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13 ENT > Hearing Loss and Tinnitus > Flashcards

Hearing Loss and Tinnitus Flashcards

(63 cards)

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1
Q

t/f the inner 2/3 (bony) of the ear does not have ceruminous and sebaceous glands = no cerumen

A

true, skin is thin and tight, prone to injury

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2
Q

most common cause of hearing loss in ph

A

cerumen impaction

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3
Q

causes of cerumen impaction

A

cotton buds use

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4
Q

clinical presentation and treatment of cerumen impaction

A
  • hearing loss or ear fullness
  • pain is uncommon

treatment: manual extraction

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5
Q

represent abnormal accumulation of keratin in the external ear canal

A

keratosis obturans

cholesteatoma of external ear

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6
Q

cause of keratosis obtruans

A

overproduction of sq epithelium and/or faulty migration of epithelium with subsequent accumulation and impaction

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7
Q

presentation and treatment of keratosis obturans

A
  • hearing loss
  • enlarging keratin plug = diffuse widening of ear canal
  • pain

treatment: removal of debris, antibiotics

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8
Q

clinical presentation of external canal cholesteatoma

A
  • hearing loss with pain
  • epithelial plug
  • skin ulceration or bone necrosis
  • granulation tissue and otitis externa
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9
Q

treatment for external canal cholesteatoma

A

remove debris and necrotic tissue, antibiotic therapy

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10
Q

3 types of otitis externa

A

acute circumscribed otitis externa
acute diffuse oe
otomycosis

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11
Q

cause of acute circumscribe oe

A

infection from trauma (s aureus)

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12
Q

presentation of acute circumscribed oe

A
  • circumscribed swelling of outer 1/3
  • hearing loss, pain, tragal tenderness
  • purulent ear discharge
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13
Q

cause for diffuse otitis externa

A
  • dip in water
  • vigorous ear manipulation
  • pseudomonas
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14
Q

presentation of diffuse otitis externa

A
  • hearing loss and pain

- more severe than acoe

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15
Q

cause of otomycosis

A

aspergillus and candida

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16
Q

presentation of otomycosis

A
  • ear pruritus!!
  • hearing loss from cotton like fungal debris and purulent discharge
  • pain
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17
Q

foreign body is more common in __ and can cause ___

A

younger age group

causes obstruction and hearing loss

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18
Q

t/f tumors in the external ear are usually malignant

A

false, malignant uncommon, usually benign (nevi, chondroma, osteoma, papilloma)

  • no symptoms except hearing loss
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19
Q

causes of direct trauma on middle ear

A

overzealous cleaning or compressive barotrauma –> hearing loss, bloody otorrhea, tinnitus

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20
Q

otoscopy findings in direct trauma

A
  • tympanic perforation with jagged edges

- ear drum congested with preset hematoma

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21
Q

what is the persistent infection of the middle ear where drainage accompanied by perforation of the tympanic membrane is seen

A

chronic otitis media

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22
Q

otoscopy findings in chronic otitis media

A
  • tympanic membrane perforation with SMOOTH edge
  • no bleeding or hematoma
  • with mucoid discharge
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23
Q

in acute otitis media, the tympanic membrane can be perforated during the __ stage

A

suppurative stage

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24
Q

thickening of the fibrous middle layer of tympanic membrane (white patches from middle ear infections)

