Ent Medicine - Hearing Loss and Treatments
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Questions and Answers

What is the first-line antibiotic treatment for mild to moderate Acute Otitis Media (AOM)?

  • Cefdinir (Omnicef) 500 mg
  • Azithromycin 250 mg
  • Amoxicillin 875 mg (correct)
  • Cefuroxime 1 g

    • In cases of TM perforation, which treatment is recommended?

  • Topical antihistamine spray
  • Cortical ear packing
  • Amoxicillin eardrops
  • Cortisporin Otic 4 ear drops (correct)

    • What is a common subjective symptom of mastoid process disease?

  • Persistent cough
  • Stiff neck
  • Ear pain (correct)
  • Visual disturbances

    • Which of the following indicates a need for referral to ENT?

    <p>Chronic Otitis Media for 3 months</p> Signup and view all the answers

    What is the primary characteristic of conductive hearing loss?

    <p>Obstruction of sound waves occurs in the outer or middle ear.</p> Signup and view all the answers

    What characterizes conductive hearing loss?

    <p>Impaired sound conduction from outer to inner ear</p> Signup and view all the answers

    What is the most common cause of facial paralysis in adults?

    <p>Bell's palsy</p> Signup and view all the answers

    Which condition is associated with sensorineural hearing loss?

    <p>Presbycusis</p> Signup and view all the answers

    Which treatment is appropriate for sensorineural hearing loss?

    <p>Hearing aids and cochlear implants</p> Signup and view all the answers

    In a Rinne test indicating conductive hearing loss, which result would be expected?

    <p>Bone conduction lasts longer than air conduction.</p> Signup and view all the answers

    What is a common cause of gradual hearing loss?

    <p>Otosclerosis</p> Signup and view all the answers

    What is a common treatment approach for tinnitus?

    <p>Therapy focusing on sound masking</p> Signup and view all the answers

    What does a Weber test reveal in cases of sensorineural hearing loss?

    <p>Lateralization to the good ear.</p> Signup and view all the answers

    Which of the following conditions can lead to fluctuating hearing loss?

    <p>Multiple sclerosis</p> Signup and view all the answers

    Which type of hearing loss is characterized by fluid in the middle ear?

    <p>Conductive hearing loss</p> Signup and view all the answers

    What is the role of audiometry in assessing hearing loss?

    <p>It provides a more optimal and specific assessment of hearing.</p> Signup and view all the answers

    What is a defining characteristic of cholesteatoma?

    <p>Foul-smelling ear discharge</p> Signup and view all the answers

    Which of the following is a possible complication of cholesteatoma?

    <p>Erosion into the bones of the face</p> Signup and view all the answers

    Which medication is commonly used to treat vertigo symptoms?

    <p>Meclizine (Antivert)</p> Signup and view all the answers

    What symptom is commonly associated with severe vertigo?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Which examination finding might indicate a case of vertigo?

    <p>Positive Romberg sign</p> Signup and view all the answers

    What form of management may be suggested for patients with Meniere's disease experiencing vertigo?

    <p>Low salt diet with diuretics</p> Signup and view all the answers

    Which condition can lead to damage of cranial nerve VIII, contributing to vertigo?

    <p>Tertiary syphilis</p> Signup and view all the answers

    What is the primary goal in managing acute vertigo episodes?

    <p>Providing bedrest during attacks</p> Signup and view all the answers

    What is the appropriate method for cleaning a young child's outer ear and canal?

    <p>Cleaning with a soft cloth</p> Signup and view all the answers

    What are the likely findings in a child with congenital cholesteatoma?

    <p>Pale, whitish discoloration behind the membrane</p> Signup and view all the answers

    Which of the following is NOT part of the management for a congenital cholesteatoma?

    <p>Insertion of pressure equalizing tubes</p> Signup and view all the answers

    A child with recurrent otitis media is suspected to have which type of hearing loss?

    <p>Conductive hearing loss</p> Signup and view all the answers

    In managing a congenital cholesteatoma, which intervention is essential?

