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of
one
day
which
was
Day 1
Day 2
of
days
and
ear
fever
and
altered
of
decreased
Earache
Discharge
Ringing sensation - Tinnitus
Hard of hearing - Deafness
Spinning sensation of head - Vertigo
External ear
Ear ache
Middle ear
Painless
Painful Acute (SOM, ASOM & Mastoiditis / Abscess)
& Barotrauma
Inner ear
Painless
Temporal bone
Trauma
Ear ache
Referred otalgia
Arthritis of TM Joint
Sinusitis & ET obstruction
CA Tongue
Tonsillitis
Carious molar tooth
Referred otalgia
Ear
ache
Auriculotemporal nerve (5th CN br)
Dental
Lingual of tongue
TM joint
Floor of mouth
Glossopharygeal Nv
Tonsillar
Base of tongue
Nasopharyngeal
Vagus Nv
Pharyngeal & Laryngeal lesions
Ear
discharge
Middle ear
Ear
discharge
Reservoir sign
Ear
discharge
Deafness
Congenital
Maldevelopment of cochlea / retrocochlear
- SNHL
Ossicular chain defects
Acquired
Deafnes
s
SNHL
Appreciated by patients
Attendants
CDHL / Mixed -CSOM
Fluctuating
SOM / ASOM
Deafness
Irritated by loud sounds with deafness to normal sounds
SNHL with recruitment
Ototoxicity
Drugs
Viral diseases
Pregnancy
Sudden / Gradual
Trauma
Vascular causes
Hard of hearing
Deafness
Deaf
When no residual hearing is present &
hearing is non correctable
Hyperacusis
Increased sound sensitivity
Congenital syphilis(Henneberts sign)
Stapedius muscle paralysis
External Ear
wax
Foreign bodies
Middle ear
SOM / ASOM / CSOM
Inner Ear
Menieres disease
Acoustic neuroma
Referred causes
Vascular
TM Joint
Tinnitus Ringing
sensation
Fluctuating
Tinnitus Ringing
sensation
SOM / ASOM
Drug over dosage salicylates
Menieres disease
Pulsatile
Glomus jugulare / vascular AV shunts
Continuous
SNHL
Acoustic trauma
Vascular
Central
Vertebro basilar insufficiency
Peripheral
Labyrinthitis
Vestibular neuronitis
Menieres disease
Acoustic neuroma
Positional
BPPV
Cervical spondylosis
Ocular
Syncopal
Vertigo
Central
Labyrinthitis
Vestibular neuronitis
Menieres disease
Acoustic neuroma
I - Imbalance
G Glial diseases
O Ocular diseases
PINNA
Perichondritis
Vestibulitis
Herpes
ASOM
CSOM
Methods of removal
Facial nerve
Intracra
nial
1st
genu
2nd
genu
Intratempor
al
Extracra
Intracranial
Intratemporal
Extracranial
4
5
Bells palsy
Clinical History
Etio pathogenesis
Clinical features
Management
Investigations
Biochemical
radiological
Medical treatment
Surgical treatment
Method of examination
Pinna
Adult: Backwards & Upwards
Child: Forwards / Outwards &
Downwards
EAC
Congested / edematous
Filled with cheesy debris /
secretions
polypoidal
Method of examination
Tympanic membrane
Greyish white translucent, Cone of light seen, Pars tensa,
Pars flaccida
Pars tensa 4 quadrants
Method of examination
Tympanic membrane
Color changes
Pearly white normal
congested ASOM
Dull SOM
Blue Haemotympanum
Flamingo pink reflex
Otosclerosis - SCHWARTZ
SIGN
Method of
examination
Tympanic membrane
Position
Bulged Acute
Suppurative or non
suppurative OM
Retracted Adhesive
OM /SOM / Barotrauma
Method of examination
Tympanic membrane
Integrity - Intact
Perforated
Central /
tubotympanic /
safe(pars tensa)
Attic/ Unsafe(pars
flaccida with or without
retraction pocket)
Marginal / unsafe (Bony
Annulus absent)
Inspection
Pre auricular
Congenital Preauricular Sinus
Fistula Coloaural fistula
Methods of
examination of ear
Auricle shape
Congenital Atresia
post auricular
Sinus & Fistula of mastoid bone - Mastoid
Abscess
Methods of examination of
ear
Palpation
Tragal
tenderness
Mastoid
tenderness
Fistula test
Methods of examination of
ear
Otoscopy
ET
Patency
Valsalva manouvre
Seiglisation
Politzerization
ET Cathetrization
Methods of examination of
ear
Otoscopy with
seiglisation
TFT
Principle
Frequency
Assessment of hearing type
Rinnes
Webers
ABC
Rinnes
Principle
AC compared with BC
Frequency
256, 512 & 1024
Weber
Principle
BC of both ears
compared
Frequency
Usually 512
256 & 1024 can be
used
Assessment of hearing
type
To distinguish CDHL,
SNHL and ossicular
fixation
ABC
Principle
Compare hearing of pt
with examiner
Frequency
Usually 512
256 & 1024 can be used
Assessment of hearing
type
Normal or defective
hearing can be assessed
EUM
Important for the
type of disease
In children most
important
Prefer to perform
under GA in children
Examination of
middle ear cleft
Nystagmus eye
movements
Caloric test
Hot
Cold
Bithermal
Vestibular
system
examination
Fistula test
Rotation test
Optokinetic test
Vestibular
system
examination
Vestibular
system
Electronystagmograph examination
y
Cochlea
Auditory pathway
Pure Tone
Audiometry
Audiomet
ry
Audiomet
ry
Pure Tone
Audiometry
Conducti
ve
Sensorineural hearing
loss
Mixed
Audiomet
ry
Impedance
Audiometry
Mixed
X Ray Mastoid
X Ray Mastoid
X Ray Mastoid
X Ray Mastoid
Townes view
Biochemical investigations
Aural Toilet
Prefer to do under
microscope
Mopping
Dry
Wet
Symptomatic management
Analgesics
Antihistamines - 2nd generation cetirizine,
levocetirizine
Antacids - PPI for gastric irritation as side effects
Broad spectrum antibiotic ear drops
Or
Broad spectrum antibiotic, antifungal, anesthetic
ear drops
Surgical management
Approach
Incision
complications
Myringotomy
I&D
Tympanoplasty
Mastoidectomy
Perichondritis of pinna
I&D
repeatedly
Window
surgery
SOM / ASOM
Myringotomy with or without grommet insertion
Types of grafts
TEMPORALIS FASCIA
Tragal perichondrium
Venous grafts
Cartilage graft
Autograft
Homograft
Allograft
Mastoid surgery
Cortical
MRM
Canal wall up
Canal wall down
Transvers
e
Longitudi
nal
of
one
day
which
was
Day 1
Day 2
of
days
and
ear
fever
and
altered
of
decreased
THAN Q