Flashcards in ENT Deck (125)
What is meant by conductive hearing loss?
Failure of sound to be conveyed from the external ear to the inner ear
List common aetiology for conductive hearing loss
Ossicular damage (otosclerosis)
What is meant by sensorineural hearing loss?
Failure of sound to be transduced from inner ear
List common aetiology for sensorineural hearing loss
A positive Rinne's test is a normal finding. True/False?
Sound/vibration should be louder over the auditory canal compared to bone conduction
If sound localises to the affected ear in a Weber's test, what type of hearing loss is this?
If sound localises to the unaffected ear in a Weber's test, what type of hearing loss is this?
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
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
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)
What is otitis externa?
Inflammation of the skin of the ear canal/external ear
List aetiology/risk factors for otitis externa
Trauma (scratching, cleaning)
Absence of wax
Narrow ear canal
Pseudomonas, Staph aureus
List clinical features of otitis externa
Severe pain, tender pinna and tragus
Swollen ear canal
Conductive hearing loss
Outline management of otitis externa
Topical gentamicin + steroid drops
Strip of ribbon soaked in glycerine-ichthammol/aluminium acetate
What is barotrauma/aerotitis?
Occluded Eustachian tube does not allow middle ear pressure to equalise, particularly during aircraft descent or diving
List clinical features of aerotitis
Severe pain as drum indraws
Outline management of aerotitis
Avoid flying with URTI
Nasal decongestants (xylometazoline)
Repeated yawns/swallows/jaw movements
List clinical features of TMJ dysfunction
Stress, psychological impact
Outline management of TMJ dysfunction
Cognitive behavioural therapy
What is otitis media?
Inflammation of the middle ear cavity
List aetiology/risk factors for otitis media
Bacterial: H. influenzae, Pneumococcus, Moraxella
Blocking of Eustachian tube
List clinical features of otitis media
Acute: rapid onset earache, fever, irritability, vomiting
Chronic: fluid discharge lasting several months
Conductive hearing loss
Describe the appearance of the tympanic membrane in otitis media
Bulging, opaque eardrum
Outline management of otitis media
Amoxicillin for up to 10 days if unresolving
What is cholesteatoma?
Presence of keratinising stratified squamous epithelium in the middle ear
List aetiology/risk factors for cholesteatoma
Eardrum perforation, retracted eardrum
List clinical features of cholesteatoma
Facial paralysis, meningitis (indicates cerebral infiltration)
Outline management of cholesteatoma
Good ear hygiene
What is otitis media with effusion/glue ear?
Fluid in the middle ear cavity due to Eustachian tube dysfunction or maldevelopment