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53 Cards in this Set

  • Front
  • Back
What is the function of the eustachian tube?
protecting, regulating, & clearing the middle ear from nasopharyngeal secretions
What is the temporal mandibular joint dysfunction?
• inflammation of the jaw joint that may present as an earache or headache
• cycle of inflammation that causes referred pain to the ear and head
What are symptoms of TMJ dysfunction?
• Ear pain
• Frequent head/neck aches
• Jaw popping/ clicking
• Locking of the jaw Temple/cheek pain
• Trismus
What is the treatment for TMJ dysfunction?
breaking the cycle by:
• Mild muscle relaxants
• Decreased mastication – avoid gum chewing.
• Warm compress to jaw joint
• Relaxation and stress reduction
What is the MCC of an infected pre-auriclar sinus tract?
• S. aureus
• Tx: Keflex or Omnicef
What is the perichondritis?
a painful erythematous inflammation of the pinna not usually associated with trauma but infection of the cartilage.
What is the MCC of perichondritis? What is the treatment?
• pseudomonas
• Tx: cephalosporins or quinolone
What is cauliflower ear?
hematoma associated with trauma
What is the MCC of cauliflower ear (hematoma)?
• S. aureus (most common)
• pseudomonas
• TX: irrigation/drainage, Cephalosporin or Quinolone
What is polychondritis?
• rare episodic & progressive multi-system inflammatory rheumatic disease
• involves all types of cartilage/connective tissue
• affects ears, nose, larynx, trachea, bronchi, & joints
What is the treatment for polychondritis?
• drainage
• medical treatment
- prednisone
- methotrexate
What is a keloid?
hypertrophic scarring
What is the MCC of keloids? What is the treatment?
• MCC is trauma
• TX: steroid injection, surgery
What is the MCC of cerumen impaction? What is the treatment?
• MCC is Q-tip use
• Tx: cerumolytics (ex. debrox)
What is an osteoma?
• a white, hard, slow growing solitary benign lesion of the bony cranial wall
• asymptomatic and not associated with hearing loss
What is an exostoses?
multiple osteomas
What is malignant otitis externa?
• a severe but rare form of otitis externa
• seen mostly in elderly diabetics
• granulation tissue and infection may spread to middle and inner ear and affect the brain
What is the treatment for malignant otitis externa?
• quinolone
• ototopical steroidal drops
• otowick
What are bacterial causes of otitis externa?
• Pseudomonas
• S. aureus
• Proteus, Klebsiella, E. coli
What are fungal causes of otitis externa?
• aspergillus (90%)
• Candida
Upon otoscopic examination, you see exudate and black mycelia, which suggests what etiology?
Aspergillus niger
Upon otoscopic examination, you see white, cotton-like material with small black tufts. These findings suggest what etiology?
mixed topical fungal infection
What are treatment options for otitis externa?
• Aural toilet (microsuction, dry-mopping, or irrigation)
• Otowicks (should be removed after 2-3 days)
What precaution must be taken before irrigation?
tympanic membrane must be intact
When should oral antibiotics be used in the treatment of otitis externa?
• persistent otitis externa
• assocaited otitis media
• local or systemic spread has occured
• severe pain or regional lymphadenopathy is present
• signs of necrotizing otitis externa
• immuno-compromised patients (ex. HIV, diabetes)
What are different ototopical agents that can be used to treat otitis externa?
• 2% Acetic acid otic solution (VoSol)
• Polymyxin/neomycin hydrocoritsone solution (Cortisporin Otic Suspension)
• Ciprofloxacin/dexemethesone (Ciprodex Otic)
• Ofloxacin (Floxin Otic)
• Clotrimazole 1% (Lotrimin)
• M-cresyl acetate (Cresylate)
• Vinegar & alcohol
• Betamethasone dipropionate 0.5% (Diprolene)
• Mineral oil
Which ototopical agent is highly effective and has no risk of ototoxicity?
What is the most common surgical procedure performed in the US?
myringotomy with tympanostomy tube insertion
What are genetic risk factors for otitis media?
• ethnicity (ex. Native American, Native Alaskan, Caucasian)
• genoytpe
• male gender
• midface abnormalities (ex. Downs syndrome, Cleft palate)
What are environmental risk factors for otitis media?
• bottle-feeding
• exposure to second-hand smoke
• involvement in a daycare setting
• low socioeconomic status
Differentiate between otitis media with serous effusion and suppurative effusion
• serous effusion is a thin watery fluid behind the TM (usualy viral)
• suppurative effusion is a thick pus-like fluid behind TM
Name and describe the subcategories of otitis media
• acute otitis media (AOM): less than 3 weeks duration
• recurrent acute otitis media (RAOM): between 3 weeks and 3 months; clears between episodes w/ antibiotics
• chronic otitis media: greater than 3 months duration
What can cause a unilateral otitis media?
nasopharyngeal mass blocking Eustachian tube orifice
What is the causative agent of acute mastoiditis?
Streptococcal pneumonia
What is the treatment for acute mastoiditis?
• drainage (TT or mastoidectomy)
• antibiotics
What is chronic suppurative otitis media?
an infection of the middle ear characterized by a purulent discharge through a chronically perforated TM
What is the treatment for acute otitis media?
• Amoxicillin 45 mg/kg/day
• Amoxicillin/Clauvinate (Augmentin) 90 mg/kg/BID: used for high-risk patients
• Cefuroxime (Ceftin) 10 mg/kd/day
• Ceftriaxone 50 mg/kg IM/IV x 3
What are the top 5 indications for BMT?
• otitis media with effusion > 3 months

• hearing loss > 30 dB in patient w/ otitis media with effusion

• recurrent episodes of acute otitis media (> 3 episodes in 6 months or > 4 episodes in 12 months that do not respond well to antibiotics

• craniofacial anomalies that predispose to middle ear dysfunction

• chronic retraction of tympanic membrane or pars flaccida
When should tympanostomy tubes be removed?
• chronic infection
• granulation tissue that fails to respond to topical & systemic antibiotics
• if they have been in place longer than 3 years
What is tympanosclerosis?
• hardening of the ear drum
• appears as a chalky, white substance
• can be a long term sequela of chronic otitis media and PE tubes
What is a myringoplasty?
closing of the tympanic membrane
What is a cholesteatoma?
a skin cyst formed from long term retraction of the eardrum
What are different methods of audiometry testing for adults?
• air bone conduction
• speech discrimination
What are different methods of audiometry testing for children?
• play audiometry
• otoacoustic emissions & brainstem evoked response (both measure cochlear function)
What are causes of conductive hearing loss?
• cerumen impaction
• infection
• otosclerosis
What are causes of sensorinueral hearing loss?
• presbycusis
• congenital
• acoustic neuroma
• sudden deafness
• secondary to disease
Bilateral and symmetrical hearing loss with a slow onset typically found in older patients describes what type of hearing loss?
What differential must be considered in a patient presenting with unilateral sensorineural hearing loss that is gradual and progressive?
acoustic neuroma
What are some examples of infectious diseases that can cause hearing loss?
• Lyme disease
• Syphilis
Acute onset sudden deafness is a medical emergency characterized by tinnitus, ear pressure, & hearing loss w/o vertigo. What is the most common cause of sudden deafness?
What are the 4 "D"s of vertebrobasilar insufficiency?
• dizziness
• diplopia
• dysphagia
• dropattacks
What is the treatment for vertebrobasilar insufficiency?
antiplatelet medication
What is the treatment for Meniere's Syndrome (aka endolymphatic hydrops)?
• low salt diet
• diuretics
• increased hydration
• corticosteroids