A

tympanosclerosis

otoscopy: whitish plaque

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25
what is bullous myringitis
- primary inflammation of tympanic membrane - bleb/blister/bulla - caused by m pneumoniae, s pneumoniae, and moraxella
26
presentation of bullous myringitis
- acute progressive otalgia and hearing loss - self limiting - otoscopy: bleb/ blister/ bulla in lateral wall
27
cause of eustachian tube problems
stiffness of tympanic membrane increases due to negative pressure in middle ear and tympanic membrane is pulled inwards
28
causes of compromise in patency of e tube
- nasopharyngeal or nasal inflammation - mechanical compression == persistent middle ear negative pressure
29
most severe form of tympanic membrane retraction where pars tensa becomes adherent to bony medial wall of middle ear
adhesive otitis media
30
presentation of adhesive otitis media
- persistent conductive hearing loss | - otoscopy: retraction of tympanic membrane and outlining of ossicles (han solo)
31
when negative pressure induces transudation of fluid from middle ear mucosa into ear space
otitis media with effusion
32
presentation of otitis media with effusion
- only mild or no ear pain - fullness in ear - otoscopy: middle ear fluid is clear, air fluid level
33
occurs due to poor e tube function and drops in barometric pressure during diving/flying
otitic barotrauma
34
presentation of otitic barotrauma
- high pressures can retract ear drum and small vessels = hemorrhage - hemotypmanum - pain, ear fullness, loss of hearing - otoscopy: hemorrhagic eardrum or hemotympanum
35
t/f increased stiffness or discontinuity of ossicular chain can cause decreased hearing
true
36
t/f chronic external ear infection can cause the gap between bony parts of ossicular chain to occur
false, middle ear infections
37
ossicular stiffness in children can be caused by ___
congenital underdevelopment of ear structures
38
what happens in cholesteatoma in middle ear
chronic infection -> squamous epithelium accumulates in mastoid and middle ear -> erode surrounding bone -> conductive hearing loss
39
hereditary condition that causes progressive hearing loss starting adulthood
otosclerosis
40
pathology in otosclerosis
- otospongosis forms at lip of stapes causing fixation of stapes on otic capsules - normal otoscopy
41
most common congenital hearing loss
scheibe aplasia (aplasia of cochlear duct) ``` michel aplasia (lack of development of inner ear) mondini aplasia (underdeveloped cochlea has 1.5 instead of 2.5 turns) genetic syndromes ```
42
mechanisms of infectious hearing loss
- oval or round windows - pre-formed pathways - blood (hematogenous)
43
viruses that can cause hearing loss
mumps!!! | chickenpox, measles, influenza, adenovirus
44
t/f ototoxic drugs can use sensorineural hearing loss as well
true
45
enlarging masses in the __ can cause dysfunction in cn 8 can cause __ and __
internal acoustic canal cause slowly progressive hearing loss, tinnitus, and vertigo
46
tumors in the iac
cn 7 schwannomas, meningiomas, hemangiomas, vascular malformations
47
age related hearing loss
presbycusis (loss of hair cells and cochlear neurons)
48
the __ is affected the most in environmental hearing loss
basal hair cells causes hearing loss and reduced speech discrimination
49
abnormal noise perceived in one or both ears in the head
tinnitus
50
t/f tinnitus is a diagnosis
false, it's a symptom and very common
51
most common form of tinnitus
subjective tinnitus rare: objective tinnitus
52
hyperacusis and misophonia / phonophonia
hyperacusis: perception of over amplification of environmental sounds misophonia / phonophonia: dislike or fear of environmental sounds
53
causes of tinnitus
- loud noise - presbycusis - middle ear problems - vestibular disorders - cn 8 damage or central auditory system change - head and neck trauma - medications - vascular - others
54
abnormal amounts of endolymph collecting in the middle ear tear or rupture of oval windows --> leak of perilymphatic fluid from membranous to middle ear
secondary endolymphatic hydrops perilymphatic fistula
55
damages to the cn 8
- acoustic neuroma (vestibular schwannoma) - vestibular neuritis (viral) - microvascular compression syndrome
56
hyperactivity in central auditory system is caused by damage to __
cochlea and vestibulocochlear nerve (8)
57
t/f tinnitus in head and neck trauma is perceived as louder and more severe
true (somatic tinnitus)
58
t/f masking devices can eliminate tinnitus
false, can obscure but not eliminate
59
therapy to help person retrain the brain to avoid thinking about tinnitus
tinnitus retraining therapy goal: retrain conditioned negative response
60
t/f psychological treatment can help manage tinnitus
true
61
t/f there is a drug to cure tinnitus
false, but drugs can treat psychological effects
62
indications for surgery in tinnitus
acoustic neuroma, perilymph fistula, otosclerosis
63
most important interventions for reducing risk of tinnitus
- avoid exposure to loud sounds | - get prompt treatment for ear infections

13 ENT (18 decks)

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