Week 5: Middle Ear Disorder/Diseases (I)

Question 1

What are the middle ear disorders/diseases discussed in class?

Answer 1

congenital malformations
acute otitis media
retraction pocket
atelectasis
otitis media with effusion
tympanostomy tube
ossicular chain discontinuity

Question 2

What is a congenital malformation?

Answer 2

a physical defect present in a baby at birth

also called birth defect or congenital anomaly

Question 3

Congenital malformation is caused by?

Answer 3

genetic factors

non-genetic (prenatal events - during pregnancy)

Question 4

Both genetic and non-genetic factors of congenital malformation have two groups, which are?

Answer 4

non-syndromic

syndromic

Question 5

Non-genetic factors of congenital malformation are acquired by?

Answer 5

acquired by prenatal events such as infections, drugs, alcohol, etc.

Question 6

What are the two types of syndrome under Syndromic of Genetic factors for Congenital malformation?

Answer 6

Treacher Collins syndrome

Crouzon syndrome

Question 7

Define syndrome

Answer 7

the combination of signs and symptoms which together represent a particular disease or disorder - different parts of the body are affected

Question 8

What is Treacher Collins Syndrome?

Answer 8

an autosomal dominant hereditary
craniofacial malformation (dysostosis) that affects ears, eyelids, cheekbones, and mandible (lower jaw)

Question 9

What caused Treacher Collins Syndrome?

Answer 9

it is caused by a mutation in the TCOF1 gene located at chromosome 5

Question 10

Treacher Collins Syndrome causes?

Answer 10

malformed outer and middle ear
Conductive hearing loss
eyes slant downward
notch in the lower cheekbones
mandibular hypoplasia (underdeveloped) - shortened jaw
cleft palate (in some cases)

Question 11

What is Crouzon Syndrome?

Answer 11

an autosomal dominant 10 hereditary
craniofacial malformation (dysostosis) that affects ears, eyes, jaw and upper lip

Question 12

What caused Crouzon Syndrome?

Answer 12

it is caused by a mutation in the FGFR2 gene at chromosome

Question 13

Crouzon Syndrome causes?

Answer 13

malformed outer and middle ear
Conductive hearing loss
bulging eyes and vision problems (eyes do not point in the same direction)
beaked nose
underdeveloped upper jaw, and enlarged mandible (lower jaw)
shortened upper lip
cleft palate (in some cases)

Question 14

What is Acute Otitis Media?

Answer 14

infection of the mucous membrane lining the middle ear tympanic activity
primarily a disease of childhood, it can occur at any age

Question 15

Acute Otitis Media is most common when?

Answer 15

fall and winter

Question 16

Describes how Acute Otitis Media is developed

Answer 16

first, there is an upper respiratory tract infection (nasopharynx)
then bacteria or viruses gain access to the tympanic cavity through the Eustachian tube from the nasopharynx

Question 17

Patient who suffers from Acute Otitis Media, will presents what?

Answer 17

otalgia (earache)
aural pressure (sense of fullness in the ear)
Conductive hearing loss

Question 18

Otoscopy of a patient who suffers from Acute Otitis Media will reveal what?

Answer 18

redness of the tympanic membrane

when severe, tympanic membrane can be seen to bulge outward

Question 19

What are the result of a hearing assessment done to a patient who suffers from Acute Otitis Media? (Audiometry, Speech Audiometry, Audiogram)

Answer 19

Audiometry: Conductive hearing loss
Speech Audiometry: SRT and PTA are 0 - 6 of each other, accordance/agreement between SRT and PTA is GOOD, WRS is 100 to 96%
Audiogram: WNL (right ear), unilateral conductive slight to mild hearing loss (left ear)

Question 20

What is Retraction pocket?

Answer 20

is any condition that interferes with the Eustachian tube’s function (allergies, enlarged adenoids, etc.)

Question 21

What are Allergic Rhinitis (and sinusitis) and Adenoids, in relation to Retraction pocket?

Answer 21

Allergic rhinitis (and sinusitis) causes swelling of tissue lining in the Eustachian tube - may become clogged with mucus
Adenoids is masses of lymphatic tissues located high on the posterior wall of pharynx

Question 22

What may result due to the Retraction pocket?

Answer 22

may result in chronic (long-lasting) negative pressure within the tympanic cavity (middle ear)
then causes a SMALL area of the tympanic membrane to be retracted (sucked inside) toward the tympanic cavity resulting in a retraction pocket

Question 23

Depending on the size of the retraction pocket, what results does the pure-tone audiometry reveals?

