All About Your Ears Information for Patients This Information Leaflet Has Been Written to Tell You About Your Ears and How to Look After Them
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Instruction Sheet: Otitis Externa
University of North Carolina Wilmington Abrons Student Health Center INSTRUCTION SHEET: OTITIS EXTERNA The Student Health Provider has diagnosed otitis externa, also known as external ear infection, or swimmer's ear. Otitis externa is a bacterial/fungal infection in the ear canal (the ear canal goes from the outside opening of the ear to the eardrum). Water in the ear, from swimming or bathing, makes the ear canal prone to infection. Hot and humid weather also predisposes to infection. Symptoms of otitis externa include: ear pain, fullness or itching in the ear, ear drainage, and temporary loss of hearing. These symptoms are similar to those caused by otitis media (middle ear infection). To differentiate between external ear infection and middle ear infection, the provider looks in the ear with an instrument called an otoscope. It is important to distinguish between the two infections, as they are treated differently: External otitis is treated with drops in the ear canal, while middle ear infection is sometimes treated with an antibiotic by mouth. MEASURES YOU SHOULD TAKE TO HELP TREAT EXTERNAL EAR INFECTION: 1. Use the ear drops regularly, as directed on the prescription. 2. The key to treatment is getting the drops down into the canal and keeping the medicine there. To accomplish this: Lie on your side, with the unaffected ear down. Put three to four drops in the infected ear canal, then gently pull the outer ear back and forth several times, working the medicine deeper into the ear canal. Remain still, good-ear-side-down for about 15 minutes. -
Ear, Page 1 Lecture Outline
Ear - Hearing perspective Dr. Darren Hoffmann Lecture Objectives: After this lecture, you should be able to: -Describe the surface anatomy of the external ear in anatomical language -Recognize key anatomy in an otoscopic view of the tympanic membrane -Describe the anatomy and function of the ossicles and their associated muscles -Relate the anatomical structures of the middle ear to the anterior, posterior, lateral or medial walls -Explain the anatomy of middle ear infection and which regions have potential to spread to ear -Describe the anatomical structures of the inner ear -Discriminate between endolymph and perilymph in terms of their origin, composition and reabsorption mechanisms -Identify the structures of the Cochlea and Vestibular system histologically -Explain how hair cells function to transform fluid movement into electrical activity -Discriminate the location of cochlear activation for different frequencies of sound -Relate the hair cells of the cochlea to the hair cells of the vestibular system -Contrast the vestibular structures of macula and crista terminalis Let’s look at the following regions: Hoffmann – Ear, Page 1 Lecture Outline: C1. External Ear Function: Amplification of Sound waves Parts Auricle Visible part of external ear (pinna) Helix – large outer rim Tragus – tab anterior to external auditory meatus External auditory meatus Auditory Canal/External Auditory Meatus Leads from Auricle to Tympanic membrane Starts cartilaginous, becomes bony as it enters petrous part of temporal bone Earwax (Cerumen) Complex mixture -
Bedside Neuro-Otological Examination and Interpretation of Commonly
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.2004.054478 on 24 November 2004. Downloaded from BEDSIDE NEURO-OTOLOGICAL EXAMINATION AND INTERPRETATION iv32 OF COMMONLY USED INVESTIGATIONS RDavies J Neurol Neurosurg Psychiatry 2004;75(Suppl IV):iv32–iv44. doi: 10.1136/jnnp.2004.054478 he assessment of the patient with a neuro-otological problem is not a complex task if approached in a logical manner. It is best addressed by taking a comprehensive history, by a Tphysical examination that is directed towards detecting abnormalities of eye movements and abnormalities of gait, and also towards identifying any associated otological or neurological problems. This examination needs to be mindful of the factors that can compromise the value of the signs elicited, and the range of investigative techniques available. The majority of patients that present with neuro-otological symptoms do not have a space occupying lesion and the over reliance on imaging techniques is likely to miss more common conditions, such as benign paroxysmal positional vertigo (BPPV), or the failure to compensate following an acute unilateral labyrinthine event. The role of the neuro-otologist is to identify the site of the lesion, gather information that may lead to an aetiological diagnosis, and from there, to formulate a management plan. c BACKGROUND Balance is maintained through the integration at the brainstem level of information from the vestibular end organs, and the visual and proprioceptive sensory modalities. This processing takes place in the vestibular nuclei, with modulating influences from higher centres including the cerebellum, the extrapyramidal system, the cerebral cortex, and the contiguous reticular formation (fig 1). -
