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. Peri-tonsillar abscess:
------------------------. Muffled voice make one consider other diagnosis than simple tonsillitis or
pharyngitis. . Deviation of the Uvula + Unilateral lymphadenopathy = Peri-tonsillar
abscess.
. Tx: URGENT NEEDLE ASPIRATION + IV Antibiotics.
. PRESBYCUSIS:
-------------. Old pt in 60s.
. Sensori-neural hearing loss.
. HIGH frequency BILATERAL hearing loss.
. Difficult hearing in noisy crowded places.
. OTOTOXIC drugs:
----------------. Aminoglycosides antibiotics.
. Loop diuretics e.g. Furosemide. NOT THIAZIDEs !!
. Aspirin.
. REMEMBER:
----------. SE of BBs -------> Bronchoconstriction - Bradycardia - fatigue - depression.
. SE of ACEIs -----> Cough - Hyperkalemia - Angioedema.
. SE of Aspirin ---> Tinnitus.
. SE of Thiazides -> Orthostatic Hypotension - photosensitivity - hypercalcemia.
. Serous O.M.
------------. is associated with HIV pts manifesting as middle ear effusion without infection.
. causing dull hypomobile tympanic membrane.
NASAL POLYP:
. LEKOPLAKIA:
------------. Hard to remove white patches in the floor of the mouth.
. due to chronic irritation by smoking or alcohol.
. May lead to squamous cell carcinoma.
. CANDIDIASIS:
-------------. Diabetic pt. with poor control.
. Whitish plaques with underlying erythema.
. Easily scrapped off with a tongue depressor.
. Epiglottitis:
--------------. High fever.
. Severe sore throat.
. Odynophagia.
. DROOOOOOOOOOOOOOOOLING.
. Progressive airway obstruction.
. HARSH SHRILL.
. Causative organisms: Haemophilus influenzae & Streptococcus pyogenes.
. Otosclerosis:
--------------. is the most common cause of conductive hearing loss in middle aged adults 2030s.
. AMINOGLYCOSIDES - GENTAMYCIN is the most common cause of sensorineural
hearing loss.
. Retro-pharyngeal abscess:
. MENIERE's disease:
-------------------. Vertigo = Severe spinning sensation + nausea.
. The type of vertigo is peripheral not central as it last just for 1-2 hours with the
presence of ear fullness & H/O of excessive cell phone use.
. EAR FULLNESS suggests Meniere's disease
. from an abnormal accumulation of endo-lymph within the inner ear.
. Meniere's dis. is an INNER ear disease.
. Simply exclude CEREBELLAR dis. by absence of inco-ordination or gait
disturbances!
Meniere's disease:
. When the TF is placed on the middle of the forehead, she feals the vibration better
in her Rt ear than the Lt
-> Abnormal Weber test
-> The sound lateralizes to the diseased ear due to better bone conduction.
-> CONDUCTIVE hearing loss.
. APHTHOUS ULCERS:
----------------. CROHN's disease can involve any part of the GIT from the MOUTH to the ANUS.
. APTHOUS ulcers in the mouth can be seen as extra-intestinal manifestation.
. Pathology: GRANULOMATOUS inflammation.
2-SEQUELAE OF CSOM......O-CART
Ossicular necrosis
Cholesterol granuloma
Atrophic tympanic membrane and atelactatic middle ear
Retraction pockets and cholesteatoma
Tympanosclerosis
3-Sequelae
S-SNHL
C-Cholesteatoma
A-Atelectasis
L-Learning Disability
P-Perforation of TM
C-Conductive HL
O-Ossicular Necrosis
S-Speech Impairment
T-Tympanosclerosis
4-Causes of SNHL
1.Congenital
-Prenatal factors
-Paranatal factors
I-Infections
T-Trauma to labyrinth/VIIITH nv
O-Ototoxic drugs
P-Presbyacusis
S-Systemic Dz.
"TARGET"
12-Auditory pathway
' E.COLI-MA'
Eighth nerve
Cochlear nuclei
Olivary complex
Lateral lemniscus
Inferior colliculus
Medial geniculate body
Auditory cortex
M