Ent Review- Otology And Neurotology Set 2!

Front 1

AR causes of syndromic hearing loss?

Most common?
Type of hearing loss?

Back 1

PJUG
Pendred
JLN
Usher* (MC)
Goldenhar

All SNHL, Goldenhar BOTH

Front 2

Features of Golenhar
- EAR features
- Others

Back 2

- Abnormal auricle/atresis
- CHL (ossicles)
- SNHL (oval window)

Ocular- upper lid coloboma (Vs. TC with lower lid coloboma)
Hemifacial microsomia

Front 3

AD caused of syndromic

Back 3

"What The Balls, Syndromes Are Not Cool"
- Wardenberg
- Treacher Collins
- BOR
- Stickler
- Apert
- NF1and3
- Crouzon

Front 4

Progressive SNHL
ocular problems
marfanoid habitus
PRS

Gene?

Back 4

Stickler

COL2A1 (type 1)

Front 5

Auricular deformities, atresia
malformed ossicles (CHL)
Mondinia association
slanting palpebral fissures

Coloboma location?

Gene?

Back 5

TCS

Lower eyelid

TCOF gene

Front 6

Features of Waardenburg Syndrome?

Back 6

- Pigment/Hair issues
- Heterochromia iritis
- white forelock
- synophrys (unibrow)
-CF
- dystopia canhtorum
(wide canthi, telecanthus)

Front 7

Brachio-Oto-Renal
- Findings?
- Hearing?
- Association
- Gene

Back 7

- Ear pits, renal abnormalities
- Mixed/SNHL
- Mondini
- EYA1

Front 8

Syndactyly
Midface abnormalities
Trapezoid mouth

Hearing problem?
Gene?

Back 8

Apert syndrome

Syndactyly = Lobster claw

-Stapes fixation --> CHL
-FGFR2

Front 9

Cranial abnormalities
-small maxilla
- parrot nose
- prognathism
- hypertelorism

Hearing loss?
Gene?

Back 9

Crouzon

- Atresisa and EAC stenosis (Bone issue) --> CHL

- FGFR

Front 10

NF1
- Mutation location
- Risk of schwannoma
- Features

Back 10

- Chromosome 17
- 5% risk fo UNILATERAL
- Features: Cafe-au-let spots, lisch nodules (hamartomas of eye), NF

Front 11

NF 2
- Chromosome location
- Risk of schwanomma

Back 11

- Chromosome 22
- 95% risk of BILATERAL AN <21 years old

Front 12

3 common X-linked Cuases of hearing loss

Back 12

1) X linked stapes gusher
- POU3F4 gene
- congenital stapes fixation
2) Alport
- Type IV collagen gene
- Progressive renal disease and SNHL
3) Otopalatal digital syndrome
- CHL- ossicular issues

Front 13

Pneumonic for syndromes with CHL

Back 13

"GOT Abnormal Conduction"
Goldenhar
Otopalatodigital
TC
Apert
Crouzon

Front 14

Aural atresisa
% syndromic
% bilateral

Back 14

10% syndromic
30% bilateral

Front 15

3 Grades of microtia

Back 15

1) Auricle slightly small but all subunits present (lop or cup)
2) Aurilce half size, all strutures present, deficient tissue
3) Peanut ear

Front 16

2 syndromes associted with renal problems and SNHL

Back 16

BOR and Alport

Front 17

Vestibular definitions
1) occular dysmetria
2) Sinusoidal-Tracking tests

Back 17

1) During Saccad testing --> overshoot or undershoot (CNS)
2) Following a spot- failure to keep up at low velocity = CNS

Front 18

Directinal preponderance
How?
Abnormal?

Back 18

Compares All left directional beating nystagmus from both sides vs. All right beating nystagmus

- >20-25% = unilateral weakness

Front 19

Unilateral weakness
How?
Abnormal?

Back 19

Compares stimulation (right and left beating nystagmus) from one side with the other side

- >20-25% = Unilateral peripheral weakness

Front 20

Bilateral weakness on caloric testing?

Back 20

total caloric maximum slow phas velocity rom each ear is <12-24 degrees/second

Front 21

Rotational Chair (RT)
Indications?

