1
Q
whisper
A
30dB
2
Q
conversation
A
60dB
3
Q
shouting
A
90dB
4
Q
rhinophyma
A
hypertrophy of sebaceous glands; un treated rosacea
5
Q
oral cavity 7 parts:
A
- lips
- gingiva
- floor of mouth
- anterior 2/3 tongue
- buccal mucosa
- hard palate
- retromolar trigone
6
Q
oropharynx 5 parts:
A
- soft palate
- tonsils
- base of tongue
- posterior pharynx
- lateral pharynx
7
Q
age for visual response audiometry/ distraction testing
A
less than 4 years old
8
Q
flat tympanometry, kids
A
otitis media
perforation
9
Q
OAE=
A
oto-acoustic emission
SCREENING IN KIDS
10
Q
BSER=
A
brain stem evoked response
OBJECTIVE IN KIDS, GA
11
Q
external ear causes–> CHL
A
- wax
- otitis externa
- atresia
12
Q
middle ear causes–> CHL
A
- otitis media
- tympanic mem perforation
- ossicular discontinuity
- otosclerosis
- cholesteatoma
- glomus tumor
13
Q
PC otosclerosis
A
tinnitus
CHL–> SNHL
UNI–> BI
14
Q
risk factors for otosclerosis
A
female
pregnant
20-30yo
FAMILY HX
15
Q
tx of otosclerosis
A
hearing aid
stapedectomy
16
Q
problem in otosclerosis
A
fixation of stapes foot plate by immature new bone
17
Q
MCC sudden SNHL
A
IDIOPATHIC
18
Q
causes of sudden SNHL
A
ii-tt-an idiopathic infection- mumps/measles/TB/ syphilis trauma- surgery, base of skull fracture tumor- vesticular schwannoma autoimmune- wegners neuro- MS
19
Q
tx of SNHL
A
underlying causes…
STEROIDS
CARBOGEN
20
Q
differential gradual bilateral SNHL
A
- noise induced
- presbycussis
- ototoxic drugs
21
Q
noise induced gradual SNHL
A
- cisplatin
- furosemide
- aminoglycosides
- erythromycin
- vancomycin
- aspirin
22
Q
reversible ototoxic drug
A
ASPIRIN
23
Q
irreversible ototoxic drug
A
CISPLATIN
24
Q
1 macrloide= ototoxic
A
erythromycin
25
frequency for noise induced
4000-- 500-2000Hz
26
audiogram for conductive hearing loss
AIR-BONE GAP
27
audiogram for SNHL
NO air-bone gap
28
mcc hearing loss in kids
serrous otitis media= glue ear
29
5 risk factors for serious otitis media
- congenital
- second hand smoke
- large adenoids
- nasal allergy
- cleft palate
30
protective for serrous otitis media
BREAST FEEDING
31
5 complications of serrous otitis media
1. atelectasis
2. retraction pockets
3. tympanosclerosis
4. ossicle erosion
5. cholesteatoma
32
tx criteria for serrous otitis media
RECURRENT otitis media OR > 3 months
33
how long do grommets stay in for serrous otitis media
9-12months
34
3 complications with grommets
- 50%= discharge
- hole in tymp mem
- tympanosclerosis
35
causes of tympanosclerosis
1. serrous otitis media
2. grommets
3. RECURRENT ACUTE OTITIS MEDIA
36
tympanosclerosis
calcification/ hyaline degeneration of middle fibrous layer of tympanic membrane
37
when to refer acute otitis media
- NON-resolving
- complications
1. CN7
2. chronic= persistent discharge
3. acute mastoiditis
38
4 things for tx acute otitis media
- decongestant
- Abx-- bacterial
- antipyretics
- analgesics
39
definition acute mastoiditis
subperiosteal abscess with empyema in mastod
40
extra for PC acute mastoiditis
Protruding Pinna
post auricular swelling
BLUNTING OF SULCUS
41
2 complications of acute mastoiditis
1. abscess
- extradural temporal lobe
- subdural
2. meningitis
42
tx acute mastoiditis
- abx IV
- grommets
- MASTOIDECTOMY
43
chronic otitis media definition
persistent discharging > 3/12, with non-intact tympanic membrane; PAINLESS -- otorrhea/ hearing loss
44
safe chronic otitis media
tubotympanic
45
unsafe chronic otitis media
atticoantral---> cholesteatoma
46
tx of chronic otitis media
- topical abx
- aural toilet
- tympanoplasty/ mastoidectomy
47
things that can lead to ossicle erosion; thus going from CHL--> SNHL
1. otosclerosis
2. serrous otitis media
3. cholesteatoma
48
2 intra-cranial complications of cholesteatoma
1. MENINGITIS
| 2. ABSCESS-- intracranial/extradural/subdural
49
2 inner ear complications of cholesteatoma
1. VERTIGO-- semicircular canals
| 2. SNHL-- cochlea
50
2 middle ear complications of cholesteatoma
1. CHL
| 2. CN7 palsy
51
2 vascular complications of cholesteatoma
1. internal jugular vein thrombophlebitis
| 2. sigmoid sinus thrombosis
52
tx cholesteatoma
MASTOIDECTOMY
53
otoscopy for glue ear=
DULL and RETRACTED
54
PC otitis externa
```
PAIN
otorrhea
ITCHYNESS
red
oedematous skin
debris
```
55
otoscopy otitis externa
NORMAL- TM and mobile
56
tx otitis externa
- topical: Abx and steroid
- analgesia
- otowick
- canal toilet
57
complications of otitis externa
perichondritis
| malignant otitic extern
58
malignant otitis externa
severe osteomyelitis of temporal bone--> granulation tissue
| = grnaulomatous polypoid otitis externa
59
2 risk factors for malignant otitis externa
DM
| CN7
60
PC malignant otitis externa
PAIN OUT OF PROPORTION
| CN palsies: 7, 9-12
61
tx malignant otitis externa
- topical antibiotic
- IV antibiotic- 6 weeks
- aural toilet
62
when to refer otitis externa
1. non-resolving
2. complications-- malignant
3. oedematous canal
4. aural toilet
63
causes of otitis externa
1. FB/ water/ cotton bud
2. DM
3. infection- Pseudomonas, S.aureus, proteus, fungal
4. Skin- eczema, psoriasis, dermatitis
5. earl canal stenosis
64
diagnosis of acute mastoiditis
URGENT CT with CONTRAST
| --> brain abscess and subperiosteal abscess
ENT SC1
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