Hearing Loss, Vertigo and Tinnitus
HEARING LOSS, VERTIGO AND TINNITUS Jonathan Lara, DO April 29, 2012 Hearing Loss Facts S Men are more likely to experience hearing loss than women. S Approximately 17 percent (36 million) of American adults report some degree of hearing loss. S About 2 to 3 out of every 1,000 children in the United States are born deaf or hard-of-hearing. S Nine out of every 10 children who are born deaf are born to parents who can hear. Hearing Loss Facts S The NIDCD estimates that approximately 15 percent (26 million) of Americans between the ages of 20 and 69 have high frequency hearing loss due to exposure to loud sounds or noise at work or in leisure activities. S Only 1 out of 5 people who could benefit from a hearing aid actually wears one. S Three out of 4 children experience ear infection (otitis media) by the time they are 3 years old. Hearing Loss Facts S There is a strong relationship between age and reported hearing loss: 18 percent of American adults 45-64 years old, 30 percent of adults 65-74 years old, and 47 percent of adults 75 years old or older have a hearing impairment. S Roughly 25 million Americans have experienced tinnitus. S Approximately 4,000 new cases of sudden deafness occur each year in the United States. Hearing Loss Facts S Approximately 615,000 individuals have been diagnosed with Ménière's disease in the United States. Another 45,500 are newly diagnosed each year. S One out of every 100,000 individuals per year develops an acoustic neurinoma (vestibular schwannoma). -
Ear Infections
EAR INFECTIONS How common are ear infections in cats? Infections of the external ear canal (outer ear) by bacteria or yeast are common in dogs but not as common in cats. Outer ear infections are called otitis externa. The most common cause of feline otitis externa is ear mite infestation. What are the symptoms of an ear infection? Ear infection cause pain and discomfort and the ear canals are sensitive. Many cats will shake their head and scratch their ears attempting to remove the debris and fluid from the ear canal. The ears often become red and inflamed and develop an offensive odor. A black or yellow discharge is commonly observed. Don't these symptoms usually suggest ear mites? Ear mites can cause several of these symptoms including a black discharge, scratching and head shaking. However, ear mite infections generally occur in kittens. Ear mites in adult cats occur most frequently after a kitten carrying mites is introduced into the household. Sometimes ear mites will create an environment within the ear canal which leads to a secondary infection with bacteria or yeast. By the time the cat is presented to the veterinarian the mites may be gone but a significant ear infection remains. Since these symptoms are similar can I just buy some ear drops? No, careful diagnosis of the exact cause of the problem is necessary to enable selection of appropriate treatment. There are several kinds of bacteria and fungi that might cause an ear infection. Without knowing the kind of infection present, we do not know which drug to use. -
ANATOMY of EAR Basic Ear Anatomy
ANATOMY OF EAR Basic Ear Anatomy • Expected outcomes • To understand the hearing mechanism • To be able to identify the structures of the ear Development of Ear 1. Pinna develops from 1st & 2nd Branchial arch (Hillocks of His). Starts at 6 Weeks & is complete by 20 weeks. 2. E.A.M. develops from dorsal end of 1st branchial arch starting at 6-8 weeks and is complete by 28 weeks. 