Ear disorders Flashcards by Melissa Ring

What is the most common cause of hearing impairment in elderly

cerumen impaction

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What factors can increase cerumen impaction

qtip abuse
hearing aids
narrow ear canal
dermatologic conditions

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What is another name for otitis externa

swimmers ear

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What are physical signs of otitis externa

Painful tragus
swollen ear canal
blocked by debris
cant see TM

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What causes otitis externa

Bacteria
Fungus

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Which bacterial organisms can cause otitis externa

Psuedamonas
S. Aureus
Klebsiella
Ecoli

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What fungi cause otitis externa

Aspergillus
Candida albicans

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What is Ramsay-Hunt syndrome

Zoster otitis

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How does Ramsay hunt syndrome present

Severe pain w/ facial paralysis

hearing loss/ vertigo

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What is the biggest concern with zoster oticus

Vision loss

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How do you treat otitis externa

clean ear canal
acidify ear w/ acetic or Boric acid
Keep water out of hear

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What are some antibacterial ototopicals

Cortisporin (Neomycin, polymyxin B, Hydrocortisone)

Fluoroquinolones ( Cipro / otofloxacin drops)

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What are some antifungal ototopicals

Clotrimazole
nystatin
voraconazole

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What is the purpose of an ear wick (Pope sponge)

Keeps canal patent
keeps meds in contact w/ canal
leave in for 3-5 days

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What can cause an auricular hematoma

Blunt trauma

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How would an auricular hematoma be describes

fluctuant anterior ear swelling

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How do you treat a auricular hematoma

I&D
anti-staph antibiotics
compressive dressing

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what are dangerous foreign bodies for the ear canal

beans
button batteries

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What is the best way to remove foreign bodies from the ear canal

with an otoscope

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If there is an insect in the ear canal, what has to be done prior to removal

Drown them with mineral oil or lidocaine

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Where is the Eustachian tube

connection of the middle ear and nasopharynx

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What are the 3 functions of the eustachian tue

equalizes pressure in the middle ear

Drain mucus produced in middle ear

Prevents fluid reflux into middle ear

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Is the Eustachian tube normally open or closed

closed

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What causes the Eustachian tube to open

by palate muscles (yawning /swallowing etc.)

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What allows Eustachian tube to close after opening

tissue elasticity

What is the underlying cause for most middle ear problems

Eustachian tube disorders

What can cause obstructions in the Eustachian tube

adenoid hypertrophy nasopharyngeal cancer

What is patulous Eustachian tube (PET)

TM moves with nasal respiration Can cause rapid Weight loss Autophony (Bucket over head)

What can cause Eustachian tube dysfunction

Nasal mucosa disease Allergies Viral URI

How can a patulous Eustachian tube be treated

estrogen nasal drops (Females) Weight stabilization

if the TM is red and bulging, what is the dx

acute otitis media

What can cause a TM perforation

infection ET dysfunction penetrating trauma skull base fracture pressure changes

What are some tests for TM perforation

pneumotoscopy tuning fork exm audiogram

How do you treat a TM perforations

most close with time keep water out of ear

When do you consider surgery with TM perforations

if its non healing after 6 weeks

What are the 2 types of otitis media

serous suppurative

What are the 2 durations of otitis media

acute chronic

What are 2 designations of otitis media

w/ and w/o perforations

What is otitis media with effusion (OME)

Presence of fluid in the middles with without signs or symptoms of an acute ear infection

What is recurrent acute otitis media (RAOM)

Mulitple episodes of AOM with symptom free periods

What is chronic otitis media with effusion (COME)

persistent fluid in middle ear no signs of inflammation (fever /otalgia)

