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Chronic Otitis Media and Cholesteatoma

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1.  The following are the most common presenting symptoms of patients with cholesteatoma: Hearing loss/ear drainage Ear pain/facial paralysis Dizziness/headache Neck stiffness/sensitivity to light

2.  All of the following are true regarding tympanic perforations EXCEPT: In general, the larger the perforation, the greater the hearing loss The severity of hearing loss is not dependent on the location of the perforation Tympanic perforations always result in a cholesteatoma Hearing loss varies inversely with the size of the middle ear space/mastoid air space

3.  Cholesteatoma is made up of: Trapped skin Hair follicles Bone Cartilage

4.  A congenital cholesteatoma has all of the following characteristics, EXCEPT: A whitish mass behind the tympanic membrane An intact tympanic membrane Is the result of skin remnants trapped behind the tympanic membrane Always causes ear drainage

5.  All of the following are true regarding tympanosclerosis, EXCEPT: Is usually not associated with hearing loss Always causes significant hearing loss May involve the tympanic membrane and ossicles May be confused with a cholesteatoma on otoscopic exam

6.  The most common location for ossicular erosion from chronic otitis media or cholesteatoma is: The incudostapedial joint The malleus The malleoincudo joint The stapes

7.  Which of the following is true regarding cholesteatoma? Always requires surgical treatment Rarely causes hearing loss Only occurs in patients younger than 18 years old Causes bone destruction through pressure effects/enzymatic action

8.  Which of the following is true regarding adhesive middle ear disease: Always requires surgical treatment May result in near normal hearing Always worsens with time Usually causes tinnitus

9.  Ossicular reconstruction options include all of the following materials, EXCEPT: Bone cement Titanium Stainless steel Hydroxyapatite (synthetic form of bone)

10.  The acoustic reflex (AR) can be used to differentiate between middle ear issues and third window lesions, as presented in the chart that is available in the course handout. Typically: AR is present in middle ear issues and absent in third window lesions AR is present at lower stimulus levels in middle ear issues AR is absent in both middle ear issues and third window lesions AR is absent in middle ear issues and present in third window lesions