Answer 23

normal (WNL)

slight conductive hearing loss

Question 24

What are the result of a hearing assessment done to a patient who suffers from Retraction pocket? (Audiometry, Speech Audiometry, Tympanogram, ECV)

Answer 24

Audiometry: normal (WNL) or
slight conductive hearing loss (depending on the size of the retraction pocket)
Speech Audiometry: SRT and PTA are at 0 -6 dB of each other, accordance/agreement between SRT and PTA is GOOD, WRS is 100 to 96%
Tympanogram: Type C
ECV: normal

Question 25

What is Atelectasis?

Answer 25

is any condition that interferes with the Eustachian tube’s function (allergies, enlarged adenoids, etc.)

Question 26

What may result due to Atelectasis?

Answer 26

may result in chronic (long-lasting) negative pressure within the tympanic cavity (middle ear) then causes a LARGE area of the tympanic membrane to be retracted (sucked inside) toward the tympanic cavity resulting in Atelectasis

Question 27

What may happen in the large area that resulted in Actelectasis?

Answer 27

the large area may cover or adhere to the ossicular chain and the promontory

Question 28

Depending on the size of the tympanic membrane retraction in Atelectasis, what results does the pure-tone audiometry reveals?

Answer 28

Atelectasis may causes mild to moderate conductive hearing loss

Question 29

What are the result of a hearing assessment done to a patient who suffers from Atelectasis? (Audiometry, Speech Audiometry, Tympanogram)

Answer 29

Audiometry: mild to moderate conductive hearing loss varying degrees (depending on the size of the tympanic membrane retraction) Speech Audiometry: SRT and PTA are at 0 - 6 dB of each other, accordance/agreement between SRT and PTA is GOOD, WRS is 100 to 96% Tympanogram: Type B

Question 30

What is Otitis Media with Effusion?

Answer 30

accumulation of effusion (fluid) within the middle ear behind an intact tympanic membrane one of the most common causes of hearing loss in children

Question 31

What is Serous Otitis Media?

Answer 31

any condition that interferes with the Eustachian tube’s function (allergies, enlarged adenoids, etc.)

Question 32

Serous Otitis media may result in what?

Answer 32

chronic (long-lasting) negative pressure within the tympanic cavity (middle ear) reduced middle ear drainage function may cause—golden-yellow “watery” fluid (effusion) to accumulate within the middle ear

Question 33

What is Mucous Otitis Media?

Answer 33

any condition that interferes with the Eustachian tube’s function (allergies, enlarged adenoids, etc.)

Question 34

Mucous Otitis Media may result in what?

Answer 34

chronic (long-lasting) negative pressure within the tympanic cavity (middle ear) reduced middle ear drainage function frequent infections of the upper respiratory tract (nasopharynx) may cause— “glue-like”, thick, mucoid fluid (effusion) to accumulate within the middle ear

Question 35

What are the result of a hearing assessment done to a patient who suffers from Otitis Media with Effusion? (Audiometry, Speech Audiometry, Tympanogram, ECV, Audiogram)

Answer 35

Audiometry: Conductive hearing loss (the degree of the hearing loss is directly related to the amount of fluid in the middle ear) Speech Audiometry: SRT and PTA are at 0 - 6 dB of each other, accordance/agreement between SRT and PTA is GOOD, WRS is 100 to 96% Tympanogram: Type B ECV: normal Audiogram: bilateral slight asymmetrical conductive hearing loss, mild to slight (right ear), moderate to slight (left ear)

Question 36

What is Tympanostomy Tube?

Answer 36

to provide ventilation of the middle ear tympanic cavity by allowing the free passage of the air through the tympanic membrane

Question 37

What are the result of a hearing assessment done to a patient who suffers from a Tympanostomy Tube? (Tympanogram, ECV)

Answer 37

Tmpanopgram: Type B ECV: large

Question 38

What is Ossicular Chain Discontinuity?

Answer 38

the separation of the joint connecting two middle ear bones

Question 39

Where does Ossicular Chain Discontinuity most often occur?

Answer 39

in the incudostapedial joints

Question 40

When can Ossicular Chain Discontinuity occur?

Answer 40

after a head trauma, or erosion of the joint by a cholesteatoma

Question 41

What are the result of a hearing assessment done to a patient who suffers from Ossicular Chain Discontinuity (Audiometry, Speech Audiometry, Tympanogram, ECV, Audiogram)

Answer 41

Audiometry: moderate to moderately severe conductive hearing loss Speech Audiometry: SRT and PTA are at 0 - 6 dB of each other, accordance/agreement between SRT and PTA is GOOD, WRS is 100 to 96% Tympanogram: Type Ad (the ascending and descending sides of the tracing may not meet at all) ECV: normal Audiogram: WNL (right ear), unilateral conductive moderate to moderately severe hearing loss (left ear)