ENT

Question 1

How to interpret Rinnes and Webver’s test ?

Answer 1

Rinnes - test the tuning fork in front of the ear and then over the mastoid process. Air conduction should be louder than bone conduction. Bone conduction being louder suggests conductive hearing loss in that ear.
In sensorineural hearing loss, air conduction would still be heard louder than bone conduction (normal)

Webers - tuning fork on the centre of the forehead. Normal result is heard equally in both ears. In conductive hearing loss - heard louder in the affected ear. In sensorineural hearing loss - heard louder in the unaffected ear.

Question 2

What is the most common cause of otitis externa fungal infections?

Answer 2

Aspergillus

Tx = Clotrimazole 1% ear drops

Question 3

Which medications are common culprits to cause tinnitus?

Answer 3

Loop diuretics
NSAIDs / Aspirin
Aminoglycoside antibiotics (Gentamicin, Neomycin)

Question 4

How should sudden onset unilateral sensorineural hearing loss be managed ?

Answer 4

Defined as sudden onset if developed over a period of less than 3 days in the past 30 days
If no obvious cause on examination of external or middle ear - should have immediate ENT referral to exclude rapidly expanding vestibular schwannoma, autoimmune cause or stroke