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Otology Flashcards

(67 cards)

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1
Q

What is Rinne’s Test?

A

Air vs bone conductive hearing test

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2
Q

What is a Rinne’s positive result?

A

Sound is louder by air than by bone

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3
Q

What is a Rinne’s negative result?

A

Sound is louder by bone than by air

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4
Q

What does a Rinne’s negative result mean?

A

Conductive hearing loss

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5
Q

What does a Rinne’s positive result mean?

A

Hearing normal OR

Sensorineural hearing loss (proportionate loss of both)

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6
Q

What is Weber’s test?

A

Tuning fork placed on midline of skull

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7
Q

If Weber’s test is heard louder in the left ear than the right, it implies what?

A

Sensorineural hearing loss in right ear

Conductive hearing loss in left ear

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8
Q

If Weber’s test is heard louder in the right ear than the left, it implies what?

A

Sensorineural hearing loss in left ear

Conductive hearing loss in right ear

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9
Q

Why is Weber’s test heard louder in the weaker ear?

A

No sound will pass into the ear from outside sources, making it seem louder in that ear

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10
Q

What is normal hearing on a pure tone audiogram?

A

Better than 20dB

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11
Q

How will conductive hearing loss appear on a pure tone audiogram?

A

Bone conduction better than air conduction

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12
Q

How will sensorineural hearing loss appear on a pure tone audiogram?

A

Total reduction in hearing reduced for bone and air conduction?

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13
Q

What is conductive hearing loss?

A

Sound is not reaching past outer/middle ear

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14
Q

What is sensorineural hearing loss?

A

Sound information isnt passed from inner ear

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15
Q

What are the possible tympanogram results?

A

Type A: Normal middle ear pressure/compliance
Type B: Low middle ear compliance
Type C: Low middle ear pressure

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16
Q

How is auricular haematoma managed?

A

Incision and drainage
Pressure dressing
Antibiotics

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17
Q

What is the most common complication of auricular haematoma?

A

Cauliflower ear

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18
Q

What is otitis externa?

A

Inflammation of the external auditory meatus skin

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19
Q

How is otitis externa managed?

A

Antibiotics/steroid ear drops

Suction under microscope

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20
Q

How is otitis externa prevented?

A

No water or cotton buds in ear

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21
Q

What is malignant otitis externa?

A

Osteomyelitis of temporal bone

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22
Q

How does malignant otitis externa present?

A

Severe pain in elderly diabetic
Granulations in external auditory meatus
?cranial nerve palsies

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23
Q

How is malignant otitis externa treated?

A

Antibiotics for weeks/months

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24
Q

What is otitis media with effusion?

A

“glue ear”

Sterile fluid in middle ear

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25
How does otitis media present?
Hearing loss | Speech delay
26
How is otitis media with effusion managed?
Observe 3months Otovent Grommet
27
When are grommets indicated for otitis media with effusion?
No better after 3 months | Child has hearing loss
28
What is acute suppurative otitis media?
Pus in middle ear
29
How does acute suppurative otitis media present?
Otalgia ?otorrhoea (if burst) Red, bulging ear drum
30
How is acute suppurative otitis media managed?
Observation | Amoxicillin
31
What is tympanosclerosis?
Calcification of tympanic membrane +/- middle ear
32
How does tympanosclerosis present?
Asymptomatic
33
How is tympanosclerosis managed?
None
34
What causes chronic suppurative otitis media?
Perforated tympanic membrane OR Cholesteatoma
35
What is cholesteatoma?
Excess skin in middle ear +/- mastoid bone
36
What are the complications of chronic suppurative otitis media?
Dead ear Facial palsy Meningitis Brain abscess
37
What are the causes of a perforated tympanic membrane?
Infection Trauma Grommet
38
How does a perforated tympanic membrane present?
Recurrent infections | Hearing loss
39
How is perforated tympanic membrane treated?
Water precautions | ?Myringoplasty
40
What causes cholesteatoma?
Eustachian tube dysfunction | Impaired skin migration
41
How does cholesteatoma present?
Persistent offensive otorrhoea
42
How is cholesteatoma managed?
Mastoidectomy
43
How does otosclerosis present?
Conductive hearing loss with a normal tympanic membrane
44
How does otosclerosis cause hearing loss?
Fixation of stapes by extra bone
45
How is otosclerosis managed?
Hearing aid | Stapedectomy
46
What are the main causes of sensorineural hearing loss?
``` Presbyacusis Head injury Viral infections Ototoxic medications Noise exposure Acoustic neuroma (especially when unilateral) ```
47
When should tinnitus be investigated?
Unilateral - acoustic neuroma? | Pulsatile - vascular?
48
How is tinnitus treated?
Treat underlying cause Sound enrichment Stress management
49
What is vertigo?
Perception of movement
50
What is the DDx for vertigo?
Benign positional vertigo Menieres disease Vestibular neuritis/labyrinthitis Migraine
51
What is the cause of benign positional vertigo?
Otoconia in semicircular canals
52
How does benign positional vertigo present?
Vertigo for seconds causes by changes in head position No associated symptoms Positional/rotatory nystagmus
53
How is benign positional vertigo tested?
Dix-Hallpike test
54
How is benign positional vertigo treated?
Epley manoeuvre
55
What is the cause of vestibular neuritis/labyrinthitis?
Reactivation of latent HSV infection of vestibular ganglion
56
How does vestibular neuritis/labyrinthitis present?
Spontaneous vertigo for days Associated unilateral hearing loss Horizontal nystagmus towards ear
57
How is vestibular neuritis/labyrinthitis managed?
Acute: Vestibular sedatives Chronic: Vestibular rehabilitation
58
What is the cause of Meniere's disease?
Endolymphatic hydrops
59
How does Meniere's disease present?
Spontaneous vertigo for hours | Associated unilateral hearing loss/tinnitis/aural fullness
60
What is the management for Meniere's disease?
Bendroflumethazide Intratympanic dexamethasone Intratympanic gentamicin
61
What is the cause of migraine?
Vascular, neural
62
How does migraine present?
Spontaneous vertigo for variable duration ?headache ?trigger precipitated ?past history of migraine
63
How is migraine managed?
Migraine triggers | Prophylaxis
64
How does facial nerve palsy present?
Lower motor neuron facial palsy
65
What is the differential diagnosis for facial nerve palsy?
Intratemporal (cholesteatoma) Extratemporal (parotid tumour) Idiopathic
66
What is Bell's Palsy?
Idiopathic facial nerve palsy
67
How is facial nerve palsy managed?
Treat cause Bell's: Steroids Eye care/dryness

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