History

Question 1

6 things you need to ask!!!!

Answer 1

Pain
Discharge
Hearing impairment 
Tinnitus 
Dizziness/balance
Itching/irritation

Question 2

Other small things you can ask:

• Neurological
• General

Answer 2

Abnormality of taste
Facial weakness

Fever
Other nose and throat symptoms

Question 3

Pain - SOCRATES

Answer 3

Site – unilateral / bilateral
Onset – sudden, gradual
Character – pressure, throbbing
Radiation – throat, face, head
Associated symptoms - other causes earache (eg. dental, sore throat)
Timing – progression, chronology
Exacerbating and Relieving – response to painkillers
Severity - impact

Question 4

Ear discharge

• important question
• nature

Answer 4

Unilateral or bilateral?
Nature: wax? pus? watery? blood/blood stained?
Smell?

Question 5

Hearing

• important question
• onset and time course
• degree

Answer 5

UNILATERAL/BILATERAL*

ONSET AND TIME COURSE: sudden/gradual, static/progressive

DEGREE muffled blocked reduced complete?

Question 6

Tinnitus:

• character
• site
• time course

Cause

Answer 6

Character: ringing, buzzing, whistling, pulsing or other
Site: unilateral / bilateral
Time course: intermittent or continuous
Varies in loudness

Medication

Question 7

Dizziness / Loss of balance

Causes

What is it associated with?

Answer 7

It is caused by inner ear disease or disorders of vestibular nerve

It may be associated with loss of balance and vomiting

Question 8

Ototoxic drugs examples

Answer 8

Antibiotics - gentamicin
Loop diuretics - furosemide
Chemo - platinum-based - cisplatin, carboplatin