Ear Disease

Question 1

What are the 3 main types of hearing loss?

Answer 1

Conductive
Sensorineural
Mixed

Question 2

What is otalgia?

Answer 2

Pain in the ear

not always from ear structures, can be referred pain

Question 3

Why may facial weakness be a sign of ear disease?

Answer 3

CN VII runs through middle ear/ tympanic membrane

chorda tympani

CN VII supplies muscles of facial expression

Question 4

What are the main signs of ear disease?

Answer 4

• abnormalities of ear canal/ drum
• discharge/bleeding
• swelling/masses
• mastoid swelling
• facial weakness
• hearing loss

Question 5

What is otitis externa

Answer 5

• Inflammation of ear canal skin

- Almost always infective (bacterial or fungal)

Question 6

What are the most common causes of otitis externa?

Answer 6

water
cotton buds
skin conditions

Question 7

Otitis media is more common in adults than children. TRUE/FALSE?

Answer 7

FALSE

More common in children

Question 8

What other common children’s conditions are associated with otitis media?

Answer 8

Associated with glue ear

and after URTIs

Question 9

Describe what is meant by “glue ear”?

Answer 9

Otitis media with effusion

Question 10

Chronic otitis media is associated with what other conditions?

Answer 10

Otitis media with effusion (Glue Ear)
Cholesteatoma
Perforation

Question 11

If the ear drum perforates in otitis media, it can heal without any serious problems. TRUE/FALSE?

Answer 11

TRUE

pressure down, pus out, pain released

Question 12

What is the most likely cause of glue ear in children?

Answer 12

Dysfunctional eustachian tube OR obstruction

Question 13

Describe how the “glue” forms in glue ear?

Answer 13

• Eustachian tube should open when we yawn etc
• Children usually have large adenoids which cause dysfunction
• air is absorbed in middle ear causing low pressure
• Effusion thickens and becomes glue substance

Question 14

What is used to remove glue ear?

Answer 14

Grommets

perforation made in ear drum and grommet left in for around a year

Question 15

What can cause glue ear in adults if their eustachian tube was previously functioning?

Answer 15

Rhinosinusitis
Nasopharyngeal Carcinoma
Nasopharyngeal Lymphoma
swelling/mass blocking eustachian tube

Question 16

What type of hearing loss is found in glue ear?

Answer 16

Conductive hearing loss with flat tympanogram

Question 17

How can hearing loss present in children?

Answer 17

Recurrent otitis media
Speech and Language delay
Poor Behaviour

Question 18

What usually causes perforation?

Answer 18

Acute otitis media

Post trauma

Question 19

What is a cholesteatoma?

Answer 19

Keratin build up in a pocket of ear drum

Can erode into bones of ear canal

Question 20

What symptoms are present in cholesteatoma?

Answer 20

Hearing loss

Discharge

Question 21

What parts of the tympanic membrane are susceptible to cholesteatoma?

Answer 21

Pars flaccida

Pars tensa

Question 22

What are the complications of cholesteatoma if it invades medially?

Answer 22

• Sensorineural hearing loss, Tinnitus, Vertigo, Facial palsy

Question 23

What are the complications of cholesteatoma if it invades superiorly?

Answer 23

• brain abscess, meningitis

Question 24

What are the complications of cholesteatoma if it invades posteriorly?

Answer 24

• venous sinus thrombosis

Question 25

What can a mastoiditis swelling behind the ear cause?

Answer 25

One ear pushed further forward than other

Question 26

What does a signet ring on CT head show?

Answer 26

Lateral semicircular canal

Question 27

What type of hearing loss is seen in otosclerosis?

Answer 27

Gradual onset conductive hearing loss

Question 28

Otosclerosis is more common in women. TRUE/FALSE?

Answer 28

TRUE | Also progresses more rapidly during pregnancy

Question 29

Does otosclerosis have a familial genetic component?

Answer 29

Yes, but it can skip generations

Question 30

What is otosclerosis and how can it be treated?

Answer 30

Fixation of stapes footplate | Corrected via stapedectomy

Question 31

What is presbycusis more commonly known as?

Answer 31

Age-related hearing loss

Question 32

What frequencies are lost as we age?

Answer 32

Higher frequencies lost

Question 33

Noise induced hearing loss causes a classical dip in hearing at what frequency?

Answer 33

4kHz

Question 34

Do employers have legal responsibility to provide hearing protection at work if noise induced hearing loss could occur in the occupation?

Answer 34

Yes | Should either provide protection or regular auditory check ups

Question 35

What drugs are known to cause sensorineural hearing loss?

Answer 35

- Gentamicin and other aminoglycosides - Chemo - Cisplatin, Vincristine - Aspirin and NSAIDs (in overdose)

Question 36

Where does a vestibular schwannoma arise and how is it visualised on imaging?

Answer 36

- Benign tumour in Internal Acoustic Meatus | - Diagnosis on MRI scan

Question 37

How do vestibular schwannomas present?

Answer 37

Hearing loss, tinnitus and imbalance

Question 38

What is haemotympanum?

Answer 38

Blood behind the ear drum (usually due to a base of skull fracture)

Question 39

What is Battle's sign?

Answer 39

- Bruising over mastoid caused by base of skull fracture