TM Perforation
What test do we want to run when we see a perforation during otoscopy? And what result do we want to see?
Tympanometry and large ECV, refer to ped/adult norms
Are cholesteatomas acquired or congenital?
Can be either ;)
- read note!
Case study!
!!
What is it called when plaques are ONLY on the tympanic membrane?
Myringosclerosis (more common than tympanosclerosis)
MY-ring-goh-SKLEH-roh-sis
What is a medical term referring to a partial dislocation of the ossicular chain?
Subluxation.
- ossicular chain discontinuity
- ossicular chain disarticulation
- ossicular chain dislocation
What is the treatment for a perforation?
Typically they will heal on their own. Unless large, long-standing, or recurring infections
Or, surgical repair
What can untreated cholesteatomas lead to?
Eroding ossicles, facial nerve paralysis, tegmen tympani, mastoid, horizontal semicircular canal. Can even lead to meningitis and neurologic symptoms
What is the hallmark symptom, in ~ 75% of patients?
Pulsatile tinnitus
What type of hearing loss will we anticipate with someone who has tympanosclerosis?
Conductive
Elevated or absent
If the perforation is located in the pars flaccida, what is a concern we should have?
Cholesteatoma
In what regions within the ear are most common for a cholesteatoma to manifest?
- Prussak's space
- where there is a perforation
- retraction pocket!- can vary and so much so into the petrous portion of temporal bone
What do the official 4 types of tumors tell us?
The classifications inform us about the location and severity. Glassock-Jackson (1982), Fisch (1979)
What type of tympanogram will we anticipate?
Reduced static compliance
What tympanometric results do we anticipate for ossicular discontinuity?
Hypercompliant, Ad
What test should a patient with a perforation NOT do?
Calorics!
What pure tone and tymp results may we anticipate?
Conductive component , can be normal
VaRiAbLe tymp results, depends on ossicle involvement. Compliance is reduced because more mass.
What are worst case scenarios regarding glomus tumors?
Facial nerve paralysis, erosion of labyrinth --> vertigo, sensorineural hearing loss, impact other cranial nerves
Case study!
!!
Ossicular discontinuity can create pts to have a maximum conductive loss. If they undergo ossiculoplasty (repair of the chain), what surgical results can we anticipate?
Air bone gap within 10 dB, or even less 75% of the time.