Otology

Question 1

What are the possible symptoms of otological pathology?

Answer 1

Hearing loss
Tinnitus
Vertigo
Otalgia
Otorrhoea
Facial weakness

Question 2

What is the pathology of tinnitus?

Answer 2

No direct treatable pathology in the vast majority

Question 3

What is the treatment of tinnitus?

Answer 3

Sound enrichment

Stress management

Question 4

What is the differential diagnosis of vertigo?

Answer 4

Benign positional vertigo
Meniere’s disease
Vestibular neuritis
Migraine

Question 5

What history should be taken for vertigo?

Answer 5

Duration
Frequency
Associated symptoms
Precipitating factors

Question 6

What examinations can be carried out for otological pathology?

Answer 6

Otoscope
Microscope
Tuning fork tests
Whispered voice test

Question 7

What are the types of tuning fork tests?

Answer 7

Rinne’s

Weber’s

Question 8

What is the Rinne’s test?

Answer 8

Tuning fork placed in front of ear and on bone and asked which is louder

Question 9

What would the result of the Rinne’s test be in conductive hearing loss?

Answer 9

Bone>air

Question 10

What would the result of the Rinne’s test be in sensorineural hearing loss?

Answer 10

Air>bone

Question 11

What is the Weber’s test?

Answer 11

Tuning fork placed in centre of forehead and patient asked which side it is heard louder

Question 12

What would the result of the Weber’s test be in sensorineural hearing loss?

Answer 12

Heart louder in opposite ear

Question 13

What would the result of the Weber’s test be in conductive hearing loss?

Answer 13

Heard louder in blocked ear

Question 14

What is a type B result in tympanometry?

Answer 14

Tymanic membrane immobile

Question 15

What is a type C result in tympanometry?

Answer 15

Middle ear pressure low

Question 16

What are the types of outer ear pathology?

Answer 16

Auricular haematoma
Otitis externa
Malignancy otitis externa

Question 17

What is otitis externa?

Answer 17

Inflammation of ear canal

Question 18

What are the symptoms of otitis externa?

Answer 18

Itching, pain, discharge, debris shed into ear canal

Question 19

What is the treatment of otitis externa?

Answer 19

Topical treatment

Question 20

How is malignancy otitis externa treated?

Answer 20

Systemic antibiotics

Question 21

What are the pathologies of the middle ear?

Answer 21

Otitis media with effusion
Acute otitis media
Chronic supprative otitis media
Tympanosclerosis
Otosclerosis

Question 22

What causes otitis media with effusion?

Answer 22

Eustachian tube not working, meaning middle ear pressure can’t be stabilised
This causes a vacuum to be created and fluid to be secreted as a result

Question 23

What is the treatment of otitis media with effusion?

Answer 23

Grommet insertion

Question 24

What is acute otitis media?

Answer 24

Inflammation of middle ear accompanied by signs and symptoms of an ear infection

Question 25

What are the types of chronic supprative otitis media?

Answer 25

Perforated tympanic membrane | Cholesteatoma

Question 26

What causes a perforated tympanic membrane?

Answer 26

Otitis media Barotrauma Noise, foreign objects, severe trauma

Question 27

How is a perforated eardrum treated?

Answer 27

Usually resolve spontaneously

Question 28

What causes cholesteatoma?

Answer 28

Eustachian tube dysfunction creates vacuum in middle ear pulling tympanic membrane into middle ear and creating a cyst that can turn into cholesteatoma

Question 29

What is tympanosclerosis?

Answer 29

Calcium deposits in tympanic membrane

Question 30

What is otosclerosis?

Answer 30

Extra bone formed in the ear

Question 31

What does otosclerosis cause?

Answer 31

Conductive hearing loss but normal tympanic membrane

Question 32

What are the inner ear pathologies?

Answer 32

``` Presbyacusis Noise induced hearing loss Ototoxic medications Meniere's disease Head injury Infections Vestibular schwannoma ```

Question 33

What is presbyacusis?

Answer 33

Age associated high frequency hearing loss

Question 34

What is a vestibular schwannoma?

Answer 34

Benign tumour causing sensorineural hearing loss in 1 ear

Question 35

What is benign positional vertigo?

Answer 35

Otoconia in semicircular canals

Question 36

What are the clinical features of benign positional vertigo?

Answer 36

Precipitated by specific changes in head position Lasts a few seconds and can happen up to several times a day No associated symptoms ad positive Dix-Hallpike test

Question 37

What is the treatment for benign positional vertigo

Answer 37

Epley manoeuvre

Question 38

What is vestibular neuritis?

Answer 38

Reactivation of latent HSV infection of vestibular ganglion

Question 39

What are the clinical features of vestibular neuritis?

Answer 39

Spontaneous vertigo No associated symptoms Can last a few days several times

Question 40

What is the treatment of acute and chronic vestibular neuritis?

Answer 40

Acute- vestibular sedatives | Chronic- vestibular rehabilitation

Question 41

What is Meniere's disease?

Answer 41

Endolymphatic hydrops

Question 42

What are the clinical features of Meniere's disease?

Answer 42

Spontaneous vertigo Fluctuating, progressive unilateral hearing loss, tinnitus, aural fullness Lasts several hours and can occur every few days to few months

Question 43

What is the treatment of Meniere's disease?

Answer 43

Betahistine Bendrofluazide Intratympanic dexamethasone Intratympanic gentamicin

Question 44

What is the pathology of migraines?

Answer 44

Vascular or neural

Question 45

What are the clinical features of migraines?

Answer 45

Spontaneous vertigo Variable duration and frequency Associated with headache, sensory sensitivity, auras Can be precipitated by migraine triggers

Question 46

What is the treatment of migraines?

Answer 46

Avoid triggers Prophylaxis Analgesia

Question 47

What is a facial palsy?

Answer 47

Lower motor neurone facial weakness

Question 48

What is Bell's palsy?

Answer 48

Acute, idiopathic facial palsy