Final Exam

Question 1

Aural Atresia reconstruction time periods

Answer 1

Microtia repair: 6-7 y/o

Atresia repair: 1-2 years later

Question 2

Exostoses side effects:

Answer 2

Traps debris
impinges on TM
reduces visibility of TM
can cause CHL

Question 3

What are exostoses

Answer 3

benign bony growths in medial ear canal secondary to cold water exposure (scuba)

Question 4

Why can otitis externa become concerning?

Answer 4

Infection of pinna or ear canal can turn from brief problems to life-threatening situation in immunocompromised individuals

Question 5

What is otitis externa?

Answer 5

Infection of pinna or ear canal that presents with mucopurulent matter/otorrhea, redness, edema, and pain.

Question 6

What is a furuncle?

Answer 6

Abscess from hair follicle. Swelling

Question 7

Otomycosis:

Answer 7

Fungal infection of the ear canal. Most seen in hearing aid users.

Question 8

Otomycosis presentation:

Answer 8

Pruritis, otorrhea, reduced hearing, otalgia (otoscopy: fungal hyphae)

Question 9

Dermatitis (Alt names and etiology)

Answer 9

Chronic external otitis or seborrheic external otitis
Etiology: irritants (q-tips, hairspray) and secondary to bacterial infection.
Chronic drainage causing pruritis and edema.

Question 10

What is myringitis

Answer 10

inflammation and infection, presence of painful vessicles on TM.

Question 11

Tm Perforation

Answer 11

Usually heal by themselves or may require tympanoplast if not healing. Concerns: CHL & Cholesteatoma

Question 12

Myringoplasty Vs Tympanoplasty

Answer 12

M: TM reconstructive surgery
T: Middle ear reconstructive surgery.

Question 13

Tympanosclerosis

Answer 13

Calcified plaques or connective tissue. Associated with chronic otitis media & other inflamm disorders, PE tubes.

Question 14

Tympanosclerosis presentation:

Answer 14

Tymps: A or A(s)
AR: Depends on severity, CHL pattern (probe ear)
Audio: CHL possible if more than TM is involved

Question 15

TM Perforation etiology and presentation:

Answer 15

Etiology: Trauma/blast/penetration/head trauma
Presentation: 
Otoscopy-perf
Tymp: Type B, HIGH volume
Audio: CHL up to 50 dB (depends on size)

Question 16

Retracted TM Etiology & presentation

Answer 16

etiology: Hx of secretory or ROM, ETD
presentation:
otoscopy: small retraction pockets to more global involvement
tymp: varies (usually not A)
Reflexes: varies
Audio: possible CHL

Question 17

Cholesteatoma (The 3 types)

Answer 17

Congenital- Ant to malleus
-Dx’d between 6mo to 5y
-May obstruct ET, CHL, chronic middle ear effusion
Primary - TM Retraction, ETD, or infection (acquired after impingement on ossicles = CHL)
Secondary- Injury to TM (perf, PE tube)
-Squamous cells migrate through TM to ME. (foul smell due to bacterial colonization)

Question 18

Hallmark Sign of Cholesteatoma:

Answer 18

Otorrhea w/o otalgia

Question 19

Cholesteatoma Presentation:

Answer 19

Otorrhea w/o otalgia (possibly dizziness)
Tymp: Variable
Reflexes: Variable
Audio: CHL (obstruction of ME space), mixed (ossicular chain damage), or SNHL (Erosion into cochlea)

Question 20

Glomus Jugulare

Answer 20

Develop from tissue in/near jugular bulb

May extend through skull base, into and through temporal bone

Question 21

Glomus Tumors

Answer 21

Slow glowing paragangliomas.
Develop from neuroendocrine (PNS cells, highly vascularized)
Most common tumor of middle ear.

Question 22

Glomus tumor MC signs and symptoms:

Answer 22

CHL
Pulsatile tinnitus (hallmark)
Aural fullness
Otalgia
Otorrhea
Bruit (audible vascular flow)
Expansion into mastoid: CN VII paralysis, labyrinthine erosion (vertigo, SNHL)

Question 23

Glomus tumor treatment

Answer 23

Surgical removal (mastoidectomy)
Radiation
Therapy (for CN involvement)
Audiologic management for residual HL

Question 24

Eustachian Tube Functions

Answer 24

Ventilate ME
Protect ME from nasopharynx
Clear secretions from ME
(Should be closed at rest)

Question 25

Patulous Eustachian Tube Symptoms:

Answer 25

Autophony
breathing sounds in ear
Head or aural pressure
Tinnitus