Ears - Ear pathologies

Question 1

What is pinna haematoma

Answer 1

Collection of blood

Question 2

What is the issue w/ pinna haematomas (2)

Answer 2

can incr infection risk

Can –> cartilage necrosis –> cauliflower ear

Question 3

Mx pinna haematoma

Answer 3

Rx ENT

Aspiration/drainage

Question 4

What is Otorrhoea

Answer 4

Discharging ear

Question 5

When to suspect necrotising otitis externa w/ otorrhoea

Answer 5

Unilateral severe ear pain
W/ foul discharge
CN palsies

Question 6

What is a medical emergency in otology

Answer 6

Sudden SNHL

Question 7

Mx Sudden SNHL (4)

Answer 7

Vasodilators
Carbon
Steroids
Aciclovir

Question 8

TMJ dysfunction S+S

Answer 8

Pain anterior to tragus, worse on eating
Normal eardrum
Tender over TMJ
Misaligned, clicking bite

Question 9

Hx points otorrhoea (8)

Answer 9

Duration of discharge 
Associated otalgia 
Systemic fever Sx 
Associated HL/dizziness 
FB in ear 
Any CN palsies 
Hx of trauma 
Recent topical Abx

Question 10

Why ask about recent TO ABx in otorrhoea Hx

Answer 10

Predisposes to antifungal ear infection

Question 11

What % of the pop suffer from otitis externa?

Answer 11

10%

Question 12

What is otitis externa

Answer 12

External inflammation of the exterinal ear

Question 13

PS Otitis externa (3)

Answer 13

Severe ear pain
Itching
HL

Question 14

RF otitis externa (6)

Answer 14

Cotton buds
h2o expsoure 
FB
Warm/humid climates
Underlying skin condition - eczema 
hearing aids

Question 15

O/E otitis externa (3)

Answer 15

Tragus = tender
Red swollen canal
T M not visible

Question 16

Complications of otitis externa (2)

Answer 16

Periauricular cellulitis

Necrotising otitis externa

Question 17

Causative organisms otitis externa (3)

Answer 17

Pseudomonas
Staph
Strep

Question 18

Tx Otitis externa - simple

Answer 18

GP + TO Abx

Question 19

Tx of complex otitis external

Answer 19

Aural toilet
Steroids
TO antifungals/Abx
PO flucloxacillin if really bad

Question 20

DDx otitis externa (3)

Answer 20

Malignant OE
Mastoiditis
Pinna perichondritis

Question 21

Who gets Nec OE (3)

Answer 21

Elderly
DM
Immunocomp

Question 22

Cause of nec OE

Answer 22

Pseudomonas

Question 23

What palsies can nec OE cause? (4)

Answer 23

8
9
10
12

Question 24

Worst outcome nec OE

Answer 24

death

Question 25

Tx Nec OE (3)

Answer 25

High dose ciprofloxacin facial debridement refer

Question 26

What is Otitis media

Answer 26

Inflammation of the middle ear

Question 27

Cause of OM?

Answer 27

URTI --> obstruction of eustachian tube

Question 28

Sx OM in an infant (4)

Answer 28

Fever Ear pulling Irritable Vomiting

Question 29

Sx OM in a child/adult (5)

Answer 29

``` Otalgia Fever Malaise Hearing loss Bulging T M ```

Question 30

Another name for OME

Answer 30

Glue ear

Question 31

What is Glue Ear

Answer 31

Sterile collection fluid in middle ear

Question 32

Causes Glue ear (3)

Answer 32

Infection/allergy AOM ET dysfunction

Question 33

Who gets affected by Glue ear? (3)

Answer 33

Children w: Large adenoids Cleft Palate Downs syndrome

Question 34

Sx glue ear (3)

Answer 34

Painless HL Poor speech development T M dull +/- fl level

Question 35

Tx glue ear (6)

Answer 35

``` Most = W+W Eval at 3 months If not gone away - grommets Ab Adenoidectomy to reduce recurrence ```

Question 36

Fct of grommets (2)

Answer 36

Aerate middle ear | P equaliser

Question 37

What is AOM

Answer 37

Bacterial infection of the middle ear

Question 38

Causative agents AOM (2)

Answer 38

Strep | Hib

Question 39

Sx AOM

Answer 39

Pus --> inflammed --> bulging ™ --> pain, fever and reduced hearing Rupture --> blood and pus into EAM

Question 40

How long does it take the ear drum to heal after AOM rupture

Answer 40

4-5 days

Question 41

Tx AOM (4)

Answer 41

Augmentin Analgesia Myringotomy if fails to resolve Nasal decongestants

Question 42

What is chronic suppurative OM

Answer 42

Repeated infection --> microabscesses and inflammatory cells infiltrating +/- perf

Question 43

PS chronic suppurative OM (2)

Answer 43

Odourless discharge | Conductive HL

Question 44

Tx chronic suppurative OM (6)

Answer 44

``` H2O avoidance Few weeks to heal Cipro + steroid drops Hearing aids May have to repair surgically ```

Question 45

What is a cholesteatoma?

Answer 45

Meatal skin protrudes --> production of keratin --> forms a bag --> cyst

Question 46

Where does cholesteatoma occur

Answer 46

In attic/epitympanic recess

Question 47

Sx cholesteatoma (4)

Answer 47

Foul discharge Conductive HL Attic retraction Aural polyps

Question 48

Cholesteatoma erosion into cochlea - Sx

Answer 48

SN deafness

Question 49

Cholesteatoma erosion into ossicles - Sx

Answer 49

Conductive HL

Question 50

Cholesteatoma erosion into SC canal Sx

Answer 50

Vertigo

Question 51

Cholesteatoma erosion into roof

Answer 51

IC abscess. | Sepsis

Question 52

Ix cholesteatoma (2)

Answer 52

CT scan temporal bone | PTA

Question 53

Tx cholesteatoma

Answer 53

Surgery