Signs, Symptoms & RFs

Cards (22)

  • What is otalgia?
    Ear pain
  • What is otorrhoea?
    Discharging ear
  • What are the signs & symptoms of cholesteatoma?
    Gradual conductive hearing loss (due to damage to ossicles or obstruction of auditory tube)
    Persistent discharge from the ear (usually watery & smelly)
    Defect in TM full of white, cheesy material
    Some may experience slight ear pain
  • What are the risk factors for cholesteatoma?
    Male
    Hx of middle ear disease
    Trauma to ear (may introduce keratinocytes to middle ear)
    Auditory tube dysfunction (following otitis media or congenital abnormalities (cleft palate & Down syndrome))
  • What are the differential diagnosis of cholesteatoma?
    Otitis media w/effusion
    Otitis externa
    Tympanosclerosis
    Osteonecrosis of the external auditory canal
    Benign necrotising otitis externa
    Myringitis
  • What is tympanosclerosis?
    White appearance of fibrotic scarring of TM
    Commonly seen after grommet insertion, can give the impression of a cholesteatoma deeper within the middle ear
  • What is osteonecrosis of the external auditory canal?
    Rare complication of biphosphonate treatment
  • What is benign necrotising otitis externa suggested by?
    Severe otologia AND
    Hx of diabetes or immunosuppression
    On otoscopy, granulations in ear
  • What is myringitis?
    Inflammation of tympanic membrane (with or without granulations)
  • What are the signs & symptoms of otitis media with effusion?
    Dull TM w/loss of light reflex
    Fluid w/air bubbles visible in the middle ear
    Children can have adenoidal hypertrophy & nasal blockage
    Aural fullness or pressure
    Possible hearing loss
  • What are the risk factors of otitis media w/effusion?
    Childhood
    Upper resp tract infection
    Acute otitis media
    Craniofacial anomalies
    Eustachian tube dysfunction
    Genetic predisposition in children
    Daycare attendance
    Adenoid hyperplasia, adenoiditis
  • Why is being a child a RF of OME?
    Eustachian tube is shorter & more horizontal in children
  • Why is an upper resp infection a risk factor for OME?
    Mucosal inflammation (secondary to infection) can lead to obstruction & dysfunction of Eustachian tubefluid accumulation in the middle ear
  • Why is acute otitis media a risk factor for OME?
    Otitis media w/effusion typically follows acute otitis media once acute inflammation resolves
  • Why are craniofacial anomalies a RF for OME?
    E.g. cleft palate & Down syndrome
    Predisposes to Eustachian tube dysfunction & subsequent chronic OME
  • Why is Eustachian tube dysfunction a RF of OME?
    Eustachian tube plays an important role in maintaining health & function of middle ears (esp. pressure equalisation & mucociliary clearance)
    Dysfunction → increased risk of OME
  • Why is daycare attendance a RF for OME?
    Increased exposure to viral pathogens, which can cause upper resp tract infections
  • Why is adenoid hyperplasia is RF of OME?
    Adenoid enlargement can lead to obstruction of Eustachian tube orifices
  • What are the common symptoms of an ear infection?
    Pain
    Fever
    Vomiting
    Fatigue
    Difficulty hearing
    Discharge running out of ear
    Feeling of aural pressure/fullness
    Itching/irritation in & around ear
    Scaly skin in/around ear
  • What is the rate of recurrence of cholesteatoma?
    High
  • What is the appearance at rest of facial palsy?
    Absence of horizontal lines of forehead on affected side (preserved in UMN lesion)
    Affected eye larger
    Lack of blink in affected eye (mostly preserved in UMN)
    Altered position or absence of naso-labial folds on affected side
    Position of affected corner of the mouth lower than the side
  • What are the risk factors of facial palsy?
    Diabetes
    Pregnancy
    Ear infection
    Upper resp tract infection
    Obesity