Inner and Middle Ear

The __________ connects the middle ear cavity with the nasopharynx.

Eustachian Tube (ET)

Which type of ETD is characterized by hearing one's own voice abnormally loud (autophony) and often improves when lying down?

Patulous ETD

A patient presents with "ear popping" and a feeling of fullness after a recent URI. Otoscopy shows a retracted TM. What is the most likely diagnosis?

Obstructive ETD

Autoinflation (forced exhalation against closed nostrils) is recommended even if the patient has an active intranasal infection.

False

 According to ______, an increase in ambient pressure results in a proportional decrease in gas volume in the middle ear.

Boyle’s Law

Most cases of otic barotrauma occur during the ______ phase of a flight or dive.

descent

What is the recommended timing for taking oral decongestants (e.g., Sudafed) to prevent barotrauma before a flight?

Several hours before arrival

A scuba diver descends too rapidly and develops severe vertigo and sensory hearing loss. What complication should be suspected?

Perilymphatic fistula

What are the three most common bacterial pathogens associated with Acute Otitis Media?

• S. pneumoniae

• H. influenzae

• M. catarrhalis

A moderate-to-severe bulging of the tympanic membrane is the hallmark of _________ and generally suggests a bacterial pathogen.

Acute Otitis Media

______ otoscopy is the preferred diagnostic method to evaluate tympanic membrane mobility in Acute otitis media.

Pneumatic otoscopy

What is the first-choice antibiotic for treating AOM in both adults and children?

Amoxicillin

What is the preferred alternative antibiotic treatment for AOM, for a patient with a penicillin allergy?

Azithromycin

Antibiotics are mandatory for all children over age 2 with unilateral AOM and mild symptoms.

False

A 10-month-old presents with a high fever and bilateral bulging, erythematous tympanic membranes. Should this patient be treated or observed?

Treated

_________, also known as Serous Otitis Media, is defined as middle ear fluid in the absence of signs of acute infection (no fever or erythema).

Otitis Media with Effusion (OME)

What is the most common cause of pediatric hearing impairment in the developed world?

OME

Otoscopy in OME typically reveals a ______ tympanic membrane, often with visible air bubbles.

Flat or retracted

What is the initial recommended management for children with OME who are not at high risk for speech/language problems?

Watchful waiting for 3 months

A parent reports their 4-year-old child seems "withdrawn" and has difficulty following instructions. Exam shows bilateral non-erythematous middle ear fluid. What is the likely diagnosis?

Serous Otitis Media

Chronic Suppurative Otitis Media is defined as a persistent infection lasting longer than ______.

6 weeks

What is the most common bacterial pathogen found in CSOM?

Pseudomonas aeruginosa

What class of medication is the treatment of choice for CSOM?

Topical Quinolones

A patient presents with a history of recurrent AOM and now has persistent, purulent ear discharge through a perforated TM for 2 months. He has no fever. What is the diagnosis?

CSOM

If medical therapy for CSOM fails and infection involves the mastoid air cells, what surgical procedure is indicated?

Mastoidectomy

A cholesteatoma is a benign cystic lesion made of ______ squamous epithelium.

Keratinizing

What is the "classic" clinical presentation of a cholesteatoma?

Painless, foul-smelling otorrhea

On otoscopy, a cholesteatoma often appears as a ______ mass within a retraction pocket.

White pearly or yellow mass

What is the definitive treatment for a cholesteatoma?

Surgical resection (Tympanomastoidectomy)

A patient with a history of cleft palate and TM tubes presents with a white mass behind an intact TM. They have no history of prior ear infections or rupture. What type of cholesteatoma is this?

Congenital Cholesteatoma

Otosclerosis involves abnormal bone remodeling that leads to the fixation of the ___________.

Stapes footplate

In Otosclerosis, ________ typically reveals a completely normal-appearing tympanic membrane, despite the patient's progressive hearing loss

otoscopy

The ______ sign is a reddish blush seen over the promontory and oval window in 10% of patients.

Schwartze Sign

A 35-year-old Caucasian female reports gradual, progressive hearing loss that seems to improve in noisy environments (paracusis of Willis). What is the likely diagnosis?

Otosclerosis

What is the Gold Standard imaging modality if the diagnosis of otosclerosis is in question?

Non-contrast high-resolution CT

What surgical procedure involves replacing the fixed stapes with a prosthesis?

Stapedectomy or Stapedotomy

 Following AOM, ear pain often ______ immediately after the tympanic membrane ruptures.

decreases

Patients with a perforated TM should be instructed on "strict dry ear precautions," which means no ______.

No pools/lakes/swimming

 If a patient has a TM rupture and the Weber test lateralizes to the unaffected ear, what should be suspected?

Sensorineural hearing loss (Stapes subluxation)

___________ is characterized by foul otorrhea, deep ear/retro-orbital pain, and a CN VI (lateral rectus) palsy resulting from  Petrous Apicitis (Petrositis).

Gradenigo Syndrome

_________ is characterized by very painful vesicles (blisters) in the superficial layers of the TM.

Bullous Myringitis

___________ appears as Crescent or horseshoe-shaped white plaques in the TM due to calcified deposits.

Tympanosclerosis

The ______ is the thin plate of bone that forms the roof of the middle ear and separates it from the temporal lobe of the brain.

Tegmen tympani

This procedure, which involves aspirating middle ear fluid, is reserved for OM that is ______.

Unresponsive to antibiotics

According to 2022 guidelines, a child with bilateral chronic OME for ______ months and documented hearing loss is a candidate for tubes.

3 months

Which antibiotic combination is a common alternative if first-line Amoxicillin fails?

Amoxicillin-clavulanate (Augmentin)

To prevent barotrauma while flying, passengers should be advised to ______ frequently during descent.

swallow, yawn, or chew gum

The first step in the development of Acute Otitis Media is typically a(n) ______.

Upper respiratory tract viral infection

Which genetic condition is a significant risk factor for both ETD and AOM?

Down Syndrome

Conductive hearing loss in CSOM is caused by the destruction of the TM or the ______.

Ossicular chain