    <p>Debris removal from the ear canal</p> Signup and view all the answers

    What risk arises from using cotton-tipped swabs to clean the ear?

    <p>Damage to the tympanic membrane</p> Signup and view all the answers

    What defines primary acquired cholesteatoma?

    <p>Retraction of the pars flaccida</p> Signup and view all the answers

    Which condition typically presents with scarring of the tympanic membrane?

    <p>Primary acquired cholesteatoma</p> Signup and view all the answers

    What is the most common cause of impacted ear canals?

    <p>Cerumen wax</p> Signup and view all the answers

    What is a common symptom of otitis externa?

    <p>Pruritus and hearing loss</p> Signup and view all the answers

    Which bacteria are commonly associated with otitis media?

    <p>Streptococcus pneumoniae and Haemophilus influenzae</p> Signup and view all the answers

    What treatment is appropriate for otitis externa?

    <p>Topical antibiotics and cotton wick</p> Signup and view all the answers

    What is the characteristic feature of otitis media with effusion?

    <p>Serous fluid behind the tympanic membrane without infection</p> Signup and view all the answers

    What is the primary cause of benign paroxysmal positional vertigo (BPPV)?

    <p>Calcium carbonate crystals in the semicircular canals</p> Signup and view all the answers

    Which condition is classified as sensorineural hearing loss?

    <p>Presbycusis</p> Signup and view all the answers

    What is the recommended treatment for a patient presenting with otitis media with effusion?

    <p>Observation and supportive therapy with oral decongestants</p> Signup and view all the answers

    A patient exhibits aural fullness and decreased hearing without significant pain. Which finding on otoscopic exam is expected?

    <p>Clear yellow fluid behind an intact tympanic membrane</p> Signup and view all the answers

    Which of the following is NOT a common feature of acute otitis media?

    <p>Intact tympanic membrane</p> Signup and view all the answers

    What kind of hearing loss is caused by disruption in the outer or middle ear, rather than the inner ear or auditory pathways?

    <p>Conductive hearing loss</p> Signup and view all the answers

    Which treatment should be avoided in managing otitis media with effusion due to its ineffectiveness?

    <p>Immediate use of antibiotics</p> Signup and view all the answers

    What should be monitored in a child with recurrent cerumen impaction?

    <p>Appropriate ear cleaning techniques</p> Signup and view all the answers

    What is the most common cause of vertigo in the US?

    <p>Benign paroxysmal positional vertigo (BPPV)</p> Signup and view all the answers

    Which option describes the primary symptom of presbycusis?

    <p>Difficulty hearing high-pitched sounds</p> Signup and view all the answers

    What initial management is recommended for a patient with otitis media with effusion?

    <p>Observation and supportive therapy with oral decongestants</p> Signup and view all the answers

    What is a common cause of conductive hearing loss in children?

    <p>Otitis media</p> Signup and view all the answers

    Which condition is primarily characterized by the presence of an intact tympanic membrane with yellow fluid behind it?

    <p>Otitis media with effusion</p> Signup and view all the answers

    Which of the following conditions is associated with a need for rapid ENT evaluation?

    <p>Chronic otitis media</p> Signup and view all the answers

    What is a common intervention for a child with recurrent cerumen impaction?

    <p>Education on proper ear hygiene</p> Signup and view all the answers

    Which factor can be ruled out in BPPV cases due to the absence of specific auditory symptoms?

    <p>Tinnitus</p> Signup and view all the answers

    What is a common symptom associated with otitis externa?

    <p>Itching in the ear canal</p> Signup and view all the answers

    Which bacteria are most commonly associated with acute otitis media?

    <p>Streptococcus pneumoniae</p> Signup and view all the answers

    What is the appropriate treatment for impacted cerumen?

    <p>Irrigation with body temperature water and hydrogen peroxide</p> Signup and view all the answers

    Which symptom suggests the presence of otitis media with effusion?

    <p>Aural fullness and decreased hearing</p> Signup and view all the answers

    In managing otitis externa, what is an important treatment method?

