otology

Question 1

what are the kind of symptoms someone with ear problems could present with?

Answer 1

hearing loss
tinnitus
vertigo
otalgia
ottorrhoea
facial weakness

Question 2

what instrument would you use examining the ear

Answer 2

otoscopy

Question 3

in a rinne’s test, what would give a negative result?

Answer 3

bone conduction is greater than air conduction- this is a sign of conductive hearing loss

Question 4

in a rinne’s test what would give positive results

Answer 4

air conduction is greater than bone production- this can either lead to normal ear or sensorineural hearing loss

Question 5

management of auricular haematoma

Answer 5

incision and drainage
pressure dressing
antibiotics

Question 6

complications of auricular haematoma

Answer 6

cauliflower ear

Question 7

management of foreign body in ear

Answer 7

removal

Question 8

definition of otitis externa

Answer 8

inflammation of external auditory meatus

Question 9

management of otitis externa

Answer 9

antibiotic/steroid ear drops

+/- suction under microscope

Question 10

prevention of otitis externa

Answer 10

no water or cotton buds

Question 11

definiton of malignant otitis externa

Answer 11

osteomyelitis of temporal bone

Question 12

presentation of malignant otitis externa

Answer 12

severe pain in elderly diabetic
granulations in external auditory meatus
+/- cranial nerve palsies

Question 13

management of malignant otitis externa

Answer 13

antibiotics for weeks or months

Question 14

definition of otitis media with effusion

Answer 14

sterile fluid in middle ear “glue ear”

Question 15

presentation of otitis media with effusion

Answer 15

hearing loss

speech delay

Question 16

management of otitis media with effusion

Answer 16

observation for 3 months
Otovent
grommet

Question 17

definition of acute suppurative otitis media

Answer 17

pus in middle ear

Question 18

presentation of acute suppurative otitis media

Answer 18

otalgia +/- otorrhoea

Question 19

management of acute suppurative otitis media

Answer 19

observation

amoxicillin

Question 20

definition of tympanosclerosis

Answer 20

calcification in tympanic membrane +/- middle ear

Question 21

presentation of tympanosclerosis

Answer 21

asymptomatic

Question 22

management of tympanosclerosis

Answer 22

none

Question 23

pathology of chronic suppurative otitis media

Answer 23

perforated tympanic membrane

or

cholesteatoma
(skin in middle ear +/- mastoid bone)

Question 24

complications of chronic suppurative otitis media

Answer 24

“dead ear”
facial palsy
meningitis
brain abscess

Question 25

causes of perforation of tympanic membrane

Answer 25

infection trauma grommet

Question 26

perforation of tympanic membrane presentation

Answer 26

recurrent infections | hearing loss

Question 27

perforation of tympanic membrane management

Answer 27

water precautions | +/- myringoplasty

Question 28

causes of cholesteatoma

Answer 28

Eustachian tube dysfunction | impaired skin migration

Question 29

presentation of cholesteatoma

Answer 29

persistent offensive otorrohoea

Question 30

management of cholesteatoma

Answer 30

mastoidectomy

Question 31

presentation of otosclerosis

Answer 31

conductive hearing loss | normal tympanic membrane

Question 32

pathology of otosclerosis

Answer 32

fixation of stapes by extra bone

Question 33

management of otosclerosis

Answer 33

hearing aid or stapedectomy

Question 34

causes of sensineural hearing loss

Answer 34

``` presbyacusis noise exposure head injury ootoxic medication viral infections acoustic neuroma ```

Question 35

management of sensineural hearing loss

Answer 35

hearing aids

Question 36

definnition of tinnitus

Answer 36

any perception of sound

Question 37

investigation of tinnitus

Answer 37

unilateral | pulsatile

Question 38

management of tinnitus

Answer 38

treat underlying cause (if possible) sound enrichment stress management

Question 39

definition of vertigo

Answer 39

any perception of movement

Question 40

differential diagnosis of vertigo

Answer 40

benign positional vertigo Ménières disease vestibular neuritis / labyrinthitis migraine

Question 41

pathology og benign positional vertigo

Answer 41

otoconia in semicircular canals

Question 42

clinical features of benign positional vertigo

Answer 42

vertigo precipitated by specific changes in head position duration: seconds no associated symptoms nystagmus: positional and rotatory

Question 43

investigation of benign positional vertigo

Answer 43

Dix-Hallpike test

Question 44

management of benign positional vertigo

Answer 44

epley manoeuvre

Question 45

pathology of vestibular neuritis/ labrynthistis

Answer 45

reactivation of latent HSV infection of vestibular ganglion

Question 46

clinical features of Vestibular neuritis / labyrinthitis

Answer 46

spontaneous vertigo associated unilateral hearing loss (labyrinthitis) duration: days nystagmus: horizontal, towards affected ear

Question 47

management of Vestibular neuritis / labyrinthitis

Answer 47

acute: vestibular sedatives chronic: vestibular rehabilitation

Question 48

pathology of Ménière’s disease

Answer 48

endolymphatic hydrops

Question 49

clinical features of Ménière’s disease

Answer 49

spontaneous vertigo associated unilateral hearing loss / tinnitus / aural fullness duration: hours

Question 50

management of Ménière’s disease

Answer 50

bendroflumethazide intratympanic dexamethasone intratympanic gentamicin

Question 51

pathology of migraine

Answer 51

vascular ? neural

Question 52

clinical features of migraine

Answer 52

``` spontaneous vertigo duration: variable ± headache, sensory sensitivity ± precipitated by migraine triggers ± past history of migraine ```

Question 53

management of migraine

Answer 53

avoid migraine triggers | prophylactic medication

Question 54

clinical feature of facial nerve palsy

Answer 54

lower motor neuron facial palsy | forehead involved

Question 55

differential diagnosis of facial nerve palsy

Answer 55

intratemporal eg cholesteatoma extratemporal eg parotid tumour idiopathic = Bell’s palsy

Question 56

management of facial nerve palsy

Answer 56

treat underlying cause (if possible) steroids eye care