Ear pathology Flashcards by Finlay Strivens

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

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What can affect the outer ear?

Trauma

Otitis externa

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What is otitis externa?

Inflammation of the skin of the ear canal

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What can cause otitis externa?

Bacteria

Fungal- aspergillus

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What is disease of the middle ear called?

Otitis media

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What can cause otitis media?

Virus

bacteria

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What bacteria can cause otitis media?

Strep pneumonia
H. Influenza
Staph A
Pseudomonas

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What two forms of otitis media are there?

Acute

Chronic

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What are some of the symptoms of acute otitis media?

Recurrent URTI
TM retraction
Reduced TM movement and altered colour
CHL

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How do you treat acute otitis media?

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

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When should you refer acute otitis media?

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

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What three conditions does chronic otitis media cover?

Perforation
Chronic otitis media with effusion
Cholesteatoma

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What can cause perforation of the TM?

Trauma

Otitis media

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How do you treat perforation of the TM?

Keep infection free
Self-resolves
Surgery if not

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

Glue ear

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What is glue ear?

Otitis media with effusion

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What can cause Otitis media with effusion?

Rhinosinusitis

Nasopharyngeal carcinoma/lymphoma

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How does Otitis media with effusion present?

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

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How do you treat Otitis media with effusion?

Grommets

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What is cholesteatoma?

Chronic otitis media with perforated tympanic membrane.

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What causes cholesteatoma?

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

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What is cholesteatoma associated with?

Inflammation

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What are some symptoms of cholesteatoma?

Hearing loss

Discharge

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What are some of the complications of cholesteatoma?

Erodes surrounding bone
Damage facial nerve
Brain abscess
Venous sinus thrombosis

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How do you treat cholesteatoma?

Surgical excision | Reconstruction

What pathology can affect the vestibulocochlear nerve?

Vestibular Schwannoma

What is a Vestibular Schwannoma?

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

What does a Vestibular Schwannoma look like?

Tan/white/yellow mass

What are some symptoms of a Vestibular Schwannoma?

Hearing loss Tinnitus Vertigo

How do you diagnose Vestibular Schwannoma?

MRI

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

Dizziness | Hering loss

What categories of things can cause dizziness?

``` Visual CVD Proprioceptive Vestibular Central pathways ```

What things can cause central dizziness?

Stress Migraines MS

What things can cause visual dizziness?

Cataracts | DM

What things can cause CVD dizziness?

Arrhythmias | Postural Hypotension

What things can cause Proprioceptive dizziness?

DM Arthritis Neurological

What things can cause vestibular dizziness?

Benign Postural Paroxysmal Vertigo Meniere's Vestibular neuronitis Labyrinthitis

What is the most common cause of vestibular dizziness?

Benign Postural Paroxysmal Vertigo

What is the pathology of Benign Postural Paroxysmal Vertigo?

Otolith migrates from utricle into semicircular canal- normally posterior

What can cause Benign Postural Paroxysmal Vertigo?

Head trauma Ear surgery idiopathic

What are the symptoms of Benign Postural Paroxysmal Vertigo?

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

How do you diagnose Benign Postural Paroxysmal Vertigo?

Dix Hallpike test: Sit then lie down Turn head quickly

What is a differential for Benign Postural Paroxysmal Vertigo?

Vertebrobasilar insufficiency

How does Vertebrobasilar insufficiency differ from Benign Postural Paroxysmal Vertigo?

Vertebrobasilar insufficiency has: Visual disturbances Weakness Numbness

How can you treat Benign Postural Paroxysmal Vertigo?

Epley maneuver | Brandt-Daroff exercise

How long does Benign Postural Paroxysmal Vertigo last for?

Seconds

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

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

What causes Meniere's?

Unknown

What is the pathology of Meniere's?

Mixing of peri and endo lymph

What are the symptoms of Meniere's?

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

How do you treat Meniere's?

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

How long does Meniere's last?

Hours

What is a good diagnostic question for Meniere's?

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

What is vestibular neuronitis?

Inflammation of superior vestibular nerve

What causes vestibular neuronitis?

Viral infection

What are some of the symptoms of vestibular neuronitis?

Vertigo for days | No tinnitus or hearing loss

How do you treat vestibular neuronitis?

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

How longs does vestibular neuritis last for?

Days

What is a good question to ask in vestibular neuronitis?

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

What is labrynthitis?

Inflammation of the labyrinths

What can cause labrynthitis?

Viral infection

What are some of the symptoms of labrynthitis?

Vertigo for days | Tinnitus and hearing loss

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

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

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

'Do you get light sensitive?'

What is otalgia?

Ear pain

What is hemotympanum?

Blood in the inner ear

What two types of hearing loss are there?

Conductive | Sensory

Describe conductive hearing loss

Cochlea works but can't get sound to it

Describe sensory hearing loss

Cochlea doesn't work

What is a major cause of conductive hearing loss?

Otosclerosis

What is otosclerosis?

Fixation of the stapes footplate

What are some symptoms of otosclerosis?

Gradual hearing loss | Rapid progression in pregnancy

Is otosclerosis more common in men or women?

Women

How do you treat otosclerosis?

Surgery

Name three causes of sensory hearing loss

Presbycusis Noise induced Drug induced

What is presbycusis?

Olg age hearing loss

What is a symptom of presbycusis?

Loss of high frequency

What is a symptom of noise induced hearing loss?

Dip at 4kH

What drugs can cause hearing loss?

Gentamicin Aspirin OD Chemo

What is myringitis?

Inflammation of the ear drum

What 4 Ts can refer pain to the ear?

Teeth, TMJ, THyroid and Tongue

Ear pathology Flashcards

(81 cards)