What can be the cause of AOM

URI allergic rhinitis ETD *Can be serous or suppurative

What are some high risk groups for AOM

trisomy 21 immune deficiency native americas

How do you treat serous otitis media

treat underlying illness -> no antibiotics needed

What type of surgical intervention can be used with acute serous otitis media

tympanocentesis myringotomy

What is the most causative agent os acute suppurative OM

Virus S. Pneumonia

How do you treat uncomplicated suppurative AOM

Amoxicillin if PCN allergy -> Erythromycin w/ bactrim

What aural antibiotics can be used with suppurative AOM w/ perforations

fluoroquinolone drops

What are complications of otitis media

facial paralysis mastoiditis* subperiosteal abscess meningitis brain abscess

If an adult has unilateral OM, what should you be concerned for

nasopharyngeal mass blocking the Eustachian tube

What are the indications for tubes for AOM

Recurrent AOM (>3 episodes in 6months or >4 in 12 months)

What is the most common reason for tube placement

chronic non-suppurative otitis media

When are patients with chronic OM referred to a specialist

severe TM retraction Failure to improve in 2-3 months persistent unilateral effusion significant hearing loss in children

What is a cholesteatoma

Keratoma or skin where is does not belong *surgical disease

how does acute mastoiditis present

persistent otorrhea > 3wks persistent fever despite abx pain behind ear, worse at night hearing loss elevated WBC

What is the treatment for acute mastoiditis

mastoidectomy

What is oscillopsia

Jumping images

What are the areas responsible for maintaining equilibrium

eyes labyrinth CNS

How do you workup vertigo

audiology (assess peripheral vestibular system) Imaging (assess CNS) Blood test (assess systemic causes)

What are some differentials for vertigo

congenital disorders neoplastic syndromes

What is the gold standard for imaging with vertigo

MRI with gadolinium

What is the most important test with vertigo workup

audiogram

What is the most common cause of vertigo

benign paroxysmal positional vertigo (BPPV)

What will cause classic BPPV

placing the effected ear downward

What characteristic eye movement is associated with vertigo

nystagmus

What is a positive Dix- Hallpike pathognomonic for

BPPV *negative test is meaningless

What is meneires syndrome

condition of excess pressure accumulation in the inner ear

What are the 4 main features of meneires disease

attacks of vertigo fluctuating hearing loss tinnitus aural fullness

What is a canalith repositioning procedure

Employ maneuver

How do you treat meneires disease

low salt diet diuretics vasodilatos intratympanic gentamycin

What signs of vertigo should lead you to a central lesion

constant mystagmus constant vertigo vertical nystagmus vertigo w/o nystagmus nystagmus w/o vertigo

When in life does the greatest hearing loss occur

between 60-69

What is the strongest predictor of hearing loss

age

What are the two types of hearing loss

conductive Sensorineural (SNHL)

What causes conductive hearing loss

from something that stops sounds from getting through the outer/middle ear

What are the s/sx of labrynthitis

vertigo N/V ear pressure / fullness hearing loss tinnitus

What are the s/sx of cochlear neuritis

ear pressure/fullness hearing loss tinnitus

What are the s/sx of vestibular neuritis

vertigo N/V

What are the common reasons for conductive hearing loss

blockage of ear canal perf ear drum problems with ossicles fluid in middle ear

How do you begin treatment for acute prostrating vertigo

fluid stop N/V Valium

What is the most common type of hearing loss

SNHL

What is occurring with SNHL

pathology /damage of cochlea, auditory nerve, or CNS

What are the common causes of SNHL

Loud noises genetic factors natural aging process

What are s/sx of acoustic neuroma

unilateral sensorineural hearing loss

What is the cause of sudden sensorineural hearing loss

acoustic neuroma

What test can confirm tympanic membrane mobility

tympanometry testing

What are the different tests for hearing

air conducting test bone conducting test

What is otosclerosis

gradual stiffening of the ossicles = progressive hearing loss *can be unilateral or bilateral *more common in females

What is presbycusis

age related hearing loss *generally high pitched sounds

How do you treat conductive hearing loss

medical treatment hearing aids surgery

How do you treat SNHL

conventional hearing aids of implantable devices

Which children do you suspect hearing concerns in

children with speech delays

What is tinnitus

the perception of noise in the absence of an acoustic stimulus outside the body (ringing in ears)

What is the most common identifiable cause of tinnitus

SNHL

Ear disorders Flashcards

(94 cards)