Back 21

Bilateral vestibular dysnfunction or mild vestibular dysfucntion missed on ENG

Front 22

RT defintions
1) Gain
2) Phase
3) Symetry

Back 22

1) Ratio of slow eye phase velocit to chair velocity (normal =1)
2) compares max eye velocity response with max chair velocity. Normal = phase lead
3) Compares sides

Front 23

Findings in Unilateral weakness

Back 23

1) Normal Gain
2) Increased phase angle (higher positive number) at low frequency = INCREASED PHASE LEAD
3) High frequency asymetry

Front 24

RT findings
Bilateral vesitbular disease

Back 24

1) Reduced gain at low Hz, normal at high Hz
2) Normal phase
3) No asymetry

Front 25

Facial nerve injury during Mastoidectomy:
1) No injury seen--> face out at wakeup
2) Minor Injury
3) Sever injury definition? What to do?

Back 25

1) Wait for lido to wear off
2) Expose 5-10 mm above and below and observe/test electrically
3) >50% damage --> re-anastomsis vs. cable graft

Front 26

Pathway for acoustic reflex

Back 26

IPSY acoustic nerve --> IPSY cochlear nucleus --> med. superior olive (bilateral) --> Facial motor nucleus (Bilateral) --> facial nerve (Bilateral) --> Stapedius tendon (Bilateral)

Front 27

Most common facial nerve injury with:
1) Tmastoid
2) Exostosis surgery

Back 27

1) Tympanic seg
2) Mastoid seg

Front 28

What is auditory acoustic transduction?

Back 28

Transmission of mechanical energy to electrical energy

Front 29

What does detectable OAE mean in infants

Back 29

hearing loss could not be worse than 40 dB

Front 30

Patient with bilateral facial paralysis and rash?

Back 30

Lymes diseae, treat with abx

Front 31

Pediatric Matoiditis
When to perform mastoidectomy?

Back 31

Coalesence on CT or failed initial therapy

Front 32

Largest and most consistent part of pediatric ABR?
Correllation?

Back 32

Wave V

Correlates well with PTA

Front 33

Most common cause of pediatric facial palsey?
Recovery/

Back 33

Bell's
96%

Front 34

Syndromic Autosomal Dominant hearing loss?

Back 34

"What The Balls, Syndromes Are Not Cool"
W-aardenberg
T-C
B-OR

S-Stickler
A-Apert
N-F
C-rouzon

Front 35

Syndromic Causes of conductive HL

Back 35

"GOT Abnormal Conduction"
G-oldenhaar
O-topalatal digital
T-C

A-perts
C-rouzon

Front 36

Syndromic AR hearing loss

Back 36

PJUG
P-endred
J-LN
U-sher
G-oldenhar

Front 37

Definition of EVA

Back 37

1.5 mm in size- midway between operculum and common crus

Front 38

Where is carhart's notch dip

Back 38

2000 hz

Front 39

1) Peditaric CMV infection
Urine findings
% symptomatic --> Sx


2) Risk of hearing loss %
-Symptomatic
-Asymptomatic

Back 39

1) "Owl-eye" bodies in urine
- 1-2% with CM inclusion disease: Anemia, HSM, jaundice, petechia, microcephaly, IUGR, MR, occular problems

2) -symp --> 30-40% bilateral SNHL
- Asymp --> 10-15%

Front 40

Screening for early otoxicity

Back 40

High Hz audiogram

Front 41

Findings when doing a CI in severe dysplasia

Back 41

Aberrant facial nerve
CSF Gusher (40%)

Front 42

Why scala tympani for CI

Back 42

Closer ot spiral ganglion

Front 43

When to use Bondy?

Back 43

Large primary aquired cholestatoma W/O Middle ear or OCR involvment

Front 44

Where would you see a high riding jugular bulb in middle ear

Back 44

Posterior inferior

Front 45

What post-natal finding is associated wtih auditory neuropathy

Back 45

hyperbilirubinemia

Front 46

Jacobson's Nerve stimulation-->

Back 46

LSPN --> Otic ganglion --> paroitd --> Parotid secretion

GSPN --> Vidian --> Lacrimal

Front 47

Traumatic injury to TM with Q-Tip with vertigo and hearing loss? Most likely injury

Back 47

Stapes fracture/dislocation

Front 48

When do you worry about autoimmune inner ear disease?

