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Head and Neck Clinical > Middle and Outer Ear disorders > Flashcards

Middle and Outer Ear disorders Flashcards

1
Q

What is a Auricular Haematoma

A

A collection of blood underneath the perichondrium of the ear

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2
Q

What is the auricle of the ear

A

The visible part of the ear

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3
Q

What typically causes an Auricular Haematoma

A

Secondary trauma to the Auricle

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4
Q

What can happen to the ear if an auricular haematoma is badly managed

A

An auricular deformity (necrosis) (cauliflower ear)

  • seperation of the anterior auricular perichondrium from underlying cartilage
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5
Q

What type of cartilage is more prominent in the ear

A

Elastic cartilage

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6
Q

What is the management of a large auricular Haematoma

A

Incision and drainage

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7
Q

What is the management of a small/acute auricular Haematoma

A

Fine needle aspiration

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8
Q

What is the treatment post drainage of a auricular haematoma

A

Apply pressure dressing to prevent reaccumulation of haematoma
Give antibiotics to prevent infection of the Pinna

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9
Q

What determines the urgency of response to a foreign body in the ear

A

The compositions of the body in the ear

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10
Q

How quickly should an inorganic body be removed from the ear

A

Can be left for a few weeks

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11
Q

How quickly should an organic body be removed from the ear

A

Within days - to avoid infection

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12
Q

How quickly should a button battery be removed from the ear

A

Within hours to avoid corrosion

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13
Q

If you cant get a foreign body out of an ear easily then what might need to be done

A

General anaesthetic

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14
Q

What is the condition causing inflammation to the outer ear canal called

A

Otitis externa

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15
Q

What causes Otitis externa

A

Typically infection

Can also be allergy or irritation

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16
Q

What are risk factors for Otitis Externa (x5)

A 
Foreign bodies 
Swimming 
Warm weather 
Skin problems 
Excessive ear wax
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17
Q

What are symptoms for Otitis externa (x5)

A 
Itch 
Ear discharge
Temporary dulled healing 
Pain 
Usually unilateral
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18
Q

How can Otitis externa be classified

A

Acute < 3 weeks
Chronic >3 months
Recurrent

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19
Q

What is the most common cause of otitis externa

A

Bacterial infection, caused by Pseudomonas aeruginosa or Staphylococcus aureus.

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20
Q

What is the management for Otitis externa

A

Topical treatment
Antibiotics (Aminoglycoside)
Steroid Eardrops (Predinsolone)

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21
Q

What two things should patients be advised to stay away from when recovering from Otitis Externa

A

Water

Ear buds

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22
Q

What is Malignant otitis externa

A

Malignant otitis externa is spread of otitis externa into the bone surrounding the ear canal (the mastoid and temporal bones). Malignant otitis, without treatment, is a fatal condition.

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23
Q

What bacteria is responsible for Malignant otitis externa

A

Pseudomonas aeruginosa

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24
Q

What causes Malignant otitis externa

A

Otitis externa in immunocompromised

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25
Q

What are symptoms of Malignant otitis externa

A

Severe pain
Granulations in external auditory meatus
Lower cranial nerve palsies

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26
Q

What is treatment for Malignant otitis externa

A

Antibiotics (CIPROFLOXACIN) for weeks or months

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27
Q

What is the conditions which causes glue ear called

A

Otitis media with effusion

28
Q

What is Otitis media with effusion

A

Collection of fluid within the middle ear space without signs of acute inflammation.

29
Q

What age group is Otitis media with effusion most common

A

Children.

It is the most common cause of hearing loss in children

30
Q

What is the aetiology of Otitis media with effusion (x4)

A

Impaired eustachian tube function causing poor aeration of the middle ear.
Low-grade viral or bacterial infection.
Persistent local inflammatory reaction.
Adenoidal infection or hypertrophy.

31
Q

What is the pathophysiology for an impaired eustachian tube function causing poor aeration of the middle ear.

A

In children the austachina tube which joins the middle ear to the nose doesnt function as well as in adults.
The eustachian tube normally absorbs gas so if its not functioning well then there is a low pressure in the middle ear as gas is getting absorbed but not replaced.
If there is a low pressure in the ear then the epithelial cells secrete fluid

32
Q

What are symptoms of Otitis media with effusion

A

Hearing loss
Speech delay
Behavioural problems

33
Q

What is management for Otitis media with effusion

A

Observation for 3 months

Otovent, Balloon or grommet if still persists.