3. Middle Ear development —Malleus & Incus develop between 6-8 weeks from 1st & 2nd branchial arch. Branchial arches & Development of Ear Dev. contd---- • T.M at 28 weeks from all 3 germinal layers . • Foot plate of stapes develops from otic capsule b/w 6- 8 weeks. • Inner ear develops from otic capsule starting at 5 weeks & is complete by 25 weeks. • Development of external/middle/inner ear is independent of each other. Development of ear External Ear • It consists of - Pinna and External auditory meatus. Pinna • It is made up of fibro elastic cartilage covered by skin and connected to the surrounding parts by ligaments and muscles. • Various landmarks on the pinna are helix, antihelix, lobule, tragus, concha, scaphoid fossa and triangular fossa • Pinna has two surfaces i.e. medial or cranial surface and a lateral surface . • Cymba concha lies between crus helix and crus antihelix. It is an important landmark for mastoid antrum. Anatomy of external ear • Landmarks of pinna Anatomy of external ear • Bat-Ear is the most common congenital anomaly of pinna in which antihelix has not developed and excessive conchal cartilage is present. • Corrections of Pinna defects are done at 6 years of age. -
Nomina Histologica Veterinaria, First Edition
NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria. -
Anatomy of the Ear ANATOMY & Glossary of Terms
Anatomy of the Ear ANATOMY & Glossary of Terms By Vestibular Disorders Association HEARING & ANATOMY BALANCE The human inner ear contains two divisions: the hearing (auditory) The human ear contains component—the cochlea, and a balance (vestibular) component—the two components: auditory peripheral vestibular system. Peripheral in this context refers to (cochlea) & balance a system that is outside of the central nervous system (brain and (vestibular). brainstem). The peripheral vestibular system sends information to the brain and brainstem. The vestibular system in each ear consists of a complex series of passageways and chambers within the bony skull. Within these ARTICLE passageways are tubes (semicircular canals), and sacs (a utricle and saccule), filled with a fluid called endolymph. Around the outside of the tubes and sacs is a different fluid called perilymph. Both of these fluids are of precise chemical compositions, and they are different. The mechanism that regulates the amount and composition of these fluids is 04 important to the proper functioning of the inner ear. Each of the semicircular canals is located in a different spatial plane. They are located at right angles to each other and to those in the ear on the opposite side of the head. At the base of each canal is a swelling DID THIS ARTICLE (ampulla) and within each ampulla is a sensory receptor (cupula). HELP YOU? MOVEMENT AND BALANCE SUPPORT VEDA @ VESTIBULAR.ORG With head movement in the plane or angle in which a canal is positioned, the endo-lymphatic fluid within that canal, because of inertia, lags behind. When this fluid lags behind, the sensory receptor within the canal is bent. -
Audiometric Findings with Voluntary Tensor Tympani Contraction Brandon Wickens1 , Duncan Floyd2 and Manohar Bance3*
Wickens et al. Journal of Otolaryngology - Head and Neck Surgery (2017) 46:2 DOI 10.1186/s40463-016-0182-y ORIGINALRESEARCHARTICLE Open Access Audiometric findings with voluntary tensor tympani contraction Brandon Wickens1 , Duncan Floyd2 and Manohar Bance3* Abstract Background: Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction. Methods: Five volunteers possessing the ability to voluntarily contract their tensor tympani muscles were identified and enrolled. Tensor tympani contraction was confirmed with characteristic tympanometry findings. Study subjects underwent conventional audiometry. Air conduction and bone conduction threshold testing was performed with and without voluntary tensor tympani contraction. Main outcome measure: Changes in air conduction and bone conduction thresholds during voluntary tensor tympani contraction. Results: Audiometric results demonstrate a low frequency mixed hearing loss resulting from tensor tympani contraction. Specifically, at 250 Hz, air conduction thresholds increased by 22 dB and bone conduction thresholds increased by 10 dB. Conclusions: Previous research has demonstrated a low frequency conductive hearing loss in the setting of tensor tympanic contraction. This is the first study to demonstrate a low frequency mixed hearing loss associated with tensor tympani contraction. This finding may aid in the diagnosis of disorders resulting from abnormal tensor tympani function. Tensor tympani contraction -
Positive Perilymph Fistula Test with Semicircular Canal Dehiscence from Cholesteatoma
