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Rinne’s Test and Weber’s Test
Rinne’s Test Weber’s Test Rinne’s test Weber’s test Normal Air conduction > bone conduction (Positive Rinne’s) Heard in the midline Conductive hearing loss Bone conduction > Air conduction(Negative Rinne’s) Heard in the bad ear Sensorineural hearing loss Air conduction > bone conduction(Positive Rinne’s) Heard in the good ear Causes of Conductive Hearing Loss…
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Vestibular Neuronitis
Introduction Etiology Epidemiology Pathophysiology History and Physical Examination Evaluation Treatment / Management Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team Outcomes
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Benign Paroxysmal Positional Vertigo (BPPV)
Introduction Etiology Epidemiology Pathophysiology History and Physical Evaluation Treatment/Management Repositioning Maneuvers Surgical Treatment Differential Diagnosis Prognosis Complications Deterrence and Patient Education Enhancing Healthcare Team Outcomes
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Meniere Disease
from: MedicineToday 2014; 15(3): 18-26 Hallmark of Acute Attack: Vertigo Characteristics: Early Stage: Middle Stage: Late Stage: Natural History: Variants: Epidemiology: Pathophysiology – Current Understanding: Differential Diagnosis Diagnosis Diagnosis Criteria (Barany Society): Clinical Examination: Between Attacks: During Acute Attack: Investigations: Differential Diagnosis Common Causes of Disturbed Balance: Conditions Mimicking Ménière’s…
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Labyrinthitis
Anatomy Etiology Epidemiology History and Physical Examination Evaluation Treatment/Management Differential Diagnosis Complications Prognosis Deterrence and Patient Education Enhancing Healthcare Team Outcomes
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Vertigo differentials
Meniere’s Disease Vestibular Neuritis Labyrinthitis Benign Paroxysmal Positional Vertigo (BPPV) General Considerations Management Principles
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VERTIGO
These peripheral causes of vertigo are benign, and treatment involves reassurance and management of symptoms. Cause Description Peripheral causes Acute labyrinthitis Inflammation of the labyrinthine organs caused by viral or bacterial infection Acute vestibular neuronitis (vestibular neuritis)* Inflammation of the vestibular nerve, usually caused by viral infection Benign positional paroxysmal…
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Presbyacusis
Symptoms Risk Factors Diagnosis Treatment
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Noise-induced deafness
Noise trauma is a primary preventable cause of sensorineural hearing loss, which occurs due to damage to the hair cells in the inner ear. It can result from various sources: Types of Occupational Noise Damage Characteristics of Occupational Noise-Induced Hearing Loss Diagnosis Treatment Prevention
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Vestibular schwannoma/ acoustic neuroma
Overview: Epidemiology: Symptoms: Imaging: Referral: Additional Notes:
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Idiopathic Sensorineural Hearing Loss
Definition: Epidemiology: Symptoms: Diagnosis: Prognosis: Treatment:
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Sudden onset hearing loss (SOHL)
Sudden Onset Hearing Loss (SOHL) is characterized by the patient’s subjective experience of hearing loss in one or both ears. To objectively confirm the presence and severity of hearing loss, a Pure Tone Audiogram (PTA) is necessary. A thorough clinical assessment can help differentiate between: In most cases of SSNHL,…
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Tinnitus
Type of Tinnitus Description Possible Causes/Differentials Subjective Tinnitus Only the affected individual can hear the sound – Noise-induced hearing loss– Presbycusis– Ototoxic medications– Meniere’s disease– Acoustic trauma– Inner ear infections/inflammation– Stress and anxiety Objective Tinnitus The sound can also be heard by the examiner – Vascular abnormalities– Muscular disorders– TMJ…
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Barotrauma
Characteristic features differentiating inner ear barotrauma and inner ear decompression sickness Inner ear barotrauma Inner ear decompression sickness Conductive or mixed hearing loss Sensorineural hearing loss Descent or ascent Ascent Cochlear symptoms (ie hearing loss predominates) Vestibular symptoms predominant; right sided History of forced or difficult Valsalva manoeuvre Not associated with…
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Otalgia
OTALGIA Local Causes Referred (10 T’s + 2) Primary or Secondary – Primary otalgia is pain coming directly from the ear where secondary otalgia is referred pain by cranial nerves from somewhere outside the ear (Trigeminal, facial, glossopharyngeal, vagus, cervical plexus, Require higher index of suspicion, More common in adults)
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Ear wax management
Anatomy Ear Wax (Cerumen) Causes of Ear Wax Accumulation Indications for Treatment Treatment Options Safe Syringing Procedure Contraindications for Ear Syringing Side Effects and Complications Alternative Mechanical Removal Methods Referral to ENT Specialist Key Patient Education Points Mechanical jet ear irrigation system
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External auditory exostosis (Exostoses)
Clinical differential diagnoses of EAE include EAE can be classified into four grades of severity based on the percentage of obstruction of the EAC, as assessed by otoscopy Preventive Measures Surgical Treatment Risks and Considerations Alternative Treatments
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Otitis externa
Acute localised otitis externa Necrotising otitis externa
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Eustachian tube dysfunction
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Cholesteatoma
Definition: Clinical Presentation: Examination: Pathogenesis: Congenital Cholesteatoma: Acquired Cholesteatoma: Differential Diagnosis: Investigations: Management:
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Perforation
Aetiology Symptoms Red flags Signs Management Keep ear dry ENT Consultation indications Acute Traumatic Perforations: Chronic Perforations: Unsafe Perforations: Antibiotics: Surgical Indications Prognosis Key Takeaways
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Mastoiditis
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Audiological Assessment and Management
Listening behaviours and warning signs to ask parents about When to refer Diagnostic audiology Hearing assessment is recommended for the following reasons: Speech Path
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Chronic suppurative otitis media
Management
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Acute Otitis Media with Perforation (AOMwiP)
non-pharm: pharm: Review weekly until the signs of AOM have resolved. Also review within 4 weeks after resolutionfor children at high risk of CSOM Education for AOM with perforation tragal pumping When to Refer TM Perforation
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Otitis media with effusion (OME)
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Acute Otitis Media
Otitis Media Terms: Otitis Media (OM): Refers to all forms of inflammation and infection of the middle ear.Active inflammation or infection is nearly alwaysassociated with a middle ear effusion (fluid in themiddle ear space). Acute Otitis Media (AOM): General term for both acute otitis media with and without perforation. It is…