ENT

Question 1

Causes of pulsatile tinnitus, and required workup

Answer 1

Dural AV fistula 
Carotid Cavernous Sinus Fistula
Paraganglioma
Inner ear muscle spasms
Eustachian tube dysfunction

Workup- ENT eval and brain imaging

Question 2

Causes of non-pulsatile tinnitus and required workup

Answer 2

TMJ disease
Ototoxic meds
Presbycusis
Otosclerosis 
Vestibular schwannoma

usually originates in the auditory pathways, and commonly 2/2 sensorineural hearing loss. pt needs audiometry testing

Question 3

How to differentiate malignant otitis externa and SCC of the external ear?

Answer 3

MOE:
presents in older pts with severe ear pain, discharge, erosion of surrounding bones, high ESR

SCC: milder sx, subacute presentation, lower ESR

• both have pain and ulceration of the external ear with bony erosion
• get biopsy to differentiate