ENT Flashcards
(26 cards)
Ménière’s disease:
Presentation
Fluctuating hearing loss that starts unilaterally
Aural fullness
Attacks that last minutes to hours
Diagnosis needs: x2 attacks lasting at least 20 mins, tinnitus/fullness, sensorineural hearing loss
Ramsay Hunt Syndrome
Facial nerve herpes zoster
Causing facial paralysis, loss of tastes vestibulocochlear dysfunction, pain
Ramsay hunt syndrome:
Tx
Immediate steroids and anti vitals to prevent facial paralysis or hearing loss
Tympanic perforation:
Tx
None - will self heal 6-8 weeks
Tympanic perforation from otitis media:
Tx
Abx
Rinnes test:
Positive
Air conduction is better which is normal
Rinnes test:
Negative
Can hear through bone better than through air, which implies conductive hearing loss
Webers test:
Sensorineural deafness
Lateralises to unaffected side
Webers test:
Conductive deafness
Lateralises to affected side
Otitis media:
Presentation and Tx
Bulging tympanic membrane
Abx only if
Indications for ABx in sore throat
Systemic upset Unilateral peritonsilitis Hx rheumatic fever DM/ immunodeficiency 3 or more centor: tonsilar exudate, lymphadenopathy, fever, no cough
Ménière’s disease
Build up of fluid in labyrinth causing vertigo, hearing loss
Presbycusis
Age-related sensorineural hearing loss.
Audiometer shows bilateral high frequency loss
Otosclerosis
Autosomal dominant Normal bone replaced by spongey vascular bone 20-40 year olds Conductive deafness Tinnitus Flamingo tympanic membrane
Grommet criteria
Bilateral OME lasting 3 months+ with hearing of 25-30 I’m better ear
Nasal polyps:
Signs and symptoms
Vary with season or URTI Rhinitis and sinusitis Nasal obstruction Pale/grey No sensation Mobile Unilateral is malignant until proven otherwise
Nasal polyps:
Tx
Steroids - Betamethasone 2 weeks, then fluticasone 3 months
Large polyps:
Oral steroids 30mg OD 1 week then fluticasone 3w
Surgery - FESS
Rhinitis:
Ix
Rhinoscopy/endoscopy
Skin prick
RAST
Rhinitis:
Types
Allergic Infective Idiopathic Drug-induced (aspirin, NSAIDS, contraceptives, beta blockers) Pregnancy Auto-immune: SLE, RA, AIDS,
Anosmia:
Causes
Obstructive: polpys, tumor, bony deformity
Mucositis (infective): rhinitis, sinusitis
Neurological: MS, aneurysm, surgery, trauma, Parkinson’s
Cholesteatoma
Tissue collection middle ear
Can be congenital, or acquired due to Eustachian tube dysfunction, tympanic membrane trauma, acute otitis media
Progressive conductive hearing loss ottorhea +-vertigo, headache, facial nerve palsy, neck abscess, meningitis
Tx tympanoplasty/mastoidectomy
Can often recur
If left will invade local structure and can cause permanent deafness, facial weakness, brain abcess, death
Hoarse voice:
Causes
URTI laryngeal cancer Laryngeal palsy Vocal nodules Reflux pharyngitis
Laryngeal cancer:
Signs/ risk factors
Smoking Referred pain to ear - constant Neck lump Progressive Pain
Cystic hygroma
From jugular venous sac
Embryological remnant
In posterior triangle usually
Always on the left
