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The Ear

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Normal Tympanic Membrane

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Physiology of Hearing

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Auditory Pathway

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Ear Examination

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Aural speculum

Uses: Examination of EAM & TM. Surgical operations of the ear.

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Aural speculum

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Angulated Suction Tube

Uses: Suction of discharge or blood from

ear or nose

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Rinne test

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Webertest

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Tuning Fork tests

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T i F k

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Tuning Forks

Uses:1.Rinnes test2.Webers test

3.Schwabachs test

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Tuning Forks

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Siegles pneumatic otoscope

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Siegles pneumatic otoscope

Uses:1. To test the

mobility of theTM

2. Fistula test

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Microscopic Examination

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Hearing tests in childrenDistraction test

Between 2 months to 3 years

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Hearing tests in children

CooperationCooperation test Pure Tone Audiometry

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Caloric test

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Positional tests

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Myringotomy Knife

Uses:Incise the TM during myringotomy operation for:

OME after failure of medical treatment. ASOM if complicated or with impending rupture of

TM.

B E

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Bat Ears

Treatment: Plastic surgery

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Bat Ears

l l

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Microtia & Congenital MeatalAtresia

M & l M l

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Microtia & Congenital MeatalAtresia

Investigations:

CT scan temporalbone.

Audiologicalevaluation.

Treatment:

Plastic surgery

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Congenital Meatal Atresia

Treatment:

Meatoplasty

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Accessory Auricle

Treatment:Excision

Infected Preauricular fistula

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Infected Preauricular fistula

Investigations: Culture & sensitivity of dischargeTreatment:

Systemic Antibiotics Analgesics & antipyretics Incisionif pus collects Latter on excision

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Preauricular fistula

Treatment: Microscopic excision if symptomatic

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Auricular Perichondritis

Investigation: Culture & sensitivity (C&S) of discharge.Treatment:

Systemic Antibiotics Rest, Analgesics & antipyretics Wide Incisionif pus collects

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Auricular Perichondritis

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Cauliflower Ear

Treatment: Plastic surgery

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Haematoma Auris

Treatment: Aspirationif blood

still fluid.

Excisionif blood isclotted.

Tight bandage.

Systemic Antibiotics.

Foreign bodies (F B ) in the

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Foreign bodies (F.B.) in theexternal auditory canal

Treatment:

If living insect: Kill it first by

instillation of oilinEAM.

Extractionby hookor ear wash.

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Right LMNL Facial Nerve Paralysis

Investigations:1.Topognostic tests:

CT scan temporal bone. Stapedial reflex Shirmers test Electrogustometry

Salivary Flow test

2.Prognostic tests: Electroneurography ENOG Electromyography EMG

L ft LMNL F i l N P l sis

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Left LMNL Facial Nerve Paralysis

Treatment: Care of the eye Corticosteroids

Facial nerve explorationif indicated

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Schirmers Test

Postauricular Mastoid abscess

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Postauricular Mastoid abscess

Investigations:

CTscan temporal boneor plain X-ray mastoidview

Audiometry: CHL

C&Sfor dischargeTreatment: Systemic Antibiotics Rest, Analgesics&

antipyretics Cortical mastoidectomy& myringotomy

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Postauricular Mastoid abscess

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E

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Ear wax

Ot m sis

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Otomycosis

Investigation:swab for Fungal cultureTreatment: Removalof fungus by: Suction or Dry mopping Antifungalear drops

Avoid wetting the ear

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B ll s M i itis

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Bullous Myringitis

l P l

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Aural PolypInvestigations:

CTscan temporalbone or plain X-ray

mastoid view Audiometry: CHL

Culture &

Sensitivity C&Sfor discharge

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Treatment:

2. Polypectomy

3. Tympanoplasty with

mastoidectomy

Aural Polyp

Otiti M di

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Otitis Media

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Acute Suppurative

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Acute Suppurative

Otitis Media

Traumatic perforation of

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Traumatic perforation ofTympanic Membrane

Investigations:

AudiometryConductive Hearing Loss CHL

CTtemporal bone if there is fear of fracture base

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Traumatic perforation of

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Traumatic perforation ofTympanic Membrane

Otiti M di ith Eff i

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Otitis Media with Effusion

Investigations: Audiometry(CHL)

Tympanometry(type B)

Plain X-ray adenoidview

Otiti M di ith Eff i

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Otitis Media with Effusion

Treatment: Nasal decongestants,

corticosteroids,Mucolytics, antibiotics

Myringotomy & grommettubeinsertion afterfailure of medicaltreatment

Treatment of the causee.g. adenoidectomy

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M d h Eff

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Otitis Media with Effusion

V l l th d

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Valsalvas method

G t T b i l

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Grommet Tube in place

Use: Otitis Media with Effusion OME

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Grommet Tube in place

G t T b

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Grommet Tube

Adh i Otiti M di

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Adhesive Otitis Media

Investigations: Audiometry

(CHL),

Tympanometry(type B)

CT & Plain X-raynasopharynx

Adh si Otitis M di

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Adhesive Otitis Media

Treatment: Myringotomy &

T-tubeinsertion for

some early cases Hearing aid

Better Prophylacticby proper treatmentof ASOM & OME

D his t J l b lb

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Dehiscent Jugular bulb

Glomus Tumour

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Glomus Tumour

Angiogram for Glomus Tumour

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Angiogram for Glomus Tumour

Pre-embolization Post-embolization

T-tube in place

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p

Uses:

2. Adhesive otitis media, atelectatic ear some early cases

3. Chronic Eustachian tube dysfunction e.g. cleft palate

T tube

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T-tube

Haemotympanum

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Haemotympanum

Investigations:

Audiometry: CHL

CT temporal bonefor fear of fracturebase of skull

Treatment:

Conservative

Chronic suppurative 0.M.T b t mp ni T p

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Tubo-tympanic Type(Dry central perforation)

Investigations: CTscan temporal

bone or plain X-raymastoid view

Audiometry: CHL

C&Sfor discharge

(if any)

Chronic suppurative 0.M.T b t i T

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Tubo-tympanic Type(Dry central perforation)

Treatment:

Tympanoplasty operation

Chronic suppurative 0.M.

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ppTubo-tympanic Type

(Dry central perforation)

Chronic suppurative 0.M.Tubo tympanic Type

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Tubo-tympanic Type(Wet central perforation)

Treatment: Systemic Antibiotics

according to C&S

Nasal decongestantslocal& systemic

Antibiotic ear drops.

ThenTympanoplastyoperation

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Cholesteatoma

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(Attic Retraction)

Investigations:

CTscan temporalbone or plain X-ray

mastoid view Audiometry: CHL

C&Sfor discharge

Cholesteatoma

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Treatment:Tympanoplastywith mastoidectomy

Cholesteatoma

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Cholesteatoma

Cortical Mastoidectomy

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Cortical Mastoidectomy

A posterior approach & a drill are usedto uncover the mastoid antrum

The mastoid antrum is identified

Complete Cortical

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pMastoidectomy

Radical Mastoidectomy

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Radical Mastoidectomy

Otosclerosis

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Piston for stapedectomy operation

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Piston for stapedectomy operation

Uses:1. Otosclerosis

2. Congenital fixationof foot plate!!!!

Fractures of Temporal Bone

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Fractures of Temporal Bone