    <p>Use of a cotton wick for antibiotic eardrops</p> Signup and view all the answers

    What is a significant complication that cholesteatoma can cause?

    <p>Damage to the facial nerve</p> Signup and view all the answers

    Which medication should be prescribed for a patient with acute otitis externa due to swimming?

    <p>Cipro HC</p> Signup and view all the answers

    Which symptom is typically associated with severe vertigo?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What diagnostic tool is recommended for evaluating cholesteatoma?

    <p>Computed Tomography (CT)</p> Signup and view all the answers

    What is a common risk factor for developing otitis externa?

    <p>Having underlying diabetes mellitus</p> Signup and view all the answers

    What is the primary initial management approach for vertigo symptoms?

    <p>Medication reconciliation</p> Signup and view all the answers

    What is the appropriate action if cerumen prevents visualization of the tympanic membrane in a pediatric patient?

    <p>Remove the cerumen and visualize the tympanic membrane</p> Signup and view all the answers

    What is a characteristic symptom of otitis media with effusion?

    <p>Change in hearing acuity</p> Signup and view all the answers

    In cases of Meniere's disease, what dietary recommendation is suggested?

    <p>Low salt diet</p> Signup and view all the answers

    Which is NOT a risk factor for developing otitis externa?

    <p>Exposure to high humidity environments</p> Signup and view all the answers

    Which of the following treatments is used for acute vertigo episodes?

    <p>Scopolamine patches</p> Signup and view all the answers

    Which statement is true regarding the treatment of mild fungal infections in the ear?

    <p>Vinegar and alcohol are effective and safe options</p> Signup and view all the answers

    What finding on examination might indicate vertigo?

    <p>Positive Romberg sign</p> Signup and view all the answers

    Which condition could potentially lead to damage of cranial nerve VIII, contributing to vertigo?

    <p>Tertiary syphilis</p> Signup and view all the answers

    Which medication is least effective for treating acute otitis externa caused by bacteria?

    <p>Fluconazole</p> Signup and view all the answers

    What condition is characterized by tympanic membrane inflammation accompanied by fever?

    <p>Acute otitis media</p> Signup and view all the answers

    What does a Rinne test indicating conductive hearing loss show?

    <p>Bone conduction &gt; air conduction</p> Signup and view all the answers

    Which finding is NOT typically associated with acute suppurative otitis media?

    <p>Visualize mobility of the tympanic membrane</p> Signup and view all the answers

    Which clinical manifestation is characteristic of acute otitis media?

    <p>Unilateral ear pain</p> Signup and view all the answers

    Which bacterium is commonly associated with otitis externa?

    <p>Pseudomonas aeruginosa</p> Signup and view all the answers

    What might a patient with diminished hearing, tinnitus, and episodes of vertigo likely be experiencing?

    <p>Menieres disease</p> Signup and view all the answers

    Which of the following findings indicates a diagnosis of otitis media with effusion?

    <p>Fluid in the middle ear without infection</p> Signup and view all the answers

    What is the most typical management technique to assess tympanic membrane mobility in otitis media?

    <p>Tympanometry</p> Signup and view all the answers

    What characterizes the tympanic membrane in a patient with acute otitis media?

    <p>Bulging and erythematous</p> Signup and view all the answers

    Which viral infection is not associated with an increased incidence of Bell's Palsy?

    <p>Marburg virus</p> Signup and view all the answers

    What is a definitive diagnostic test for Bell's Palsy?

    <p>No definitive test exists; diagnosis is based on exclusion</p> Signup and view all the answers

    Which symptom is characteristic of Bell's Palsy?

    <p>Unilateral paralysis of the face</p> Signup and view all the answers

    What factor may correlate with the clinical appearance of Bell's Palsy?

    <p>Periods of stress</p> Signup and view all the answers

    Which of the following is a common management strategy for Bell's Palsy?

    <p>Use of steroids to decrease inflammation</p> Signup and view all the answers

    What is the typical timeframe for resolution of Bell's Palsy symptoms?

