications

Infection/ abscess - cauliflower ear

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Foreign body ear canal removal - bugs how to do it

drown insects with mineral oil or lidocaine before attempting removal

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Eustachian tube is the connection between

middle ear and nasopharynx

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function of the eustachian tube

equalizes pressure in middle ear
drains thin mucus produced in middle ear
prevents reflux of fluid into middle ear

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The eustachian tube is normally

closed - by tissue elasticity

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The eustachian tube is opened by

palate muscles - yawning swallowing, etc

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Eustachian tube treatment

treat underlying sinus issue
nasal steroid spray
air travel - gum chewing, decongestant spray

PET - patulous eustachian tube = estrogen nasal drops, wt stabilization, surgery?

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PET - patulous eustachian tube is when

TM moves with nasal respiration and may be seen on exam
rapid wt loss
‘bucket over the head’ (autophony)

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TM perforation causes

Study These Flashcards

infection
eustachian tube dysfunction
penetrating trauma (Qtip)
base of skull fracture
pressure changes (barotrauma)

TM perf evaluation

side, location, size condition of mucosa secondary structures involved safe vs unsafe degree of hearing loss

Treatment of TM perf

Most close with time (4-6 wks) Keep water out of ear surgical eval if non-healing after 6 wks

Types of otitis media

serous or suppurative

Two durations of otitis media

acute or chronic

two designations of otitis media

with or without perforation

otitis media with effusion (OME) is

presence of fluid in the middle ear without signs or sx of an acute ear infection

Acute otitis media (AOM) is

infectious, inflammatory condition of the middle ear effusion behind the intact TM may be suppurative or serous

Contributing factor for AOM

URI Eustachian tube dysfunction

Acute serous Otitis Media treatment

treat underlying illness NOT a bacterial middle ear infection, abx not needed surgical drainage

Acute suppurative otitis media treatment

amoxicillin augmentin PCN allergy = erythromycin or clindamycin with bactrim fluoroquinolone (for adults only)

Otitis Media complications

mastoiditis meningitis brain abscess facial paralysis

Unilateral Otitis Media in adults should raise suspicion for

nasopharyngeal mass blocking eustachian tube orifice

Indication for tubes

Recurrent AOM: greater than or equal to 3 seperate episodes of AOM in 6 months or greater than or equal to 4 episodes of AOM in 12 months

Cholesteatoma is

keratoma or skin where it does not belong - this is a surgical disease

Acute mastoiditis is associated with

AOM

Acute Mastoiditis is

infection that spreads beyond mucosa of middle ear cleft

Vertigo is

an abnormal sense of motion characterized by a spinning sensation

Vertigo testing

audiogram positional testing MRI with Gadolinium contrast - gold standard

A positive Dix Hallpike is pathognomonic for

BPPV - but a neg test is meaningless

BPPV is

benign paroxysmal positional vertigo - a phantom sensation of motion elicited by specific changes in head position

Meniere's syndrome four main features

attacks of vertigo fluctuating hearing loss tinnitus (ringing in ears) aural fullness (pressure sensation in ears)

Meniere's syndrome is a

condition of excess pressure accumulation in inner ear

Vestibular neuritis / neuronitis labyrinthitis is usually due to

viral infection / inflammation of nerve/ labyrinth watch for ramsey hunt syndrome

Vertigo treatment

BPPV - Epley maneuver Meniere's Disease - low salt diet, avoidance of alcohol and caffeine, diuretics, vasodilators

Hearing loss two types

conductive or sensorineural

Conductive hearing loss is

caused by something that stops sounds from getting through the outer or middle ear common reasons - blockage of ear canal, perforated drum, problems with the ossicles or fluid in middle ear

Sensorineural hearing loss is

most common type loss due to pathology (damage) of cochlea, auditory nerve, or CNS exposure to loud noises, genetic factors, or natural aging process

Acoustic Neuroma is

Sudden cause of unilateral sensorineural hearing loss dizzy but not usually vertigo MRI scan

Acoustic Neuroma treatment

observation if tumor is small and does not cause sx surgical removal radiation to stop from growing

Presbycusis is

age related hearing loss - gradual overtime usually bilateral - usually greater for high pitched sounds

Presbycusis treatment

devices/ mechanical aids - vibrating alarms, flashing phone or doorbells, tv listening systems, personal amplifiers hearing aids

Any child with speech delays suspect

hearing concerns

Tinnitus is

defined as the perception of noise in the absence of an acoustic stimulus outside of the body sx not a disease - most often idiopathic, SNHL m/c identified cause

Tinnitus treatment

avoid dietary stimulants - coffee, soda, tea smoking cessation avoid meds - aspirin, NSAIDS, many others reassurance feedback training white noise and other maskers

Ear Disorders Flashcards

(58 cards)