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53 Cards in this Set
- Front
- Back
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What is the function of the eustachian tube?
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protecting, regulating, & clearing the middle ear from nasopharyngeal secretions
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What is the temporal mandibular joint dysfunction?
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• 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 |
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What are symptoms of TMJ dysfunction?
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• Ear pain
• Frequent head/neck aches • Jaw popping/ clicking • Locking of the jaw Temple/cheek pain • Trismus |
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What is the treatment for TMJ dysfunction?
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breaking the cycle by:
• NSAIDs • Mild muscle relaxants • Decreased mastication – avoid gum chewing. • Warm compress to jaw joint • Relaxation and stress reduction |
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What is the MCC of an infected pre-auriclar sinus tract?
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• S. aureus
• Tx: Keflex or Omnicef |
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What is the perichondritis?
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a painful erythematous inflammation of the pinna not usually associated with trauma but infection of the cartilage.
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What is the MCC of perichondritis? What is the treatment?
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• pseudomonas
• Tx: cephalosporins or quinolone |
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What is cauliflower ear?
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hematoma associated with trauma
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What is the MCC of cauliflower ear (hematoma)?
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• S. aureus (most common)
• pseudomonas • TX: irrigation/drainage, Cephalosporin or Quinolone |
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What is polychondritis?
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• rare episodic & progressive multi-system inflammatory rheumatic disease
• involves all types of cartilage/connective tissue • affects ears, nose, larynx, trachea, bronchi, & joints |
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What is the treatment for polychondritis?
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• drainage
• medical treatment - prednisone - methotrexate |
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What is a keloid?
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hypertrophic scarring
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What is the MCC of keloids? What is the treatment?
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• MCC is trauma
• TX: steroid injection, surgery |
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What is the MCC of cerumen impaction? What is the treatment?
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• MCC is Q-tip use
• Tx: cerumolytics (ex. debrox) |
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What is an osteoma?
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• a white, hard, slow growing solitary benign lesion of the bony cranial wall
• asymptomatic and not associated with hearing loss |
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What is an exostoses?
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multiple osteomas
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What is malignant otitis externa?
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• 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 |
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What is the treatment for malignant otitis externa?
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• quinolone
• ototopical steroidal drops • otowick |
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What are bacterial causes of otitis externa?
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• Pseudomonas
• S. aureus • Proteus, Klebsiella, E. coli |
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What are fungal causes of otitis externa?
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• aspergillus (90%)
• Candida |
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Upon otoscopic examination, you see exudate and black mycelia, which suggests what etiology?
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Aspergillus niger
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Upon otoscopic examination, you see white, cotton-like material with small black tufts. These findings suggest what etiology?
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mixed topical fungal infection
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What are treatment options for otitis externa?
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• NSAIDs
• Aural toilet (microsuction, dry-mopping, or irrigation) • Otowicks (should be removed after 2-3 days) |
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What precaution must be taken before irrigation?
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tympanic membrane must be intact
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When should oral antibiotics be used in the treatment of otitis externa?
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• 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) |
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What are different ototopical agents that can be used to treat otitis externa?
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• 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 |
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Which ototopical agent is highly effective and has no risk of ototoxicity?
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fluoroquinolones
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What is the most common surgical procedure performed in the US?
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myringotomy with tympanostomy tube insertion
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What are genetic risk factors for otitis media?
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• ethnicity (ex. Native American, Native Alaskan, Caucasian)
• genoytpe • male gender • midface abnormalities (ex. Downs syndrome, Cleft palate) |
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What are environmental risk factors for otitis media?
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• bottle-feeding
• exposure to second-hand smoke • involvement in a daycare setting • low socioeconomic status |
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Differentiate between otitis media with serous effusion and suppurative effusion
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• serous effusion is a thin watery fluid behind the TM (usualy viral)
• suppurative effusion is a thick pus-like fluid behind TM |
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Name and describe the subcategories of otitis media
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• 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 |
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What can cause a unilateral otitis media?
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nasopharyngeal mass blocking Eustachian tube orifice
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What is the causative agent of acute mastoiditis?
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Streptococcal pneumonia
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What is the treatment for acute mastoiditis?
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• drainage (TT or mastoidectomy)
• antibiotics |
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What is chronic suppurative otitis media?
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an infection of the middle ear characterized by a purulent discharge through a chronically perforated TM
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What is the treatment for acute otitis media?
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• 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 |
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What are the top 5 indications for BMT?
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• 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 |
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When should tympanostomy tubes be removed?
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• chronic infection
• granulation tissue that fails to respond to topical & systemic antibiotics • if they have been in place longer than 3 years |
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What is tympanosclerosis?
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• hardening of the ear drum
• appears as a chalky, white substance • can be a long term sequela of chronic otitis media and PE tubes |
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What is a myringoplasty?
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closing of the tympanic membrane
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What is a cholesteatoma?
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a skin cyst formed from long term retraction of the eardrum
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What are different methods of audiometry testing for adults?
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• air bone conduction
• speech discrimination |
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What are different methods of audiometry testing for children?
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• play audiometry
• otoacoustic emissions & brainstem evoked response (both measure cochlear function) |
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What are causes of conductive hearing loss?
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• cerumen impaction
• infection • otosclerosis |
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What are causes of sensorinueral hearing loss?
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• presbycusis
• congenital • acoustic neuroma • sudden deafness • secondary to disease |
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Bilateral and symmetrical hearing loss with a slow onset typically found in older patients describes what type of hearing loss?
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presbycusis
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What differential must be considered in a patient presenting with unilateral sensorineural hearing loss that is gradual and progressive?
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acoustic neuroma
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What are some examples of infectious diseases that can cause hearing loss?
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• Lyme disease
• Syphilis |
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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?
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viral
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What are the 4 "D"s of vertebrobasilar insufficiency?
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• dizziness
• diplopia • dysphagia • dropattacks |
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What is the treatment for vertebrobasilar insufficiency?
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antiplatelet medication
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What is the treatment for Meniere's Syndrome (aka endolymphatic hydrops)?
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• low salt diet
• diuretics • increased hydration • corticosteroids |
