ENT
Right
-SNHL
+ ve Rinne's
Hearing Loss
Mixed
hearing loss
• Conductive Hearing Loss
- - Bone > Air = Rinne
Right - Lateralises to affected ear = Weber
• Sensorineural Hearing Loss (SSNHL)
- Air > Bone = Rinne
- Lateralises to unaffected ear = Weber
• SSNHL = urgent ENT referral within 24 hrs
• Majority of SSNHL cases = idopathic
• MRI scan - exclude vestibular schwannoma
• Management = high-dose PO
corticosteroids
, ACUTE OTITIS MEDIA
• Common in young children Management
• Preceded by bacterial or viral URTIs &
most common cause • Self-limiting - normally no antibiotics
- Streptococcus pneumonaie, haemophilus influenzae • Analgesia for otalgia
• Seek help if worse or no improvement after 3 days
Features - can have a
of sudden cessation
aspressure tympanicmembe
pain
are
on
• 1ST LINE = amoxicillin 5-7 days
• Otalgia - tug or rub ear - Allergies = erythromycin, clarithromycin
• Fever
• Hearing loss Prescribe antibiotics immediately if:
• Revent URTI symptoms • Symptoms > 4 days or not improving
>
• Ear discharge - if tympanic membrane perforates • Systematically unwell by don’t need admission
• Immunocompromised or high risk of complications
Signs • Younger than 2 years than bilateral otitis media
• Bulging tympanic membrane -> loss of light reflex • Otitis media with perforation and/or discharge
• Opacification or erythema of tympanic membrane
• Perforation with purulent otorrhoea Complications
·
• Perforation of tympanic membrane -> otorrhoea
Diagnosis - Chronic suppurative otitis media if > 6 weeks
• Acute onset of symptoms - otalgia • Hearing loss, labyrinthitis
• Presence of middle ear effusion - signs as above • Mastoiditis, meningitis, brain abscess
• Inflammation of the tympanic membrane
Right
-SNHL
+ ve Rinne's
Hearing Loss
Mixed
hearing loss
• Conductive Hearing Loss
- - Bone > Air = Rinne
Right - Lateralises to affected ear = Weber
• Sensorineural Hearing Loss (SSNHL)
- Air > Bone = Rinne
- Lateralises to unaffected ear = Weber
• SSNHL = urgent ENT referral within 24 hrs
• Majority of SSNHL cases = idopathic
• MRI scan - exclude vestibular schwannoma
• Management = high-dose PO
corticosteroids
, ACUTE OTITIS MEDIA
• Common in young children Management
• Preceded by bacterial or viral URTIs &
most common cause • Self-limiting - normally no antibiotics
- Streptococcus pneumonaie, haemophilus influenzae • Analgesia for otalgia
• Seek help if worse or no improvement after 3 days
Features - can have a
of sudden cessation
aspressure tympanicmembe
pain
are
on
• 1ST LINE = amoxicillin 5-7 days
• Otalgia - tug or rub ear - Allergies = erythromycin, clarithromycin
• Fever
• Hearing loss Prescribe antibiotics immediately if:
• Revent URTI symptoms • Symptoms > 4 days or not improving
>
• Ear discharge - if tympanic membrane perforates • Systematically unwell by don’t need admission
• Immunocompromised or high risk of complications
Signs • Younger than 2 years than bilateral otitis media
• Bulging tympanic membrane -> loss of light reflex • Otitis media with perforation and/or discharge
• Opacification or erythema of tympanic membrane
• Perforation with purulent otorrhoea Complications
·
• Perforation of tympanic membrane -> otorrhoea
Diagnosis - Chronic suppurative otitis media if > 6 weeks
• Acute onset of symptoms - otalgia • Hearing loss, labyrinthitis
• Presence of middle ear effusion - signs as above • Mastoiditis, meningitis, brain abscess
• Inflammation of the tympanic membrane