PRACTICE | CLINICAL IMAGES Positive perilymph fistula test with semicircular canal dehiscence from cholesteatoma Ming-Chih Hsieh MD, Chen Chi Wu MD PhD, Shih-Hao Wang MD n Cite as: CMAJ 2019 January 28;191:E104. doi: 10.1503/cmaj.180799 54-year-old man presented to our outpatient department with left-side hearing loss and tinnitus that had progressed for several years. The patient had vertigo with nausea, whichA was aggravated on applying pressure over the left external ear canal and tragus. Physical examination showed left-side tym- panic membrane retraction with a whitish mass at the epitympa- num, suggestive of cholesteatoma. Gently compressing the left-ear tragus induced apparently left-beating horizontal nystagmus (see video, Appendix 1, available at www.cmaj.ca/lookup/suppl/ doi:10.1503/cmaj.180799/-/DC1), consistent with a positive peri- lymph fistula test. Pure tone audiometry showed mixed-type hear- ing loss of 104 dB in the patient’s left ear and sensorineural hearing loss of 62 dB in his right. High-resolution computed tomography (CT) scan of the patient’s temporal bone showed a soft-tissue mass in his left middle ear and mastoid cavity with left lateral semicircular canal erosion (Appendix 2, available at www.cmaj.ca/lookup/suppl/ Figure 1: Microscopic view of left lateral semicircular canal dehiscence with doi:10.1503/cmaj.180799/-/DC1). These findings were compatible erosion of bony and membranous sections (arrows) in a 54-year-old man with with cholesteatoma with lateral semicircular canal dehiscence. cholesteatoma. Note: *the malleus handle; +second genu of the facial nerve; During surgery, we noted that the osseous and membranous por- dotted lines define the tympanic segment of the facial nerve. -
Patient Information – Ear Surgery Instructions
The Oregon Clinic, Plaza ENT Division 5050 NE Hoyt #655, Portland, OR 97213 Phone: 5034882400 Fax: 5032310121 Patient Information – Ear Surgery Instructions Pre- and Post-operative Instructions for Ear Surgery (not including ear tubes) Before Surgery: Many ear surgeries involve manipulation of the eardrum (tympanic membrane), and some require the removal of bone to facilitate the treatment of your ear disease. As with any operation, infection, scarring, and blood clot formation (hematoma) are possible. The facial nerve is at risk for injury or temporary weakness during any ear surgery. Dizziness following surgery may be expected. Hearing loss or ringing in the ear (tinnitus) may be more pronounced. Taste disturbance is not uncommon in certain ear surgeries for a few weeks following surgery and, in a few instances, could be prolonged or permanent. An incision may be made behind your ear, on your earlobe, or behind the pointed cartilage in front of your ear (the tragus). These areas normally heal without problems or obvious scars. Hair around the ear may or may not be shaved. Flying is usually permitted one month after surgery. Swimming may be allowed six weeks after surgery, but check with your doctor first before resuming swimming or other water sports. If your work is not strenuous and depending upon the type of surgery you’ve had, you may return to work 3 to 4 days from the date of surgery. Generally, you will be seen about 2-3 weeks after surgery. This gives your eardrum time to heal before we see you back. Pre-operative Instructions: 1. -
Otosclerosis and Stapes Surgery | How to Prepare and What to Expect |
UW MEDICINE | PATIENT EDUCATION | | Otosclerosis and Stapes Surgery | How to prepare and what to expect | This handout explains otosclerosis, an ear problem that causes hearing loss. It also describes stapes surgery, which is done to improve hearing. What is otosclerosis? Otosclerosis (oh-toh-skleh-ROH-sis) is abnormal growth on the tiny stapes (stirrup) bone in your middle ear. This growth keeps the stapes from vibrating in response to sound. Otosclerosis is the most common cause of conductive hearing loss in adults. Conductive hearing loss is when sound waves cannot move normally in the ear (see DRAFTpage 3). At first, otosclerosis does not cause any symptoms. Hearing loss begins when the bone growth starts to affect how the stapes works. As the bone keeps growing, the Otosclerosis affects the stapes, a tiny hearing loss gets worse. bone in your middle ear. The good news is that hearing loss occurs in only 10% of people (10 out of 100) who have otosclerosis. Profound (severe) hearing loss and deafness are very rare. What causes otosclerosis? Otosclerosis can be hereditary, which means it may be passed from parents to their children. Someone in your family may have had the condition and passed it down to you. If you have otosclerosis, your children may inherit it. Hearing loss may not occur in all generations. The measles virus may affect whether or not you develop otosclerosis, but measles alone do not cause it. How is it treated? Your doctor may advise hearing aids or that you have stapes surgery to treat otosclerosis. Sometimes, both surgery and a hearing aid are needed.