34
Q

When should the child be referred to ENT with Otitis media with effusion

A
  • The child has Down’s syndrome or has a cleft palate.
  • Hearing loss is severe and/or associated with a significant impact on the child’s quality of life.
  • Significant hearing loss persists on two documented occasions.
  • The tympanic membrane is structurally abnormal (or there are other features suggesting an alternative diagnosis).
  • There is a persistent, foul-smelling discharge suggestive of a possible cholesteatoma — referral should be urgent (within 2 weeks).
35
Q

What makes children more succspitable to Otitis media with effusio

A 
Cleft palate
Down's syndrome, 
Cystic fibrosis, 
Primary ciliary dyskinesia, 
Allergic rhinitis.

Environmental factors (such as low socioeconomic group, parental smoking and frequent upper-respiratory infections)

36
Q

What is acute otitis media

A

The presence of inflammation in the middle ear, associated with an effusion, and accompanied by the rapid onset of symptoms and signs of an ear infection.

37
Q

What is chronic suppurative otitis media .

A

A chronic inflammation of the middle ear and mastoid cavity, which presents with recurrent ear discharges (otorrhoea) through a tympanic perforation’.

38
Q

What causes acute suppurative otitis media

A

Acute otitis media

39
Q

What is the management of acute suppurative otitis media

A

Observe.
Lay of antibiotics for a few days as they might not be required
If not improvement then treat with antibiotics

40
Q

What antibiotics should be used for acute suppurative otitis media

A

Amoxicillin

41
Q

What antibiotic is ototoxic and should not been given to a patient with a perforated ear drum

A

Gentamycin

42
Q

What can happen if acute suppurative otitis media is left untreated

A

If left untreated, infection in CSOM may spread extracranially (causing facial paralysis or mastoiditis) or intracranially (causing meningitis or a cerebral abscess), although this is rare.

43
Q

What does acute otitis media look like on examination

A

The tympanic membrane is distinctly red, yellow, or cloudy and may be bulging

44
Q

What is treatment for acute otitis media

A

Many people with AOM will not need antibiotic treatment as symptoms usually resolve spontaneously within a few days.
However, antibiotics are necessary in a number of situations, including for:
People who are systemically very unwell.
People who have symptoms and signs of a more serious illness or condition.
People who have a high risk of complications.

45
Q

What is the condition called with scarring and calcification of the tympanic membrane or middle ear

A

Tympanosclerosis

46
Q

What can be seen on the ear drum in tympanosclerosis

A

A white area

47
Q

What are symptoms of tympanosclerosis

A

None

48
Q

What is management of tympanosclerosis

A

None

49
Q

What are complications of chronic supparative otisis media

A

Dead ear
facial palsy
meningitis
Brain abscess

50
Q

What can causes chronic supparative otitis media

A

Perforated tympanic membrane

Cholesteatoma

51
Q

What is a cholesteatoma

A

An abnormal, non cancerous skin growth that can develop in the middle section of your ear behind the ear drum. It develops as a cyst or sac that sheds layers of old skin

52
Q

What is the aetiology of a cholesteatoma

A

Eustachian tube dysfuction cuasing retraction of ear drum (a pocket). The normal migration of skin out of the ear doesnt work. Skin gets trapped in the ear drum and after a long period of time the skin builds up backwards to the mastoid bone.

53
Q

What is the red flag presentation of cholesteatoma

A

Persistent offensive otorrhoea that is foul smelling

54
Q

What is management of cholesteatoma

A

Refer to ENT

Surgery

55
Q

What is the surgical procedure used to fix a cholesteatoma

A

Mastoidectomy - to remove the cholesteatoma

56
Q

How common are cholesteatomas

A

A general practitioner with a list size of 2,500 patients would expect to see, on average, one new case of cholesteatoma every 4–5 years.

57
Q

What is otosclerosis

A

Abnormal bone growth inside the ear

58
Q

What happens to the bones in the ear during otosclerosis

A

The stapes begins to fuse with the surrounding bone and eventually becomes fixed.

59
Q

What does the tympanic membrane look like in otosclerosis

A

Normal

60
Q

What type of hearing loss is found in otosclerosis

A

Conductive hearing loss

61
Q

What are the symptoms of otosclerosis

A

Hearing loss with a normal tympanic membrane

62
Q

What is the management of otosclerosis

A

Hearing aid

Stapectomy

63
Q

Why is a facial nerve palsy common in some ear disorders

A

The facial nerve runs through the middle ear

64
Q

What is likely to cause a infratemporal facial nerve palsy

A

Cholesteatoma

65
Q

What is likely to cause a extratemporal facial nerve palsy

A

Parotid tumour

66
Q

What is likely to cause a ideapathic facial nerve palsy

A

Bells palsy (usually of viral origin)

67
Q

What is the management of a facial nerve palsy related to an ear disorder

A

treat the underlying cause
Use steroids (for ideopathic)
Treat the eye if it cant be opened by patient themselves (tape eye open)

Head and Neck Clinical (3 decks)

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