ACADEMIC PROGRAM & LEVEL: MBBS (4th PROF)
Discipline: ENT Module / Course: MBBS
Section / Main Topic: Ear Sub-Topic: Deafness & Discharge
Cognitive Level: Application
Difficulty Level: Moderate
Importance: Need to Know
Outcome / Objective:
4th year MBBS students should be able to diagnose case of Deafness.
SEQ 1: Marks: 5
An adult reports with unilateral hearing loss in his left ear, he has a history of exposure
to blast injury his right ear is normal.
a) What damage do you expect?
b) What are Audiological investigations will you advise?
Key: Marks Breakup:
a) Expected Injuries to the Ear; 2
Tympanic membrane rupture / perforation in pars tensa
Injury to Ossicular chain
Trauma to the inner ear, temporary threshold shift or if the damage is
severe permanent hearing loss may occur.
b) Investigations 3
PTA with speech Audiometry
Tympanometry
Electrocochleography for direct measurement of cochlear and nerve
damage, no masking is required in this test.
Date: 20-07-22 Writer: Brig Maqbool Raza
HOD ENT Dept, CMH MULTAN
1
, ACADEMIC PROGRAM & LEVEL: MBBS (4th PROF)
Discipline: ENT Module / Course: MBBS
Section / Main Topic: Ear Sub-Topic: Vertigo & Tinnitus
Cognitive Level: Application
Difficulty Level: Hard
Importance: Nice to Know
Outcome / Objective:
4th year MBBS students should be able to diagnose the case of Otosclerosis.
SEQ 2: Marks: 5
A 32 year old lady lecturer visits ENT clinic with a complaint of progressive hearing loss
and a hissing sound in both ears. She hears better at a railway station. She speaks in a
low volume, well-modulated and soft voice.
a) Give most probable diagnosis?
b) Give the differential diagnosis?
c) What are the treatment options?
Key: Marks Breakup:
a) Probable Diagnosis 1
Otosclerosis
b) Differential Diagnosis 2
Fixation of Malleus or Incus
Chronic Adhesive Otitis media
Paget’s disease
Osteogenesis Imperfecta
c) Treatment Options 2
Wait and see policy in less severe cases and when a patient is not
willing for surgery.
Amplifications by bone anchored hearing aids
Stapedotomy (small fenestra) or stapedectomy (and prosthesis is placed
from the Incus into the vestibule through the opening)
Date: 20-07-22 Writer: Brig Maqbool Raza
HOD ENT Dept, CMH MULTAN
2
Discipline: ENT Module / Course: MBBS
Section / Main Topic: Ear Sub-Topic: Deafness & Discharge
Cognitive Level: Application
Difficulty Level: Moderate
Importance: Need to Know
Outcome / Objective:
4th year MBBS students should be able to diagnose case of Deafness.
SEQ 1: Marks: 5
An adult reports with unilateral hearing loss in his left ear, he has a history of exposure
to blast injury his right ear is normal.
a) What damage do you expect?
b) What are Audiological investigations will you advise?
Key: Marks Breakup:
a) Expected Injuries to the Ear; 2
Tympanic membrane rupture / perforation in pars tensa
Injury to Ossicular chain
Trauma to the inner ear, temporary threshold shift or if the damage is
severe permanent hearing loss may occur.
b) Investigations 3
PTA with speech Audiometry
Tympanometry
Electrocochleography for direct measurement of cochlear and nerve
damage, no masking is required in this test.
Date: 20-07-22 Writer: Brig Maqbool Raza
HOD ENT Dept, CMH MULTAN
1
, ACADEMIC PROGRAM & LEVEL: MBBS (4th PROF)
Discipline: ENT Module / Course: MBBS
Section / Main Topic: Ear Sub-Topic: Vertigo & Tinnitus
Cognitive Level: Application
Difficulty Level: Hard
Importance: Nice to Know
Outcome / Objective:
4th year MBBS students should be able to diagnose the case of Otosclerosis.
SEQ 2: Marks: 5
A 32 year old lady lecturer visits ENT clinic with a complaint of progressive hearing loss
and a hissing sound in both ears. She hears better at a railway station. She speaks in a
low volume, well-modulated and soft voice.
a) Give most probable diagnosis?
b) Give the differential diagnosis?
c) What are the treatment options?
Key: Marks Breakup:
a) Probable Diagnosis 1
Otosclerosis
b) Differential Diagnosis 2
Fixation of Malleus or Incus
Chronic Adhesive Otitis media
Paget’s disease
Osteogenesis Imperfecta
c) Treatment Options 2
Wait and see policy in less severe cases and when a patient is not
willing for surgery.
Amplifications by bone anchored hearing aids
Stapedotomy (small fenestra) or stapedectomy (and prosthesis is placed
from the Incus into the vestibule through the opening)
Date: 20-07-22 Writer: Brig Maqbool Raza
HOD ENT Dept, CMH MULTAN
2
