ears

Question 1

What is external otitis, commonly known as swimmer’s ear?

Answer 1

Inflammation or infection of the epithelium of the auricle and ear canal.

Question 2

What are common causes of external otitis?

Answer 2

Swimming, trauma from picking ears, piercing of the auricle, and warm, dark environments promoting microorganism growth.

Question 3

What microorganisms are responsible for external otitis?

Answer 3

Bacterial: Staphylococcus aureus; Fungal: Candida albicans, Aspergillus; Serious infections: Pseudomonas aeruginosa.

Question 4

What is malignant external otitis?

Answer 4

A severe infection caused by Pseudomonas aeruginosa in older adults with diabetes, potentially spreading to the parotid gland and temporal bone (osteomyelitis).

Question 5

What are the symptoms of external otitis?

Answer 5

Ear pain (otalgia), pain with chewing or moving the auricle, serosanguineous or purulent drainage, fever, swelling, and redness.

Question 6

How is external otitis diagnosed?

Answer 6

Otoscopic examination, culture and sensitivity of drainage, and hearing tests like audiometry, Rinne, and Weber tests.

Question 7

What challenges occur during otoscopic examination?

Answer 7

Pain when pulling on the pinna or inserting the speculum, and swelling in the canal may obscure the tympanic membrane (TM).

Question 8

What treatments are used for external otitis?

Answer 8

Topical antibiotics and corticosteroids, systemic antibiotics if surrounding tissue is involved, and moist heat, analgesics, or anesthetic drops for pain control.

Question 9

What are key interventions for patients with external otitis?

Answer 9

Education on taking antibiotics, using earplugs while swimming, drying ears properly, washing hands before ear drops, using room-temperature drops, and positioning the ear correctly for drops to run in.

Question 10

How should ear drops be administered?

Answer 10

Ensure they are room temperature, position the ear to allow drops to flow in, and stay in position for at least 2 minutes.

Question 11

What is chronic otitis media?

Answer 11

A condition resulting from repeated attacks of otitis media, often occurring in adults with a history of recurrent otitis media in childhood.

Question 12

What are the symptoms of chronic otitis media?

Answer 12

Purulent exudate, inflammation affecting ossicles, auditory tube, and mastoid bone, often painless; hearing loss, nausea, and episodes of dizziness.

Question 13

How is chronic otitis media diagnosed?

Answer 13

Through otoscopic examination (changes in tympanic membrane color, mobility, or perforation), culture and sensitivity tests, sinus X-rays, MRI, or CT scan of temporal bone.

Question 14

What medical treatments are used for chronic otitis media?

Answer 14

Otic and systemic antibiotics based on culture and sensitivity; tympanoplasty to reconstruct the tympanic membrane/ossicles, often with mastoidectomy to remove infected mastoid bone.

Question 15

Why might antibiotic resistance occur in chronic otitis media?

Answer 15

Due to prolonged or recurrent infections leading to resistant bacterial strains.

Question 16

What is a tympanoplasty?

Answer 16

A surgical procedure to reconstruct the tympanic membrane and/or ossicles, often performed with mastoidectomy.

Question 17

What postoperative interventions should be taught to a patient after surgery for chronic otitis media?

Answer 17

Change cotton packing and dressing as needed; avoid swimming, air travel, and sun exposure for 6 weeks; do not shampoo for 5 days; sleep on back or unoperated ear for 1 week.

Question 18

How can patients avoid increasing intracranial or inner ear pressure after surgery?

Answer 18

Keep the mouth open when blowing the nose, coughing, or sneezing.

Question 19

When should patients contact their healthcare provider after surgery?

Answer 19

If they experience excess drainage or severe dizziness.

Question 20

When can patients resume strenuous activity and contact sports after surgery?

Answer 20

After 1 month.

Question 21

What is Ménière disease?

Answer 21

A progressive disorder caused by an accumulation of endolymph in the membranous labyrinth, often affecting one ear.

Question 22

What are possible causes of Ménière disease?

Answer 22

The exact cause is unknown, but genetic, immune, and environmental factors may play a role.

Question 23

At what age do symptoms of Ménière disease typically begin?

Answer 23

Between 40 and 60 years of age.

Question 24

What are the hallmark symptoms of Ménière disease?

Answer 24

Episodic vertigo, tinnitus, ear pressure or fullness, nausea, hearing loss, and balance problems.

Question 25

What tests are used to diagnose Ménière disease?

Answer 25

Audiometry, vestibular tests (caloric, positional), electronystagmography, glycerol test, and ruling out other causes through H&P.

Question 26

What findings support a diagnosis of Ménière disease?

Answer 26

Low-frequency sensorineural hearing loss, 2+ spontaneous episodes of vertigo, and abnormal vestibular test results.

Question 27

What medications are used to manage Ménière disease?

Answer 27

Anticholinergics, antihistamines, antiemetics, benzodiazepines, and diuretics.

Question 28

What dietary restrictions are recommended for Ménière disease patients?

Answer 28

Reduce sodium, caffeine, nicotine, and alcohol intake.

Question 29

What surgical options are available for severe cases of Ménière disease?

Answer 29

Endolymphatic sac decompression, endolymphatic shunt, labyrinthectomy, or vestibular nerve section.

Question 30

What interventions are important during an acute attack of Ménière disease?

Answer 30

Administer medications/IV fluids, provide a quiet, darkened room, avoid sudden movements, implement fall precautions, and help with ambulation as needed.

Question 31

What environmental changes can help manage symptoms during an acute attack?

Answer 31

Avoid fluorescent or flickering lights, television, and sudden head movements.

Question 32

What long-term lifestyle modifications can help manage Ménière disease?

Answer 32

Vestibular exercises, rehab, dietary restrictions, and avoiding activities like swimming or being in high places.

Question 33

What is conductive hearing loss?

Answer 33

Conductive hearing loss occurs when problems in the outer or middle ear impair the transmission of sound waves to the inner ear.

Question 34

What are the causes of conductive hearing loss?

Answer 34

Impacted earwax, otitis media, tympanic membrane perforation, otosclerosis, allergies, and benign tumors.

Question 35

What are the manifestations of conductive hearing loss?

Answer 35

The patient may speak softly because their own voice seems loud, and they may hear better in a noisy environment.

Question 36

What are the interventions for conductive hearing loss?

Answer 36

Identify and treat the underlying cause if possible. Hearing aids may help if the loss is greater than 40-50 dB.

Question 37

What is sensorineural hearing loss?

Answer 37

Sensorineural hearing loss is caused by damage in the inner ear or the vestibulocochlear nerve.

Question 38

What are the causes of sensorineural hearing loss?

Answer 38

Congenital and hereditary factors, noise exposure, aging (presbycusis), Meniere disease, trauma, and ototoxicity.

Question 39

What are the manifestations of sensorineural hearing loss?

Answer 39

Difficulty understanding speech despite hearing sounds, inability to hear high-pitched sounds, muffled speech, dizziness/balance problems, and ear drainage.

Question 40

What are the interventions for sensorineural hearing loss?

Answer 40

Hearing aids may help but only amplify sound, not clarity; remove earwax; treat infections with antibiotics; tympanoplasty and ossiculoplasty may be considered.