Lecture 1:Disorders of the Ear

What is Otitis Externa inflammation and edema of the ear canal

skin.

What is function of Cerumen Cerumen helps protect the canal by forming

an acidic coat that helps prevent infection.

Predisposing factors for Otitis Externa = absence of cerumen, excessive cleaning of

ears, water, trauma to ear canal.

Common pathogen causing otitis externa = ● Pseudomonas and Staphylococcus.

● Aspergillus and Candida.

Compara to bacterial otitis externa, fungal ITCHY

otitis externa pts have what complaint?

Treatments of externa otitis Bacterial = cleaning the ear canal of any

debris and instilling antibiotic drops with or
without steroids

Fungal = cleaning out debris and instilling

drops(2% acetic acid or some antifungals)

What professions have Auricular Hematoma wrestlers and boxers

What is Auricular Hematoma fluctuant swelling with loss of normal auricular

landmarks.

What is complication of auricular hematoma Caudiflower ear

Treatment of auricular hematoma incision and drainage of the hematoma with

dental cotton rolls on the opposite sides of
the affected ear
Patients who present with dry cough which Ears
has not responded to usual measures should
have their ___ checked.

What drug is used to remove live bug from LIDOCAINE

ear canal? Not saline

Cerumen impaction = cerumen obstruction

Is Qtip good at helping cerumen impaction? NO, further push cerumen impaction further

Body parts at high risk for frost bite Ears, nose and cheeks

Treatment consists of quickly warming the ear

Treatment of frost bite ?
with gauze soaked in saline at 38-40 degrees
C.

What is Bullous Myringitis

painful inflammatory bullae on the tympanic
membrane.
Must distinguish Bullous Myringitis from ?
otitis externa and herpes zoster oticus.

What is Most common infection for which

children are seen in a physician’s office. Acute otitis media
Pathogen causing acute otitis media Strep pneumoniae, H. influenza and
Moraxella catarrhalis.

What are 3 criteria for acute otitis media ● acute onset

● presence of middle ear effusion
● signs of middle ear inflammation
(fever, pain, erythema of tympanic
membrane)

Erythema of the TM without middle effusion is myringitis or tympanitis

________

What is Standard of care for treatment of not to treat with antibiotics on first visit but to
AOM in children older than 2 years treat pain and observe.

___ # decibel loss or more in hearing

40 decibel loss
bilaterally mandates referral by ENT for
polyethylene tube(PE tubes) placement.

Treatment for otitis meida with effusion

What is Chronic Suppurative Otitis Media the presence of persistent purulent otorrhea
through a perforated tympanic membrane or
Tympanostomy tube.

Symptoms of chronic suppurative otitis media hearing loss, tinnitus, increasing pain, vertigo,
or facial palsy

Treatment of chronic suppurative otitis media culture and sensitivity of the discharge to get
most appropriate antibiotic selection.

Chronic otitis media can lead to infection of Mastoid = mastoiditis

___

SKIM

What are signs of Traumatic Tympanic

Membrane Perforations sudden pain which subsides quickly and
bloody otorrhea, severe vertigo can occur but
resolves quickly. Hearing loss and tinnitus
may be present.

Treatment of traumatic tympanic membrane

perforation ● Perforation will heal spontaneously
over several days to weeks
● keeping the ear dry and ototopical
antibiotics if infection is suspected.

What is Barotrauma and Barotitis ● sudden changes in middle ear

pressure while flying or scuba diving.
● This causes an accumulation of
serous fluid in the middle ear.
Treatment of barotrauma and barotitis ?
What is drug of choice of acute otitis media ?
What vaccine decreases the number of cases
of AOM in children 6-24 months.
All traumatic perforations of the TM require
___ evaluation to rule out sensorineural
hearing loss.
What is Conductive Hearing Loss
What is Sensorineural Hearing Loss
What is Central Hearing Loss
Fluid is normally resorbed over several weeks
but Autoinflation maneuvers (popping the
ears) may hasten recovery.
Amoxicillin
Influenza vaccine
audiologic
when there is a failure of normal propagation
of acoustic energy through the conducting
portions of the ear
dysfunction of the inner ear, which may be
caused by a failure of the generation of nerve
signals in the cochlea by the cochlea hair
cells or propagation of electrical signals along
the cochlear division of CN VIII.
ischemic or traumatic brain injury leading to
hearing loss
Medications leading to hearing loss

What is Otosclerosis
sclerotic fixation of the stapes.

● hearing-aid, or surgery.
Treatment of Otosclerosis
● Surgery is stapedectomy and
placement of prosthesis. Procedure
has 95% success rate

All-inclusive term to describe the process of

What is Presbycusis
hearing loss related to aging.

High pitch or low pitch voice is lost first in

higher pitched tones(women & children voice)
Presbycusis ?

● Acoustic neuroma (vestibular

What is Acoustic Neuroma
schwannoma) is a benign tumor from
the Schwann cells of CN VIII.
 Acoustic Neuroma

What are symptoms of Acoustic Neuroma asymmetric hearing loss and tinnitus.

Neurofibromatosis can be associated with

Acoustic Neuroma

Sound above # decibels is dangerous for 90

ear?