What test do you order, what does it predict?

Back 48

SNHL is bilateral and rapidly progressive

68 kd protein antibiody (89%), it indicates response to steroids

Front 49

Describe sinus tympani location

Back 49

Located between the labyrinthine wall and the pyrimidal eminence

Front 50

Suboccipital/Retrosig approach
- How common is CSF leak?
- Most likely egress point?

Back 50

- 5-15%
- Retrolabyrinthine air cells

Front 51

Most common signs of facial neuroma

Back 51

Facial weakness > facial twitching

Front 52

MC reason for CHL late after Stapes

Back 52

Displaced prosthesis > Incus erosion

Front 53

What does nerve stimulation at 0.15 (low setting) in OR indicate

Back 53

HB 1-2

Front 54

Most important prognostic factor in Bell's

Good prognostic factors for Recovery

Back 54

- Incomplete vs. Complete

- Acute onset
- partial paralysis
- early return

Front 55

Most important factor in TM success?

Back 55

ET function

Front 56

Location of abnormal pathology in Alport's

Back 56

Basement membrane (Ear and Kidney)

Front 57

MC primary facial nerve lesion

Back 57

hemangioma

Front 58

Benefits of Bilateral CI

Back 58

1) Head shadow effect
2) Improved heearin in noise

Front 59

Two most important features of good CWD mastoid

Back 59

1) Good meatoplasty
2) Facial ridge taken down

Front 60

MC cmoplication after tympanostomy tube placement

Back 60

Otorrhea

Front 61

Location of congenital cholesteatoma

Back 61

Anterior superior

Front 62

Diference in nerve fibers involving Schwannoma vs. Neurofibroma

Back 62

Schwannoma push fibers away, Neurofibromas are directly invovled with fibers

Front 63

Bell's in pregnany
- When can you give steroids
- When acyclovir

Back 63

- Steroids in 3rd trimester only
- Acyclovir Any time

Front 64

FDA approval for brainstem implants?

Back 64

NF type 2

Front 65

Effects of antibioitc drops placed during BMT

Back 65

Decreased ottorhea and improved patency

Front 66

Treatment of Tuberculosis Mastoiditis?

When to operate?

Back 66

- INH, Rifampin & Streptomycin

- Fail Medical therapy or present with otologic complications

Front 67

Procedure for labrynthine fistula

Back 67

CWD Mastoid

Front 68

Complications of Gentamycin

Back 68

#1 Tinnitus
Imbalance

Front 69

When is external ear developed

When is otic capsule developed

Back 69

6-8 weeks

12 weeks

Front 70

Who has greater heaing loss

Ossicular discontinuity with TM intact?
Ossicular discontinuity with TM perf?

Back 70

OC with intact TM

Front 71

Most common pediatric T-Bone malignancy

Back 71

Rhabdo

Front 72

Best CT view of IS joint

Back 72

Axial CT scan

Front 73

Indications for CWD

Back 73

1) Only hearing ear
2) Lateral SSC fistula
3) Tigh mastoid
4) Eroded posterior canal wall

Front 74

What travels through?
- Petrotympanic fissure
- Inferior tympanic canaliculus
- Iter chorda anterior

Back 74

- chorda tympani (EXIT)
- Jacobson nerve (ENTER)
- Chorda tympani (EXIT)

Front 75

Most common facial nerve segemen affected by Bell's

Back 75

Meatal

Front 76

MRI findings with neurosyphilis

Back 76

Meningeal enhancement

Front 77

Vertebrobasilar Insufficiency

Back 77

- AICA or PICA
- vertigo, hemiparesis, N/V
- Neck motion --> Drop attack

Front 78

Labyrinthine Apoplexy

Back 78

- AICA
- Sudden vertigo, loss of vestibular function

Front 79

What surgery is indicated for drop attacks

Back 79

Vestibular nerve section