    <p>4-6 weeks with complete resolution in 6 months</p> Signup and view all the answers

    What is the distinguishing feature of Bell's Palsy compared to a stroke?

    <p>Inability to smile or raise eyebrows</p> Signup and view all the answers

    Which lab test might be considered if there is a history of tick exposure in a suspected case of Bell's Palsy?

    <p>Lyme titer</p> Signup and view all the answers

    What is a distinguishing feature of conductive hearing loss during the Weber test?

    <p>Lateralization to the bad ear</p> Signup and view all the answers

    Which type of hearing loss is likely to be caused by aging of the cochlea?

    <p>Presbycusis</p> Signup and view all the answers

    What is true regarding the Rinne test in cases of conductive hearing loss?

    <p>Bone conduction is greater than air conduction</p> Signup and view all the answers

    Which condition is NOT typically associated with gradual hearing loss?

    <p>Acute Otitis Media</p> Signup and view all the answers

    In which scenario is an otolaryngology referral warranted?

    <p>Suspected congenital hearing loss</p> Signup and view all the answers

    Which of the following is a possible consequence of using ototoxic drugs?

    <p>Sensorineural hearing loss</p> Signup and view all the answers

    What outcome is seen in the Rinne test for a patient with sensorineural hearing loss?

    <p>Air conduction &gt; Bone conduction</p> Signup and view all the answers

    Which disorder is linked with fluctuating hearing loss?

    <p>Meniere’s disease</p> Signup and view all the answers

    What is the first-line treatment for a patient diagnosed with Meniere's disease?

    <p>Lifestyle modification including salt restriction</p> Signup and view all the answers

    Which medication is indicated for first-line therapy in a patient with acute otitis media?

    <p>Amoxicillin-Clavulanate (Augmentin)</p> Signup and view all the answers

    In a patient presenting with unilateral ear pain and decreased hearing after a respiratory infection, what finding is typically observed in an otoscopic exam?

    <p>Bulging tympanic membrane with reduced mobility</p> Signup and view all the answers

    Which symptom is characteristic of Meniere's disease?

    <p>Episodes of vertigo lasting from 20 minutes to 12 hours</p> Signup and view all the answers

    What diagnostic finding would support a diagnosis of acute otitis media?

    <p>A red, bulging tympanic membrane with opacity</p> Signup and view all the answers

    What is a common characteristic symptom in a patient suffering from benign paroxysmal positional vertigo (BPPV)?

    <p>Severe dizziness triggered by specific head movements</p> Signup and view all the answers

    In assessing a patient with dizziness, what physical examination test can indicate vestibular dysfunction?

    <p>Romberg test</p> Signup and view all the answers

    Which of the following conditions is least likely to be associated with sensorineural hearing loss?

    <p>Chronic otitis media</p> Signup and view all the answers

    What is a common clinical symptom associated with cholesteatoma?

    <p>Foul-smelling ear discharge</p> Signup and view all the answers

    Which diagnostic tools are commonly used to evaluate cholesteatoma?

    <p>CT scan and audiogram</p> Signup and view all the answers

    What is a first-line treatment option for managing vertigo symptoms?

    <p>Meclizine (Antivert)</p> Signup and view all the answers

    Which of the following symptoms is NOT typically associated with vertigo?

    <p>Foul-smelling discharge</p> Signup and view all the answers

    Which condition can lead to damage of cranial nerve VIII, contributing to the development of vertigo?

    <p>Labyrinthitis</p> Signup and view all the answers

    What should be monitored in patients experiencing episodes of severe vertigo?

    <p>Fall risk</p> Signup and view all the answers

    Which dietary adjustment may be recommended if Meniere's disease is suspected in a patient with vertigo?

    <p>Low salt diet</p> Signup and view all the answers

    Which of the following findings is characteristic of vertigo during a clinical exam?

    <p>Positive Romberg sign</p> Signup and view all the answers

    What is a common treatment for impacted cerumen?

    <p>Irrigation with body temperature water and hydrogen peroxide</p> Signup and view all the answers

    Which symptom is characteristic of otitis externa?

