Hearing Loss

Question 1

tumor that blocks ES

Answer 1

Nasopharyngeal tumor

Question 2

Tx bell’s palsy *extra

Answer 2

steroid

Question 3

DISEASES: external - pinna, canal

Answer 3

OE, Exostosis/Osteoma, Cerumen Impaction

Question 4

DISEASES: middle - TM, Ossicles, ES

Answer 4

OM, Cholesteatoma, Otosclerosis, ETD

Question 5

DISEASES: inner - cochlea, semicircular canals, auditory nerve

Answer 5

Meniere’s, BPPV, Aucoustic Neuroma, Sensorineural HL

Question 6

labyrinth - location, function

Answer 6

Inner Ear
Hearing, Balance
Transmit to CN 8

Question 7

what provide brain w/ info about Head Movement and Motion?

Answer 7

saccule

utricle

Question 8

Conductive hearing loss:

Weber lateralizes to…

Answer 8

affected side

Question 9

Sensorineural Hearing Loss:

Weber lateralizes to…

Answer 9

unaffected side

Question 10

Rinne: AC>BC

Answer 10

normal

Sensorineural hearing loss

Question 11

Rinne: BC>AC

Answer 11

Conductive Hearing loss

Question 12

tinnitus risk factors

Answer 12

noise exposure
old
male
smoker
cardio disease

Question 13

Intermittent tinnitus workup/Tx

Answer 13

NONE

Question 14

pulsatile tinnitus

Answer 14

rhythmic with pulse

Question 15

Tinnitus causes

Answer 15

idiopathic
acoustic trauma (acute/chronic)
Neuro damage
vascular
TM perf
purulent/serous OM
ETD

Question 16

Tinnitus Dx

Answer 16

Refer ENT
subjective (most) vs. objective
Pulsatile? MRA/carotid doppler
imaging/neuro-otologic tests

Question 17

Acute Tinnitus Tx

Answer 17

oral steroid taper

Question 18

Chronic Tinnitus Tx

Answer 18

Lipoflavinoids
Niacin / B complex
White noise
Hearing aid

Question 19

Tinnitus prevention

Answer 19

minimize noise exposure (<85dB)

Question 20

which are first sounds to go in elderly hearing loss?

Answer 20

low decibel, extreme high + low frequencies

Question 21

what frequency is cochlea near oval window?

Answer 21

high

Question 22

Presbycusis : characteristics

Answer 22

sensorineural hearing loss
old age
symmetrical + high frequency

Question 23

Presbycusis : risk factors

Answer 23

half adults over 75
genetic
noise exposure
DM/ atherosclerosis

Question 24

Presbycusis : presentation

Answer 24

bilateral worsening over time
difficulty w/ social situations
can't localize
tinnitus
isolation

Question 25

Presbycusis : Dx

Answer 25

Dx of exclusion | audiogram - symmetrical, high frequency loss

Question 26

Presbycusis : Tx

Answer 26

Hearing Aid | Prevention (noise)

Question 27

Acoustic trauma : damage frequency + decibel

Answer 27

high frequency, >85 dB

Question 28

Acoustic Trauma : Presentation

Answer 28

hearing loss tinnitus Hx of noise exposure

Question 29

Acoustic Trauma: Dx

Answer 29

PE normal Audiometry = 4K noise notch bilat/unilat

Question 30

Acoustic Trauma: Tx

Answer 30

hearing aid possible steroid Prevention *noise

Question 31

Where does Acoustic Neuroma/Vestibular Schwannoma grow?

Answer 31

CN 8 - Schwann cells

Question 32

Acoustic Neuroma/Vestibular Schwannoma | : S/S

Answer 32

``` UNILATERAL hearing loss + tinnitus Headaches/dizziness Facial weakness/numbness Possibly silent until large continuous vertigo ```

Question 33

Acoustic Neuroma/Vestibular Schwannoma : risk factors

Answer 33

Neurofibromatosis Type II (cafe au lait/bilat) | Ionized radiation

Question 34

What should you order if UNILATERAL Sensorineural hearing loss?

Answer 34

MRI

Question 35

Acoustic Neuroma/Vestibular Schwannoma : Dx

Answer 35

Audiogram: unilateral loss **MRI - Cerebellopontine Angle w/ gadolinium contrast Auditory Brainstem Response

Question 36

Acoustic Neuroma/Vestibular Schwannoma : Tx

Answer 36

Refer ENT/neurosurgery/radiation | Image/audio monitor every 6 mos.

Question 37

Causes of conductive hearing loss

Answer 37

``` Cerumen impaction OM/OE TM perf Otosclerosis Mastoiditis Cholesteatoma Foreign Body Exostoses/Osteomas ```

Question 38

Cerumen impaction : Presentation

Answer 38

Hearing Loss Ear discomfort Dizziness/tinnitis if impacted against TM

Question 39

Cerumen impaction: Tx

Answer 39

Dissolve (H2O2, OTC) Irrigation, removal Refer ENT if fail or no audio return

Question 40

Exostoses: cause

Answer 40

Cold water swimming as child

Question 41

Exostoses (multiple) : Tx

Answer 41

Monitor | If obstruct, refer ENT

Question 42

Osteomas (single - tympanic bone) - Tx

Answer 42

Monitor | Refer ENT if obstruction

Question 43

Otosclerosis: risk factors

Answer 43

Genetic White female Young adult to middle age

Question 44

Otosclerosis: what is

Answer 44

Spongy bone growth at stapes-oval window junction Worsens over time Possible tinnitus

Question 45

Otosclerosis: Dx

Answer 45

TM moves normal Conductive hearing loss (Carthart notch 2K) DX: Temporal bone CT/exploratory surgery

Question 46

Otosclerosis : Tx

Answer 46

Refer ENT : exploration, stapedectomy, ossicular chain reconstruction *hearing amp/monitor

Question 47

Cholesteatoma is

Answer 47

Middle ear cyst w/ keratin | Destroys middle ear, labyrinth, mastoid air cells, facial nerve, *middle cranial fossa of brain

Question 48

Cholesteatoma: associated w/

Answer 48

ETD, TM perf, Congenital

Question 49

Cholesteatoma : presentation

Answer 49

``` CHRONIC DRAINING EAR (brown/yellow/odor) PAINLESS Conductive H.L. Dizziness TM pearl DX: CT temporal bone, otoscope granular tissue ```

Question 50

Cholesteatoma: Tx

Answer 50

Surgical excision

Question 51

ETD : cause

Answer 51

* Hairs can't remove * Bad ES contraction * Narrow ES * Adenoid blocks ES * Swollen nose blocked * Adult - NP tumor (unilat OM)

Question 52

ETD: associated w/

Answer 52

OM Barotrauma Maybe cholesteatoma

Question 53

ETD : presentation

Answer 53

Follow URI/allergic rhinitis Ear pain/pressure Stuffy - valsalva useless Hearing loss/ tinnitus

Question 54

ETD : physical exam

Answer 54

Retracted TM | Tympanogram flat

Question 55

ETD : Tx

Answer 55

Nasal Decongest - *Sudafed, *Afrin Nasal steroid - *Flonase, *Nasonex SEVERE - oral steroid, myringotomy/tube