Otorhinolaryngology

Head & Neck Surgery

Self Assessment
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Otology, Neuro-otology, Audiology
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3 A 30-year old university student is referred to the outpatient Otolaryngology department
with a complaint of sudden hearing loss from the left ear. He denies any history of trauma, 20
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vertigo, aural fullness or tinnitus . Otoscopy shows no abnormalities. Tuning fork tests are 21
5 performed and the findings are shown in the video below.
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Which of the following is the most likely diagnosis ?
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8 A 24
a) Sensorineural hearing loss in the right ear
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10 B b) Sensorineural hearing loss in the left ear
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11 c) Conductive hearing loss in the right ear
C 27
12 d) Conductive hearing loss in the left ear
D 28
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e) Normal tuning fork test
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E
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An 18-month-old toddler presents with 1 week of rhinorrhea, cough, and congestion. Her
2 parents report she is irritable, sleeping restlessly, and not eating well. Overnight she developed
3 a fever. She attends day care and both parents smoke. On examination signs are found
consistent with a viral respiratory infection including rhinorrhea and congestion. The toddler
appears irritable and apprehensive and has a fever. Otoscopy reveals a bulging, erythematous
tympanic membrane and absent landmarks

Which of the following statements is correct?

a) Streptococcus pyogenes is the most likely causative agent in this patients
condition

b) Ciprofloxacin is the drug of choice for the initial treatment of this patient

c) Lateral sinus thrombosis is the most common intracranial complication of

this condition

d) Tympanocentesis should be performed immediately and a ear swab of the

pus should be sent for culture and sensitivity prior to starting antibiotics
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A 60-year old lady presents to the Cornwall Regional Hospital with to a complaint of left sided facial
2 weakness, otalgia & a sensation of “burning eyes” for the last three days. She also reports tinnitus,
3 vertigo, and hearing loss. Physical examination shows a left facial palsy with a vesicular eruption in
the left external auditory canal, ear lobe and neck on that side.

Which of the following statements is most accurate?

a) The most likely diagnosis is Bell’s Palsy

b) prescribing prednisone and acyclovir will likely improve her condition

c) Reactivation of the Epstein Barr virus within the geniculate ganglion is the
most likely cause

d) Surgical decompression of the facial nerve is recommended

e) Topical ear drops is has been shown to be effective in the management of

patients with this condition
A 19-year-old woman presents to her primary care physician due to progressive left ear
hearing loss. She is otherwise healthy with no significant past medical history. Her father
began wearing a hearing aid around the age of 23. The right Tympanic membrane is normal
on otoscopy, however the left tympanic membrane shows a positive “schwartze sign” . A
tuning fork is placed at the center of the forehead and showed lateralization to the left ear.
A 35-year-old man with neurofibromatosis type II presents
with nausea, vomiting, vertigo, and deafness in his right
ear. Hemianesthesia is present on the right side of this
face.
A 29-year-old man presents with unresolved left ear pain for the past 5 months.
He also states to having a relative hearing loss of the left ear with occasional
tinnitus. Medical history is significant for otitis media that was treated with
appropriate antibiotics. He reports completing the course of antibiotics. On
physical examination, there is an amorphous, white debri in the left middle ear.
Preparations are made to undergo a non-contrast computer tomography (CT)
scan of the temporal bone
Which of the following statements regarding the ear and hearing is incorrect?
The range of human hearing is from 20 Hz to 20 kHz

The ear is most sensitive to frequencies between about 1kHz and 3kHz.

Endolymph of the scala media is similar in composition to plasma

Test Review
 A 30-year old university student is referred to the outpatient Otolaryngology department
with a complaint of sudden hearing loss from the left ear. He denies any history of trauma,
vertigo, aural fullness or tinnitus . Otoscopy shows no abnormalities. Tuning fork test are
performed and the findings are shown in the video below.

Which of the following is the most likely diagnosis ?

❌ A Sensorineural hearing loss in the right ear

✅ B Sensorineural hearing loss in the left ear

❌ C Conductive hearing loss in the right ear

❌ D Conductive hearing loss in the left ear

❌ E Mixed hearing loss