Basics
Weber and Rinne
Auricle and External Otitis
These Sx mean what?
More Sx??
100
This is the most common sensory hearing loss, gradually progressive, predominantly high-frequency loss, advancing age
What is Presbyacusis
100
Weber Lateralizes to Left ear, Left ear also notes BC>AC
What is Left Conduction Loss
100
This is sometimes found on the auricles and is worrisome because its a precursor for a squamos cell carcinoma.
What is Actinic keratinosis
100
-Pruritus -Painful erythema and edema of the ear canal skin. -Otalgia -Purulent exudates -Manipulation of the auricle brings pain. -Erythematous tympanic membrane (lateral surface – skin). -TM moves normally with pneumatic otoscopy (vs acute otitis media) -H/o recent water exposure or mechanical trauma (eg, swimming, scratching, cotton applicators).
What is External Otitis
100
-Discomfort, possible damage due to pressure difference inside and outside of TM -Poor eustachian tube function (eg, congenital narrowness or acquired mucosal edema) -Air travel, rapid altitudinal change, or underwater diving. -Negative middle ear pressure causes collapse and blocks the eustachian tube.
What is Barotrauma
200
Results from dysfunction of the external or middle ear Causes of impairment include: Obstruction (eg, cerumen impaction) Mass loading (eg, middle ear effusion) Stiffness effect (eg, otosclerosis) Discontinuity
What is Conductive Hearing Loss
200
The Rinne test shows bone conduction exceeds air conduction, or BC>AC
What is Conductive Loss
200
Cellulitis is the inflammation of the skin where this is the inflammation of cartilage, seen often on auricles and key is developing a DDx
What is Chondritis
200
-Persistent external otitis in the diabetic or immunocompromised patient -causes osteomyelitis(bone infection caused by bacteria) of the skull base -Caused by Pseudomonas aeruginosa, -Begins in the floor of the ear canal and spreads to middle fossa floor, then clivus, and even the contralateral skull base.
What is Malignant External Otitis
200
-Infection of the mucosally lined air-containing spaces of the temporal bone. -Purulent material: middle ear cleft, pneumatized mastoid air cells and petrous apex. Pathogenesis: -Viral URI leads to Eustachian tube obstruction then accumulation of fluid and mucus then 2’ infected by bacteria Most common pathogens: Bacterial: >60% Streptococcus pneumoniae Haemophilus influenza Moraxella Catarrhalis Streptococcus pyogenes. Viral: RSV
What is ACUTE OTITIS MEDIA
300
This results from deterioration of the cochlea due to loss of hair cells from the organ of Corti or Lesions on CN VIII
What is Sensoryneural Hearing Loss
300
the first sounds to gradually lose in elderly patients. "Did you hear that??"
What is High-Frequency Sounds
300
This is not used when the foreign body contains Beans or insects
What is Aqueous Irrigation
300
Self-induced : excoriation or zealous ear cleaning.
What is Pruritis
300
Causes: -recurrent acute otitis media/trauma. -Perforation TM leads to polypoid degeneration, granulation tissue, osseous changes (osteitis/sclerosis). Common pathogens: P aeruginosa, Proteus species, Staphylococcus aureus, and mixed anaerobics
What is Chronic Otitis Media
400
Im not correctable with medical or surgical therapy, but can be given corticosteroids with this exception
What is Sudden Sensory Hearing Loss.
400
Weber lateralizes Left, Rinne in both ears AC>BC
What is Sensorineural loss in right
400
These are the main cause of external otitis
What is gram-negative rods (eg, Pseudomonas, Proteus)
400
-Fullness in the ear, mild to mod hearing loss. -Popping or crackling with swallowing or yawning (partial block) -Retraction of the tympanic membrane (TM) -Decreased mobility on pneumatic otoscopy. -Transient - days - weeks.
What is EUSTACHIAN TUBE DISFUNCTION
400
Prolonged eustachian tube dysfunction leads to chronic negative middle ear pressure then inwarded of upper flaccid TM portion then squamous epithelium-lined sac then neck fills with desquamated keratin then chronic infection
What is CHOLESTEATOMA
500
These 3 tests are all important when assessing hearing
What is Whisper Test, Weber and Rinne
500
Weber Lateralizes to Right, and Rinne shows BC>AC in both ears
What is Combined loss in left and conductive loss on right
500
Tx for External Otitis would include what ABx
What is aminoglycoside or fluoroquinolone antibiotics
500
-Prolong blockage of eustachian tube cause negative pressure then transudation of fluid. -Common in children - tubes are narrower and more horizontal in orientation. -Causes: URI, barotraumas, chronic allergic rhinitis.
What is Serous Otitis Media
500
-Perception of abnormal ear or head noises. -Intermittent periods of mild, high-pitched tinnitus lasting seconds to minutes - common in normal-hearing -Severe and persistent, interfere with sleep and the ability to concentrate, possible sensory hearing loss -May cause cochlear damage
What is Tinnitus
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