    <p>Pruritus and discharge alongside hearing loss within 48 hours</p> Signup and view all the answers

    What commonly leads to otitis media with effusion?

    <p>Eustachian tube dysfunction following a cold</p> Signup and view all the answers

    Which topical antibiotics are recommended for treating otitis externa?

    <p>Ofloxacin or Ciprofloxacin</p> Signup and view all the answers

    What type of otitis media is associated with discharge but may be painless?

    <p>Chronic otitis media</p> Signup and view all the answers

    What is the primary treatment approach for labyrinthitis?

    <p>Systemic antibiotics and psychosocial support</p> Signup and view all the answers

    In cases of vestibular neuritis, which symptom is characteristic?

    <p>Sudden onset vertigo and nausea following head movement</p> Signup and view all the answers

    What is a significant risk factor for developing Meniere's disease?

    <p>History of middle ear infections or trauma</p> Signup and view all the answers

    Which finding would likely be observed in a Rinne test when an individual has conductive hearing loss?

    <p>BC &gt; AC</p> Signup and view all the answers

    What is a common complication of labyrinthitis?

    <p>Meningitis</p> Signup and view all the answers

    What dietary restriction is often recommended for patients with Meniere's disease?

    <p>Low salt intake</p> Signup and view all the answers

    Which statement best describes the auditory function in vestibular neuritis?

    <p>Hearing remains intact despite severe vertigo</p> Signup and view all the answers

    What would likely be the expected result on a Weber test for a patient with conductive hearing loss?

    <p>Lateralization to the affected ear</p> Signup and view all the answers

    Which of the following findings indicates conductive hearing loss in a Rinne test?

    <p>Bone conduction greater than air conduction</p> Signup and view all the answers

    What clinical finding is typically associated with acute otitis media?

    <p>A bulging, erythematous tympanic membrane</p> Signup and view all the answers

    Which bacterial pathogen is commonly associated with otitis externa?

    <p>Pseudomonas aeruginosa</p> Signup and view all the answers

    Which of the following is NOT typically considered an objective finding in suppurative otitis media?

    <p>Visualization of tympanic membrane mobility via tympanogram</p> Signup and view all the answers

    Which symptom is commonly associated with acute otitis media?

    <p>Otalgia</p> Signup and view all the answers

    What finding would likely suggest a patient has acute otitis media?

    <p>A bulging tympanic membrane with reduced mobility</p> Signup and view all the answers

    In patients with a bulging, erythematous tympanic membrane, which diagnosis is most likely?

    <p>Acute otitis media</p> Signup and view all the answers

    What characteristic is typical for the sound lateralization observed in the Weber test for conductive hearing loss?

    <p>Sound lateralizes to the affected ear</p> Signup and view all the answers

    What is a characteristic finding in a patient with acute otitis media (AOM)?

    <p>Red, dull, bulging tympanic membrane with amber fluid</p> Signup and view all the answers

    Which symptom is often associated with tympanic membrane rupture?

    <p>Severe ear pain with sudden relief</p> Signup and view all the answers

    When managing otitis media with effusion, which hallmark finding would most likely be observed?

    <p>Retracted, opaque tympanic membrane with yellow fluid</p> Signup and view all the answers

    Which infectious agent is commonly associated with acute otitis media?

    <p>Streptococcus pneumoniae</p> Signup and view all the answers

    What condition might a patient with conductive hearing loss experience during an episode of AOM?

    <p>Muffled hearing and bulging tympanic membrane</p> Signup and view all the answers

    What finding would be expected in a Rinne test for a patient with conductive hearing loss?

    <p>Bone conduction lasts longer than air conduction</p> Signup and view all the answers

    Which condition is associated with sensorineural hearing loss due to damage to the cochlea?

    <p>Meniere's disease</p> Signup and view all the answers

    In patients with presbycusis, which factors can contribute to the progression of hearing loss?

    <p>Hypertension, smoking, and noise trauma</p> Signup and view all the answers

    Which condition is characterized by effusion or fluid in the middle ear?

