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What is the most common cause of LMN facial nerve paralysis, and how does it present?
- Bell palsy
- Sudden, unilateral onset, usually after an URI
- Can be due to reactivation of HSV infection
- Usually resolves spontaneously within a month; can use steroids and antivirals to lessen duration
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Causes of LMN facial nerve paralysis, apart from Bell palsy
- HSV infection (Ramsay-Hunt syndrome, may be associated with encephalitis or meningits)
- Lyme disease
- Stroke
- Middle ear infection
- Meningitis
- Temporal bone fracture
- Acoustic schwannoma
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Most common cause of sudden-onset deafness
- Viral infection (endolymphatic labyrinthitis from mumps, measles, flu, chickenpox, or adeno)
- Hearing usually returns within 2 weeks, but loss may be permanent
- No known effective treatment
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Causes of vertigo
- CN VIII lesions--Menniere disease, tumor, infection, MS,
- Benign positional vertigo
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Most common cause of viral rhinitis
Rhinovirus
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Most common cause of bacterial rhinitis
- GAS, pneumococci, staphylocci
- Often accompanied by sore throat, fever, and tonsillar exudate
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Most common cause of otitis externa ("swimmer's ear")
- P. aeruginosa
- Presents with painful auricle, smelly discharge, and conductive hearing loss
- Treat with topical antibiotics (neomycin, polymyxin)
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Infectious myringitis
- Inflammation of the tympanic membrane
- Vesicles will be visible on otoscopy
- Usually caused by mycoplasma, but can also be caused by S. pneumonia, or viruses
- Treat with erythromycin or clarithromycin
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Most common cause of progressive conductive hearing loss in adults
Otosclerosis--fusion of the bones of the middle ear
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Most common cause of sensorineural hearing loss in adults
Presbyacusis
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Management of septal hematoma in nasal fracture
Surgical removal, to prevent septal necrosis
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