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Flashcards in ENT Deck (125)
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1

What is meant by conductive hearing loss?

Failure of sound to be conveyed from the external ear to the inner ear

2

List common aetiology for conductive hearing loss

Wax
Foreign body
Otitis externa
Eardrum perforation
Ossicular damage (otosclerosis)

3

What is meant by sensorineural hearing loss?

Failure of sound to be transduced from inner ear

4

List common aetiology for sensorineural hearing loss

Congenital
Ageing (presbycusis)
Meniere's disease
Vestibular schwannoma

5

A positive Rinne's test is a normal finding. True/False?

True
Sound/vibration should be louder over the auditory canal compared to bone conduction

6

If sound localises to the affected ear in a Weber's test, what type of hearing loss is this?

Conductive

7

If sound localises to the unaffected ear in a Weber's test, what type of hearing loss is this?

Sensorineural

8

A patient with a +ve Rinne test in both ears and sound localising to the left ear on Weber's test indicates what type of hearing loss?

Right sensorineural hearing loss

9

A patient with a +ve Rinne test in the right ear and sound localising to the left ear on Weber's test indicates what type of hearing loss?

Left conductive hearing loss

10

Other than Rinne and Weber hearing tests, what other investigations could you do for hearing loss?

Pure tone audiometry
(child normal = 0-15dB, adult normal = 0-20dB)
Tympanogram measures middle ear pressure
(normal = bell-shaped curve)

11

What is otitis externa?

Inflammation of the skin of the ear canal/external ear

12

List aetiology/risk factors for otitis externa

Moisture, humidity
Swimming
Trauma (scratching, cleaning)
Absence of wax
Narrow ear canal
Hearing aids
Pseudomonas, Staph aureus

13

List clinical features of otitis externa

Severe pain, tender pinna and tragus
Auricular lymphadenopathy
Minimal discharge/debris
Swollen ear canal
Conductive hearing loss

14

Outline management of otitis externa

Aural toilet
Topical gentamicin + steroid drops
Strip of ribbon soaked in glycerine-ichthammol/aluminium acetate

15

What is barotrauma/aerotitis?

Occluded Eustachian tube does not allow middle ear pressure to equalise, particularly during aircraft descent or diving

16

List clinical features of aerotitis

Severe pain as drum indraws
Bleeding
Vertigo
Tinnitus
Deafness

17

Outline management of aerotitis

Avoid flying with URTI
Nasal decongestants (xylometazoline)
Repeated yawns/swallows/jaw movements
Valsalva maneuvre

18

List clinical features of TMJ dysfunction

Earache
Facial pain
Joint clicking/popping
Stress, psychological impact

19

Outline management of TMJ dysfunction

NSAID (diclofenac)
Orthodontic prostheses
Cognitive behavioural therapy
Physiotherapy
Acupuncture
Surgery

20

What is otitis media?

Inflammation of the middle ear cavity

21

List aetiology/risk factors for otitis media

Children
Viral
Bacterial: H. influenzae, Pneumococcus, Moraxella
Blocking of Eustachian tube
Preceding URTI
Bottle feeding
Smoking/passive smoking

22

List clinical features of otitis media

Acute: rapid onset earache, fever, irritability, vomiting
Chronic: fluid discharge lasting several months
Purulent discharge
Crescendo-decrescendo otalgia
Tender mastoid
Conductive hearing loss

23

Describe the appearance of the tympanic membrane in otitis media

Bulging, opaque eardrum

24

Outline management of otitis media

NSAID
Amoxicillin for up to 10 days if unresolving

25

What is cholesteatoma?

Presence of keratinising stratified squamous epithelium in the middle ear

26

List aetiology/risk factors for cholesteatoma

Congenital
Eardrum perforation, retracted eardrum
Down's syndrome
Turner's syndrome

27

List clinical features of cholesteatoma

Foul-smelling discharge
Deafness
Headache
Cheesy discharge
Itch
Tinnitus
Vertigo
Facial paralysis, meningitis (indicates cerebral infiltration)

28

Outline management of cholesteatoma

Surgical excision
Good ear hygiene

29

What is otitis media with effusion/glue ear?

Fluid in the middle ear cavity due to Eustachian tube dysfunction or maldevelopment

30

List aetiology/risk factors for glue ear

URTI
Oversized adenoids
Narrow nasopharynx
Boys
Atopy
Down's syndrome
Cleft palate
Passive smoking