Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
53 Cards in this Set
- Front
- Back
|
what condition would cause a tense sounding voice, vocal fatigue and prolonged close phase with reduced vibratory and mucosal wave amplitude during videostroboscopy
|
glottic hyperabduction dysphonia
|
|
|
what kind of dystonia is spasmodic dysphonia
|
focal
|
|
|
what are the characteristics of focal dystonia
|
inappropriate and excessive efferent activity of motor neurons in small areas
|
|
|
what are the two types of spasmodic dysphonia
|
adductor (more common)
abductor |
|
|
what SD is characterized by harsh, strained voice with inappropriate pitch breaks, breathiness, and glottal fry
|
Adductor SD
|
|
|
What are the typical features of abductor SD
|
breathy, effortful hypnotic voice with abnormal whispered segments of speech
|
|
|
the inability to sustain vowels during speech is suggestive of what disorder
|
adductor AD
|
|
|
voiceless consonant is suggestive of what
|
abductor SD
|
|
|
what percent of cases of SD are familial
|
12%
|
|
|
which muscles are responsible for adductor SD
|
thyroarytenoid
lateral cricoarytenoid |
|
|
which muscle is responsible for abductor SD
|
posterior cricoarytenoid
|
|
|
what is the preferred method of treatment for SD
|
chemical denervation with botulinum toxin
|
|
|
what are the two ways to deliver botox to the posterior cricoarytenoid
|
transcricoid
retrograde |
|
|
how can one confirm placement of needle in posterior cricoarytenoid
|
using EMG guidance, have the patient sniff
|
|
|
what can be done if symptoms persist after complete paralysis of the posterior cricoarytenoid
|
inject contralateral PCA with small increments of toxin or inject cricothyroid
|
|
|
how is injection into the cricothyroid muscle accomplished, how is proper placement confirmed
|
peroral route
confirmed by having pt sing with increase in EMG activity as pitch increases |
|
|
what are the adverse effects of PCA injection
|
stridor (particularly with exertion)
airway compromise dysphagia aspiration |
|
|
what is adductor laryngeal breathing dystonia have on the voice
|
none
|
|
|
what syndrome is associated with blepharospasm
|
Meige's syndrome
|
|
|
which muscles are involved in blepharospasm
|
orbicularis oculi
procerus corrugator supercilii |
|
|
what causes hemifacial spasm
|
a vascular loop most commonly anterior or posterior inferior cerebellar artery impinging on root of VII
|
|
|
what is the initial treatment for hemifacial spasm
|
baclofen
|
|
|
what is the procedure for choice for patients with hemifacial spasm
|
microvascular decompression
|
|
|
which muscles are injected when using botox to treat hemifacial spasm
|
zygomaticus major and minor
levator anguli oris risorius |
|
|
what muscles are injected when using botox to treat oromandibular dystonia
|
masseter
temporalis medial and lateral pterygoid muscles |
|
|
what percent of pts with unilateral tinnitus have retrocochlear pathology
|
11%
|
|
|
what is the most common cause of venous pulsatile tinnitus
|
idiopathic intracranial hypertension syndrome
(pseudomotor cerebri, benign intracranial hypertension) |
|
|
what is the most common cause of pulsatile tinnitus in young female patients
|
idiopathic intracranial hypertension
|
|
|
what are the five other venous etiologies of pulsatile tinnitus
|
-jugular bulb abnorm
-hydrocephalus associated stenosis of Sylvian aqueduct -increased intracranial pressure ass with Arnold-Chiari -abnormal condylar and mastoid emissary veins -idiopathic |
|
|
what is the treatment for IIH
|
weight reduction
acetazolamide furosemide lumbar-peritoneal shunt |
|
|
what is the definition of sudden sensorineural hearing loss
|
>20dB
3 contiguous frequencies within 3 days |
|
|
in what percent of cases of SSNHL is the cause determined
|
10%
|
|
|
what percent of SSNHL cases turn out to be vestibular schwannoma
|
4%
|
|
|
what are the two common theories on the etiology of idiopathic SSNHL
|
circulatory disturbance
inflammatory reaction |
|
|
what is the current standard of care for the workup and treatment of ISSNHL
|
otologic exam
audiogram rule-out retrocochlear pathology tx with steroids +/- antivirals, diuretics |
|
|
what laboratory studies are useful in workup of ISSNHL?
|
coagulation profile
viral studies ESR |
|
|
What is the prognosis of ISSNHL
|
overall recovery to functional hearing levels in 65%, no evidence there is improvement with medical treatment
|
|
|
when is spontaneous recovery of hearing more likely
|
if patient is without vestibular symptoms and suffers only partial hearing loss, particularly if low frequency
|
|
|
What treatments are used to try to optimize cochlear blood flow
|
vasodilators (histamine, papaverine, verapamil, CO2)
blood thinners (defibrinogenation, dextran, papaverine) |
|
|
WHat evidence supports the use of carbon dioxide for ISSNHL
|
Fisch et al, found inhalation therapy daily for 5d statistically significant improvement in hearing with carbogen therapy.
Findings not duplicated |
|
|
What is evidence that supports use of steroids for ISSNHL
|
randomized, prospective study
|
|
|
What evidence supports use of antivirals for ISSNHL
|
no randomized prospective study
|
|
|
What factors lead to the best rate of recovery after ISSNHL
|
pts treated with steroids and vasodilators
younger age |
|
|
when is middle ear exploration indicated for ISSNHL
|
if loss occurs in only hearing ear to rule out a fistula
|
|
|
what are the two types of bony growths in the EAC, which is more common
|
diffuse exostoses (more common)
osteomata |
|
|
Which EAC growth is at tympanosquamous suture line
|
osteomata
|
|
|
which EAC growth has male predilection
|
both
|
|
|
which EAC growth is more likely to be bilateral
|
exostoses
|
|
|
which EAC growth is more likely to be in surfers
|
exostoses
|
|
|
what are the indications for removal of exostoses
|
less than 1mm aperture
recurrent otitis externa water trapping |
|
|
what are the symptoms of patulous eustacian tube
|
aural fullness
autophony tympanophonia improves when head btwn legs onset after weight loss or irradiation to nasopharynx |
|
|
what is tympanophonia
|
audition of one's own breath sounds
|
|
|
what are some treatments for patulous eustacian tubes?
|
reassurance
weight gain SSKI premarin nasal spray occlusion of ET myringotomy and T-tube placement |
