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Flashcards in Ear pathology Deck (81):
1

What should you look for when examining the outer ear?

Discharge
Swelling
Bleeding
Masses
Scars
Changes in ear drum
Swelling over mastoid
Facial weakness
hearing loss

2

What can affect the outer ear?

Trauma
Otitis externa

3

What is otitis externa?

Inflammation of the skin of the ear canal

4

What can cause otitis externa?

Bacteria
Fungal- aspergillus

5

What is disease of the middle ear called?

Otitis media

6

What can cause otitis media?

Virus
bacteria

7

What bacteria can cause otitis media?

Strep pneumonia
H. Influenza
Staph A
Pseudomonas

8

What two forms of otitis media are there?

Acute
Chronic

9

What are some of the symptoms of acute otitis media?

Recurrent URTI
TM retraction
Reduced TM movement and altered colour
CHL

10

How do you treat acute otitis media?

Watch and wait:
60% resolve in 1/12
90% resolve in 3/12

11

When should you refer acute otitis media?

if lasts longer than 3/12
Bilateral OME
CHL >25dB
Speech/language problems

12

What three conditions does chronic otitis media cover?

Perforation
Chronic otitis media with effusion
Cholesteatoma

13

What can cause perforation of the TM?

Trauma
Otitis media

14

How do you treat perforation of the TM?

Keep infection free
Self-resolves
Surgery if not

15

What is the common name for Chronic otitis media with effusion?

Glue ear

16

What is glue ear?

Otitis media with effusion

17

What can cause Otitis media with effusion?

Rhinosinusitis
Nasopharyngeal carcinoma/lymphoma

18

How does Otitis media with effusion present?

CHL
Abnormal cone of light
Sucked in TM so can see incus

19

How do you treat Otitis media with effusion?

Grommets

20

What is cholesteatoma?

Chronic otitis media with perforated tympanic membrane.

21

What causes cholesteatoma?

Abnormal stratified epithelium in middle ear with high turnover producing lots of keratin

22

What is cholesteatoma associated with?

Inflammation

23

What are some symptoms of cholesteatoma?

Hearing loss
Discharge

24

What are some of the complications of cholesteatoma?

Erodes surrounding bone
Damage facial nerve
Brain abscess
Venous sinus thrombosis

25

How do you treat cholesteatoma?

Surgical excision
Reconstruction

26

What pathology can affect the vestibulocochlear nerve?

Vestibular Schwannoma

27

What is a Vestibular Schwannoma?

Benign tumour of Schwann cells of vestibular part of CNVIII. Arises in IAM
Generally unilateral

28

What does a Vestibular Schwannoma look like?

Tan/white/yellow mass

29

What are some symptoms of a Vestibular Schwannoma?

Hearing loss
Tinnitus
Vertigo

30

How do you diagnose Vestibular Schwannoma?

MRI

31

What are two of the major symptoms of inner ear disease?

Dizziness
Hering loss

32

What categories of things can cause dizziness?

Visual
CVD
Proprioceptive
Vestibular
Central pathways

33

What things can cause central dizziness?

Stress
Migraines
MS

34

What things can cause visual dizziness?

Cataracts
DM

35

What things can cause CVD dizziness?

Arrhythmias
Postural Hypotension

36

What things can cause Proprioceptive dizziness?

DM
Arthritis
Neurological

37

What things can cause vestibular dizziness?

Benign Postural Paroxysmal Vertigo
Meniere's
Vestibular neuronitis
Labyrinthitis

38

What is the most common cause of vestibular dizziness?

Benign Postural Paroxysmal Vertigo

39

What is the pathology of Benign Postural Paroxysmal Vertigo?

Otolith migrates from utricle into semicircular canal- normally posterior

40

What can cause Benign Postural Paroxysmal Vertigo?

Head trauma
Ear surgery
idiopathic

41

What are the symptoms of Benign Postural Paroxysmal Vertigo?

Vertigo on looking up, bending forwards, moving in bed, getting up etc

42

How do you diagnose Benign Postural Paroxysmal Vertigo?

Dix Hallpike test:
Sit then lie down
Turn head quickly

43

What is a differential for Benign Postural Paroxysmal Vertigo?

Vertebrobasilar insufficiency

44

How does Vertebrobasilar insufficiency differ from Benign Postural Paroxysmal Vertigo?

Vertebrobasilar insufficiency has:
Visual disturbances
Weakness
Numbness

45

How can you treat Benign Postural Paroxysmal Vertigo?

Epley maneuver
Brandt-Daroff exercise

46

How long does Benign Postural Paroxysmal Vertigo last for?

Seconds

47

What is a good diagnostic question for Benign Postural Paroxysmal Vertigo?

'Do you get dizzy when turning over in bed?'

48

What causes Meniere's?

Unknown

49

What is the pathology of Meniere's?

Mixing of peri and endo lymph

50

What are the symptoms of Meniere's?

hearing loss with episodes
Feeling of pressure in ear
Spontaneous vertigo
hearing loss in one ear

51

How do you treat Meniere's?

Supportive
Hearing aids
Avoid: NaCL, beta histamines, Caffeine, Alcohol, stress
Grommets
Steroid injections
Gentamicin
Surgery

52

How long does Meniere's last?

Hours

53

What is a good diagnostic question for Meniere's?

'Does one ear feel full/ do you get hearing loss during episodes?'

54

What is vestibular neuronitis?

Inflammation of superior vestibular nerve

55

What causes vestibular neuronitis?

Viral infection

56

What are some of the symptoms of vestibular neuronitis?

Vertigo for days
No tinnitus or hearing loss

57

How do you treat vestibular neuronitis?

Support
Self-limiting
Bed for 3 days, off work for 3 weeks, off balance for 3 months.

58

How longs does vestibular neuritis last for?

Days

59

What is a good question to ask in vestibular neuronitis?

'Was it severe, lasting days with N&V?'

60

What is labrynthitis?

Inflammation of the labyrinths

61

What can cause labrynthitis?

Viral infection

62

What are some of the symptoms of labrynthitis?

Vertigo for days
Tinnitus and hearing loss

63

What associated symptoms is it important to ask about with dizziness?

Lightheadedness, Syncope, palpitations
Blackouts
Visual disturbances
Weakness
Speech and swallowing problems

64

What is a good question to ask to diagnose migraine associated dizziness?

'Do you get light sensitive?'

65

What is otalgia?

Ear pain

66

What is hemotympanum?

Blood in the inner ear

67

What two types of hearing loss are there?

Conductive
Sensory

68

Describe conductive hearing loss

Cochlea works but can't get sound to it

69

Describe sensory hearing loss

Cochlea doesn't work

70

What is a major cause of conductive hearing loss?

Otosclerosis

71

What is otosclerosis?

Fixation of the stapes footplate

72

What are some symptoms of otosclerosis?

Gradual hearing loss
Rapid progression in pregnancy

73

Is otosclerosis more common in men or women?

Women

74

How do you treat otosclerosis?

Surgery

75

Name three causes of sensory hearing loss

Presbycusis
Noise induced
Drug induced

76

What is presbycusis?

Olg age hearing loss

77

What is a symptom of presbycusis?

Loss of high frequency

78

What is a symptom of noise induced hearing loss?

Dip at 4kH

79

What drugs can cause hearing loss?

Gentamicin
Aspirin OD
Chemo

80

What is myringitis?

Inflammation of the ear drum

81

What 4 Ts can refer pain to the ear?

Teeth, TMJ, THyroid and Tongue