    <p>Serous Otitis Media</p> Signup and view all the answers

    What would a Weber test reveal in a patient with conductive hearing loss?

    <p>Lateralization to the bad ear</p> Signup and view all the answers

    Which of the following is a common cause of gradual hearing loss?

    <p>Otosclerosis</p> Signup and view all the answers

    What is a typical management option for a patient with cerumen impaction leading to conductive hearing loss?

    <p>Removal of the impaction</p> Signup and view all the answers

    Which type of hearing loss is commonly linked to aging processes such as presbycusis?

    <p>Sensorineural hearing loss</p> Signup and view all the answers

    What is the likely treatment regimen for a patient with severe Acute Otitis Media?

    <p>500 mg q 8hrs</p> Signup and view all the answers

    What is a common indicator for requesting an ENT referral in a patient with recurrent Acute Otitis Media?

    <p>3-4 infections in 6 months</p> Signup and view all the answers

    Which of the following is a subjective symptom associated with mastoid process disease?

    <p>Tenderness over mastoid bone</p> Signup and view all the answers

    In cases of tinnitus, what is an effective treatment approach?

    <p>Background sounds and noise makers</p> Signup and view all the answers

    Which condition is characterized by sudden onset unilateral facial paralysis or weakness?

    <p>Bell's palsy</p> Signup and view all the answers

    What distinguishes conductive hearing loss from sensorineural hearing loss?

    <p>Impairment in air conduction</p> Signup and view all the answers

    What is often the most common cause of conductive hearing loss?

    <p>Otitis media with effusion</p> Signup and view all the answers

    Which of the following signs might indicate meningitis when observed in a patient presenting with headache?

    <p>Stiff neck</p> Signup and view all the answers

    What is a likely predisposing factor for Bell's Palsy?

    <p>History of viral infections</p> Signup and view all the answers

    Which symptom is NOT commonly associated with Bell's Palsy?

    <p>Persistent coughing</p> Signup and view all the answers

    What is the typical duration for the resolution of Bell's Palsy symptoms?

    <p>4-6 weeks</p> Signup and view all the answers

    Which diagnostic test is not typically required for Bell's Palsy?

    <p>Lumbar puncture</p> Signup and view all the answers

    What is the recommended treatment to decrease inflammation for Bell's Palsy?

    <p>Steroids</p> Signup and view all the answers

    Which condition can be confused with Bell's Palsy due to similar facial paralysis symptoms?

    <p>Stroke</p> Signup and view all the answers

    What type of reflex is abnormal in 100% of Bell's Palsy cases?

    <p>Corneal reflex</p> Signup and view all the answers

    Which of the following viruses is associated with an increased incidence of Bell's Palsy?

    <p>Herpes Simplex</p> Signup and view all the answers

    What is the first-line treatment for Meniere’s disease based on the symptoms presented?

    <p>Lifestyle modification including salt restriction</p> Signup and view all the answers

    What condition is most likely indicated by a positive Romberg test along with severe dizziness and instability?

    <p>Meniere’s disease</p> Signup and view all the answers

    Which antibiotic is indicated for first-line therapy in a patient with acute otitis media and no penicillin allergy?

    <p>Amoxicillin-Clavulanate (Augmentin)</p> Signup and view all the answers

    What symptom is NOT typically experienced by patients with Meniere’s disease?

    <p>Unilateral ear pain</p> Signup and view all the answers

    Which characteristic is associated with cholesteatoma?

    <p>Cauliflower-like growth and foul-smelling ear discharge</p> Signup and view all the answers

    In a case of acute otitis media, which examination finding is most likely present?

    <p>Bulging tympanic membrane</p> Signup and view all the answers

    What is a common symptom of severe vertigo?

    <p>Nausea and vomiting</p> Signup and view all the answers

    Which lifestyle modification may help manage symptoms of Meniere’s disease?

    <p>Restricting salt intake</p> Signup and view all the answers

    Which of the following is least likely to be recommended for treating a patient with proven acute otitis media?

