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Head and Neck - Year 2 > Otology > Flashcards

Otology Flashcards

(63 cards)

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1
Q

What are some otology symptoms?

A 
Hearing loss
Tinnitus
Vertigo
Otalgia
Otorrhoea
Facial weakness
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2
Q

What happens in Rinne’s test for a normal ear?

A

Air > bone

Test = positive

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3
Q

What happens in Rinne’s test for conductive hearing loss?

A

Bone > air

Test = negative

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4
Q

What happens in Rinne’s test for sensorineural hearing loss?

A

Air > bone

Test = positive

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5
Q

What happens in Weber’s test for normal hearing in both ears?

A 
Left = right 
Test = central
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6
Q

What happens in Weber’s test for sensorineural hearing loss in right ear?

A

Left > right

Test = lateralises to left

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7
Q

What happens in Weber’s test for conductive hearing loss in right ear?

A

Right > left

Test = lateralises to right

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8
Q

What is involved in the whispered voice test?

A

Whispered voice at 60cm
Mask other ear
No lip reading

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9
Q

What happens in a pure tone audiogram for normal hearing?

A

Better than 20dB

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10
Q

What happens in a pure tone audiogram for conductive hearing loss?

A

Bone conduction better than air conduction

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11
Q

What happens in a pure tone audiogram for sensorineural hearing loss?

A

Bone conduction the same as air conduction

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12
Q

What is type A in a tympanogram?

A

Normal middle ear pressure and compliance

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13
Q

What is type B in a tympanogram?

A

Low middle ear compliance

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14
Q

What is type C in a tympanogram?

A

Low middle ear pressure

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15
Q

What is responsible for equalising pressure around the ear drum?

A

Eustachian tube

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16
Q

What is the management for auricular haematoma?

A

Incision and drainage
Pressure dressing
Antibiotics

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17
Q

What is a complication of auricular haematoma?

A

Cauliflower ear

Blood becomes infected and destroys connective tissue in pinna

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18
Q

What is the management for a foreign body in the ear?

A

Removal

Urgent if button battery > organic > inorganic

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19
Q

What is otitis externa?

A

Inflammation of external auditory meatus

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20
Q

What is the management for otitis externa?

A

Antibiotic/steroid ear drops

+/- suction under microscope (required if ear canal obstructed as ear drops won’t work

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21
Q

How do you prevent otitis externa?

A

No water or cotton buds

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22
Q

What is malignant otitis externa?

A

Osteomyelitis of temporal bone

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23
Q

What is the presentation of malignant otitis externa?

A

Severe pain in elderly diabetic
Granulations in external auditory meatus
+/- cranial nerve palsies

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24
Q

What is the management for malignant otitis externa?

A

Antibiotics for weeks or months

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25
What is otitis media with effusion?
Sterile fluid in middle ear | Caused by eustachian tube blockage - pressure builds around ear drum
26
What is the presentation for otitis media with effusion?
Hearing loss | Speech delay
27
What is the management for otitis media with effusion?
Observe for 3 months Otovent GROMMET
28
What is acute suppurative otitis media?
Pus in middle ear
29
What is the presentation for acute suppurative otitis media?
Otalgia +/- otorrhoea | Painful and discharge if ear drum ruptures
30
What is the management for acute suppurative otitis media?
Observation | Amoxicillin (only if persistent)
31
What is tympanosclerosis?
Calcification in tympanic membrane +/- middle ear
32
What is the presentation for tympanosclerosis?
Usually asymptomatic
33
What is the management for tympanosclerosis?
Usually none
34
What are the complications of chronic suppurative otitis media?
'Dead ear' - complete loss of hearing Facial palsy Meningitis Brain abscess
35
What are the causes of a perforation of the tympanic membrane?
Infection Trauma GROMMET
36
What is the presentation of a perforated tympanic membrane?
Recurrent infections | Hearing loss
37
What is the management for perforation of the tympanic membrane?
Water precautions +/- myringoplasty | Myringoplasty - operation to repair hole in eardrum
38
What are the causes of cholesteatoma?
Eustachian tube dysfunction | Impaired skin migration
39
What is the presentation for cholesteatoma?
Persistent offensive otorrhoea
40
What is the management for cholesteatoma?
Mastoidectomy
41
What is the presentation for otosclerosis?
Conductive hearing loss | Normal tympanic membrane
42
What is the pathology for otosclerosis?
Fixation of stapes by extra bone
43
What is the management for otosclerosis?
Hearing aid or stapedectomy
44
What are the causes for sensorineural hearing loss?
``` Presbyacusis Head injury Viral infections Noise exposure Ototoxic medications Acoustic neuroma ```
45
What is the management for sensorineural hearing loss?
Hearing aids
46
What occurs in investigation of tinnitus?
Unilateral | Pulsatile
47
What is the management for tinnitus?
Treat underlying cause Sound enrichment Stress management
48
What is the differential diagnosis for vertigo?
Benign positional vertigo Meniere's disease Vestibular neuritis/labyrinthitis Migraine
49
What is the pathology of benign positional vertigo?
Otoconia in semicircular canals
50
What are the clinical features of benign positional vertigo?
Precipitated by specific changes in head position Lasts seconds No associated symptoms Nystagmus: positional and rotatory
51
What is the investigation for benign positional vertigo?
Dix-Hallpike test
52
What is the management for benign positional vertigo?
Epley manoeuvre
53
What is the pathology for vestibular neuritis?
Reactivation of latent HSV infection of vestibular ganglion
54
What are the clinical features of vestibular neuritis?
Spontaneous vertigo Associated unilateral hearing loss Lasts days Nystagmus - horizontal, towards affected ear
55
What is the management for vestibular neuritis?
``` Acute = vestibular sedatives Chronic = vestibular rehabilitation ```
56
What is the pathology for meniere's disease?
Endolymphatic hydrops
57
What are the clinical features of meniere's disease?
Spontaneous vertigo Associated unlateral hearing loss/tinnitus/aural fullness Lasts hours
58
What is the management for meniere's disease?
Bendroflumethazide Intratympanic dexamethasone Intratympanic gentamicin
59
What are the clinical features of migraine?
``` Spontaneous vertigo variable duration +/- headache, sensory sensitivity +/- precipitated by migraine triggers +/- past history of migraine ```
60
What is the management for migraines?
Avoid migraine triggers | Prophylactic medication
61
What are the clinical features of facial nerve palsy?
Lower motor neuron facial palsy | Forehead involved
62
What is the differential diagnosis for facial nerve palsy?
Intratemporal (e.g. cholesteatoma) Extratemporal (e.g. parotid tumour) Idiopathic = Bell's palsy
63
What is the management for facial nerve palsy?
Treat underlying cause Steroids Eye care

Head and Neck - Year 2 (14 decks)

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