ENT Flashcards
(49 cards)
what is presbycusis?
it is age related hearing loss - SNHL with high pitched tones first - loss of hair cells, neurons, atrophy and reduced endolymphatic potential
what are the risk factors for presbycusis?
age, male, FHx, noise, DM, HTN, smoking, ototoxic medications
how does presbycusis present?
gradual, insidious, high pitched hearing loss, dementia concerns, tinnitus
how is presbycusis investigated and managed?
audiometry
optimise environment, hearing aids, cochlear implants
what is SSNHL?
it is hearing loss over less than 72 hours that is unexplained
from infection, menieres, ototoxic changes, MS, stroke, AN, migraines
how is SSNHL investigated and managed?
audiometry, MRI, CT
immediate ent referral, treat cause, idiopathic: oral or intratympanic steroids
how does inhaled FB present and what are red flags?
cough, stridor, dyspnoea
airway compromise, oesophageal perforation, button battery ingestion, mediastinal widening on CXR
how is inhaled FB investigated and managed?
tongue depressor, nasoendoscopy, radiograph, CT neck, CXR
forceps, endoscopy, follow up, carbonated drinks, glucagon, hyoscine, prokinetics
what are predisposing factors and presentation of OSA?
marfans, large tonsils, obesity, macroglossia
partner complaints, daytime sleepiness, compensated respiratory acidosis, HTN
how is OSA investigated and managed?
Epworth sleepiness scale, multiple sleep latency test, polysomnography
lose weight, CPAP, intraoral devices, inform DVLA, pharmacological?
what are the two types of vertigo?
peripheral e.g. menieres - vestibular system
central e.g. tumour - cerebellum or brainstem
how does vertigo present?
central - gradual onset, persistent, no HL or tinnitus, impaired coordination, mild nausea and vice versa for peripheral
how is vertigo investigated and managed?
ear, neuro and CV tests
CT MRI
short term - prochlorperazine, antihistamines, betahistine, epley, triptans, propanolol, topiratmate, amitriptyline, DVLA
what is BPPV and how does it present?
it is vertigo triggered by head movement - calcium carbonate crystals displaced in semicircular canal and disrupt flow of endolymph
older, movement triggers vertigo, 20-60seconds, can recur, over few weeks and resolves, no HL or tinnitus
how is BPPV investigated and managed?
Dix Hallpike
Epley manoeuvre, Brandt Daroff exercises
how does ET dysfunction present and what causes it?
reduced or altered hearing, popping, fullness, pain, discomfort, tinnitus, worse when external air pressure changes
infection e.g. URTI, allergies, smoking
how is ET dysfunction investigated and managed?
otoscopy, audiometry, tympanometry, nasopharyngoscopy, CT
conservative, valsalva, decongestant spray, antihistamines, steroid nasal spray, surgery e.g. adenoidectomy, balloon dilatation
what is otosclerosis and how does it present?
it is the remodelling of the small bones in the middle ear - conductive hearing loss and hardening (mostly stapes)
HL, tinnitus, lower pitch first
how is otosclerosis investigated and managed?
otoscopy, webers and rinnes, audiometry, tympanometry, HRCT
conservative with hearing aids, surgical - stapedectomy/otomy, and prosthetic
what is vestibular neuronitis?
it is inflammation of the vestibular nerve from recent URTI, and presents with vertigo, N&V, balance issues, no neuro sx or loss of hearing
how is vestibular neuronitis investigated and managed?
head impulse test
prochlorperazine, antihistamines up to 3d, vestibular rehabilitation therapy
what is acoustic neuroma and how does it present?
it is benign tumour of the schwann cells around auditory nerve - usually in cerebellopontine angle of PNS and unilateral unless NF2
40-60y, gradual onset unilateral SNHL, tinnitus, dizziness, imbalance, fullness sensation, facial nerve palsy
how is AN investigated and managed?
audiometry, MRI, CT
conservative, surgery, radiotherapy
what is menieres disease?
it is recurrent vertigo, HL, tinnitus and aural fullness due to excess endolymph