    <p>Surgical intervention</p> Signup and view all the answers

    What treatment approach is typically employed for cholesteatoma?

    <p>Surgical debridement and antibiotic therapy</p> Signup and view all the answers

    Which factor is NOT a commonly associated etiology of vertigo?

    <p>Psychogenic disorders</p> Signup and view all the answers

    Which symptom distinguishes benign paroxysmal positional vertigo (BPPV) from Meniere's disease?

    <p>Position-dependent dizziness</p> Signup and view all the answers

    What is an important consideration in the management of Meniere's disease-related vertigo?

    <p>Diuretics and low salt diet</p> Signup and view all the answers

    Which diagnostic tool is commonly used in the evaluation of cholesteatoma?

    <p>CT scan</p> Signup and view all the answers

    Which symptom is frequently reported by patients experiencing vertigo?

    <p>Light-headedness or faint feeling</p> Signup and view all the answers

    Which type of hearing loss is typically not associated with vertigo?

    <p>Transient hearing loss from loud noises</p> Signup and view all the answers

    Study Notes

    Conductive Hearing Loss

    • Caused by any obstruction of sound waves, resulting in lateralization to the affected ear.
    • Outer ear: Cerumen (earwax) build-up, or otitis externa (infection), foreign bodies in the external auditory canal.
    • Middle ear: Otitis media (fluid in the middle ear), serous otitis media (fluid-filled), perforation of the tympanic membrane (TM), otosclerosis, tumors, impacted cerumen, impacted or obstructions of the eustachian tubes, obstruction of the external auditory canal.

    Sensorineural Hearing Loss

    • Caused by damage or aging of the inner ear (cochlea/vestibule), leading to lateralization to the unaffected (good) ear.
    • Presbycusis (aging of the inner ear).
    • Meniere's disease.
    • Ototoxic drugs (aminoglycosides, erythromycin, tetracycline, high-dose aspirin).
    • Noise-induced hearing loss.
    • Acoustic neuroma.
    • Damage from head trauma.

    Weber Test

    • Place the tuning fork on the forehead.
    • Normal: No lateralization (sound heard equally in both ears).
    • Conductive loss: Sound lateralizes to the bad ear.
    • Sensorineural loss: Sound lateralizes to the good ear.

    Rinne Test

    • Place the tuning fork on the mastoid process, then in front of the ear.
    • Normal: Air conduction (AC) lasts longer than bone conduction (BC).
    • Conductive loss: Bone conduction (BC) lasts longer than air conduction (AC).
    • Sensorineural loss: Air conduction (AC) lasts longer than bone conduction (BC).

    Gradual Hearing Loss Causes

    • Cholesteatoma
    • Chronic renal failure
    • Chronic otitis media
    • Diabetes
    • Hypothyroidism
    • Noise exposure
    • Otosclerosis
    • Presbycusis
    • Retrocochlear neoplasm
    • Tumors

    Fluctuating Hearing Loss Causes

    • Autoimmune disorders
    • Meniere's disease
    • Migraine headaches
    • Multiple sclerosis
    • Otitis media perilymphatic fistula
    • Sarcoidosis
    • Syphilis
    • Temporal bone disorders
    • Trauma

    Cerumen (Earwax)

    • Most common cause of impacted ear canal.
    • Irrigate with body temperature water and hydrogen peroxide for impacted cerumen.
    • Carefully remove cerumen.

    Otitis Externa (Swimmer's Ear)

    • Painful inflammation of the outer ear canal and auricle.
    • Itching, discharge, hearing loss (within 48 hours).
    • Commonly affects young adults.
    • Otoscopy shows edematous and erythematous external ear canal.
    • Pain with palpation of the tragus or repositioning the auricle.

    Otitis Media

    • Infectious process within the middle ear.
    • May be acute or chronic.
    • Suppurative (pus-filled) or serous (fluid-filled).
    • Often caused by bacteria (e.g., Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis).
    • Can be caused by viral or other underlying factors.
    • Otitis media with effusion (OME): fluid in the middle ear without active infection.

