ENT McQ points by Dr. Masoom haider
Otosclerosis
1 otosclerosis is Autosomal dominant
2 otosclerosis mainly affect white Female and age 20-30
3 in von DER hove syndrome, there is Triad of:
- Otosclerosis
- Blue sclera
- O imperfecta
4 stapedial otosclerosis cause conductive deafness.
5 cochlear otosclerosis cause semrinural deafness.
6 histologic otosclerosis cause no type of hearing loss
7 otosclerosis is bilateral
8. In otosclerosis, Rennie is negative
9 Weber is lateralized to ear with greater conductive loss
10. Loss of air conduction is more for lower frequency in otosclerosis
11 speech audiometry show normal discrimination score except for cholear type otosclerosis
12. There is dip in bone conduction in otosclerosis
13 stapedectomy with prosthesis is treatment of choice of otosclerosis
14 tempanic membrane perforation and exostosis are relative contraindications of stapedectomy
15. Inherent hearing loss of 25db cannot be corrected by lemperts fenestration operation
Meniere’s disease
1 there is spasms of internal auditory artery
2 male are affected more in meniere’s disease
3 meniere’s disea is mostly unilateral
4 meniere disease affect age 35-60 year
5 Tullio phenomenon is due to distended sacule
6 hearing loss is fluctuating type in menieres disease
7 tinnitis is low pitched in menieres disease
8. Patient of menieres disease cannot tolerate loud noise due to recruitment phenomenon
9. Weber is lateralized to better ear in menieres disease
10 quick components of nystagmus is towards unaffected ear
11 in later stages higher frequencies are affected
12 in menieres disease ratio of sp/ap is greater than 30
13 sisi score in menieres disease is better than 70%
14. Caloric test show canal paresis to affected side
15 glycerol test is diagnostic and prognostic
16 reverse of menieres disease seseen in lermoyez syndrome
17 there is no vertigo or fluctuations in hearing loss in tumarkin otolyticic crisis
18 cochlear functions are normal in vesitubular hydrops
19 in cochlear hydrops vertigo is absent
20 cogons syndrome cause menieres syndrome
21 carbogen is a cerebral vasodilator
22 betahistine is given orally
23 recurrent attack can be prevented by furosemide
24 microwick polyvinyl acetate can be used in menieres disease
25 wick delivers gentamicin and steroids
26 in cochleosaculotomy cochlear duct is punctuated
27 prerequisites of menit device is myringotomy
28 patient in which medical treatment fails but surgical treatment is asked menit device is used
Acoustic neuroma
1 it comprises 80% of all cerebellopontine angle tumors
2 in patient of neurofibromatosis it is bilateral
3 acoustic neuroma affect age of 40-60
4. Difficulty in understanding the speech is characteristic feature of acoustic neuroma
5 hyoosthesia of posterior meatal wall is called hitzilbergers sign
6 seminural hearing loss more marked at higher frequencies seen in acoustic neuroma
7. When loudness increase speech discrimination score fall in acoustic neuroma
8. Gold standard test for acoustic neuroma is MRI with galadonium contrast
9. Treatment of choice of acoustic neuroma is surgery
10. For retrocochlear lesion BERA is used
11 CO 60 is used in treatment of acoustic neuroma
External Ear
1 fruncle formed mainly in cartilaginous part of canal
2 if patient came with recurrent frunclosis
-Diabetes should be excluded
-Pay attention to vesitubule of nose which may harbor staph aureus
3. Icthmmol glycerine has
- hygroscopic action
- analgesic
- antiseptic
4. Diffuse otitis externa seen in swimmers In hot and humid environment
5. In acute phase of diffuse otitis externa initially discharge is serous
6 in chronic phase of diffuse otitis externa itching and crust seen
7. Wick is changed daily for 2-3 days
8. Intense itching watery discharge mousty odour mass in ear seen in otomycosis
9 Nystatin is used against candida
10 Ga67 is used in diagnosis and follow up of malignant otitis externa
11 Tc99 reveal bone infection but test remain positive for 1 year
12. In malignant otitis externa antibiotics therapy should continue for 6-8 week
13 itching is main complain in seborrheic otitis externa
14 Greasy yellow scales are seen in seborrheic otitis externa
15 pH of wax is acidic
16. Unilateral hearing difficulty tinnitis giddiness and reflexes cough seen in cerumen
17. Chloroform water kills maggots in ear
18. Widening of bony meatus seen in keratosis obturans
19 normal tympanic membrane is shiny and pearly grey
20 myrigitis bullosa is caused by mycoplasma pneumoniae
21 in serous otitis media middle fibrous layer of tympanic membrane get absorbed
22 4%aluminium acetate is used in perichondritus
23 peanut ear is a form of microtia
Ear tumor
1 most common benign neoplasm of middle ear is glomus tumor
2 glomus tumor mainly affect female of 40-50 year
3. Tinnitis stopped by carotid pressure in glomas tumor
4 glomus tumor can be differentiated from carcinoma based on earache
5. Bruit is present at all stages of glomus tumor
6 in differential diagnosis of petrous apex lesion CT combined MRI done
7 embolization in glomas tumor done 1-2 day before operation
8 if tumor is extending towards foramen Magnum transcondyler approach is used
9 primary carcinoma of mastoid ear cells seen in radium dial painters
10 feature of carcinoma simulate chronic supportive otitis media
11 in carcinoma severe pain seen usually at night
12 rhabdomyosarcoma affect mostly children
13 facial palsy seen early in rhabdomyosarcoma
14 ceruminoma is a tumor of modified sweat glands…
ASOM
1 Asom affect mostly infants and children of low socioeconomic status
2 most common cause of Asom is streptococcus pneumoniae
3. Tympanic membrane is congested in presupporation stage
4 cart wheel appearance in presupporation stage
5 tympanic membrane is bulged and excruciating earache in supporation stage
6. Antibiotics therapy in Asom is continued minimum for 10 days
7. If effusion persistent beyond 12week myringotomy is indicated
8. Serous otitis media seen in school going children
9. If there is unilateral serous otitis media in adults benign or malignant tumors of Nasopharynx should be excluded
10 tympanic membrane is dull opaque and absent light reflex in serous otitis media
11 in ASOM hearing loss is off 40db
12 tympanotomy is done in thick locular fluid or cholesterol granuloma
13 acute necrotizing otitis media is caused by beta hemolytic streptococcus
14 antibiotics therapy in acute necrotizing otitis media is 7-10 days
15 cortical mastoidectomy done in acute necrotizing otitis media
CSOM + cholesteatoma
1 cholesteatoma means skin in the wrong place
2. Single most common cause of hearing impairment in rural population is CSOM3 CSOM is more in developing countries
4. Perforation is central in tubotympanic type
5. Necrosis of long process of incus seen in tubotympanic CSOM
6. Chalky white deposit seen on promontory in tubotympanic CSOM
7. Artisanal type is called squamosal disea of middle ear
8. Person hears better in the presence of discharge in tubotympanic CSOM
9. Hearing loss is not appearant in cholesteatoma hearer
10. Middle eat atelectasis seen in stage 3
11. Adhesive otitis media seen in stage 4
12. Cholesteatoma appear pearly whites flake
13. Painless necrosis of tympanic membrane in tuberculer otitis media
14 Atticoantral type CSOM involve lateral semicircular canals
15. Painless loss of heating out of proportion foul smelly discharge multiple perforation in pars tensa seen in tuberculer otitis media
Reference: Dhingra (latest edition)
COMPILED BY DR. MASOOM HAIDER