    Etiology of Chronic and Acute Otitis Media

    • Chronic OM: Usually painless, always with discharge. Surgical intervention (myringotomy) may be warranted.
    • Acute OM: Eustachian tube dysfunction (or congestion) prevents middle ear drainage.
    • Hearing loss, ear pain, headache, fullness, foul drainage, bulging of the TM (with recent viral illness or allergies).
    • Infectious agents (typically respiratory bacteria): Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Pseudomonas aeruginosa..

    Otitis Media with Effusion (OME)

    • Fluid in the middle ear without infection.
    • Tympanic membrane is often retracted, fluid is yellow or opaque.
    • Can occur after a viral upper respiratory infection (URI).

    Treatment of Otitis Media (and other ear issues)

    • Antibiotics (for some cases, see notes on Otitis Media Considerations)
    • Analgesics (pain relievers)
    • Medical advice for follow up and referral (important for all ear issues)
    • If perforation occurs: Cortisporin otic drops
    • Refer to ENT (for recurring infections or specific conditions)

    Acute Facial Paralysis (Bell's Palsy)

    • Sudden onset of unilateral facial paralysis or weakness.
    • Generally self-limiting, resolving within weeks.
    • Idiopathic (unknown cause), but may be related to viral infection, inflammation of facial nerve (CN VII), or stress.
    • Symptoms and other issues listed in orginal notes

    Diagnostic Testing for Hearing Loss and Facial Paralysis

    • Diagnostic testing is often non-specific.
    • A lumbar puncture (spinal tap) may/may not be needed.
    • Consider other tests listed in orginal notes.
    • Audiological testing; audiogram, etc.

    Eye Care and other issues for Facial Paralysis

    • Artificial tears (PRN - as needed).
    • Taping eyelids closed.
    • Consult a physical therapist for exercise and stimulation.
    • Steroids to reduce inflammation around CN VII (facial nerve).
    • Early regimen of Medrol Dosepak, when appropriate, and explain the self-limiting nature of the disorder.

    Cholesteatoma

    • Cauliflower-like, foul-smelling growth.
    • Destruction of tympanic membrane due to chronic otitis media.
    • The mass is not cancerous, but can erode bone and damage the facial nerve (CN VII).
    • Treat with antibiotics, surgical debridement (removing debris), and preventing further water entry.
    • Secondary acquired cholesteatoma: results from a prior ear infection or trauma.

    Disequilibrium

    • An off-balance or lightheaded feeling without movement, often associated with nausea, and sometimes with vomiting.
    • Underlying factors listed in orginal notes.

    Hearing Loss Considerations

    • Symptoms listed in orginal notes.
    • Causes: fluid in middle ear, CNS disorders, damage to inner ear (infection, barotrauma, trauma), and related to other diagnoses (e.g., Meniere's disease), and tumors (acoustic neuroma).
    • Treatment: symptomatic care, medication reconciliation, vestibular exercises, vestibular suppressants, low-salt diet with diuretics when suspected, and specific medical advice by a professional, etc.

    Acute Otitis Externa (OE)

    • Symptoms often include ear pain (otalgia) with itching, discharge; and hearing loss within 48 hrs.
    • Underlying causes listed in orginal notes.
    • Treatments listed in orginal notes.

    Otitis Media Considerations

    • The patient's condition, symptoms, and response to treatment listed in original notes.

    Treatments for specific ear issues (e.g., otitis media, vestibular issues)

    • Specific medical advice by a professional.
    • Supportive therapies (comfort and recovery).
    • Referrals, when/if warranted.
    • Other treatments listed in orginal notes.

    Other Hearing Loss and Inner Ear Issues

    • Causes, treatments, and considerations listed in original notes.

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    Description

    Test your knowledge on the diagnosis and treatment of hearing loss and related conditions in otology. This quiz covers topics such as acute otitis media, conductive and sensorineural hearing loss, and the use of audiometry. Perfect for medical students and healthcare professionals specializing in ENT.

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