Chapter 145 Management of Temporal Bone Trauma Quinton Gopen, M.D. UCLA Medical Center

Question 1: Temporal Bone fractures are classified as longitudinal or transverse based on the fracture line relationship to: Coronal Plane Axial Plane Sagital Plane Petrous Ridge Temporal Line

Question 2 Temporal bone fractures entering into the otic capsule generally result from blows to the Temporal Region Occipital Region Parietal Region Frontal Region Parasaggital Region

Question 3 The incidence of otic capsule involvement is generally considered to occur in what percentage of temporal bone fractures? 5% 10% 20% 40% 80%

Enter Question Text Question 4 Pediatric temporal bone fractures differ from adult temporal bone fractures in that pediatric fractures have a lower incidence of Facial nerve involvement Intracranial complications Comminuted fractures Concurrent C-spine injuries None of the above

Enter Question Text Question 5 An 18y.o. man sustains a temporal bone fracture based on initial head CT on presentation to the ER. The patient complains of pain over the fracture site and hearing loss. The patient has no vertigo, nystagmus or other neurologic symptoms. What is the next best test to obtain? MRI scan brain CT angiography Caloric testing VEMP testing CT temporal bones

Enter Question Text Question 6 A 74 y.o. man sustains a temporal bone fracture. The fracture extends through the geniculate ganglion and is comminuted. The man has near complete facial paralysis but does have some minimal movement of the face on maximal effort. His hearing is grossly intact. The best treatment plan is: Oral corticosteroid therapy Facial nerve decompression via a transmastoid approach Facial nerve decompression via a middle fossa approach Facial nerve decompression via a combined transmasoid-middle fossa approach Facial nerve decompression via a translabyrinthine approach

Enter Question Text Question 7 The site of facial nerve injury in the majority of temporal bone fractures is the: Vertical segment Horizontal segment Perigeniculate region Meatal segment Second genu of the facial nerve

Enter Question Text Question 8 The theoretical time for the maximal regeneration of axoplasmic flow is considered to be how long after the injury Immediately following the injury 1 day 3 days 10 days 21 days

Enter Question Text Question 9 An ENoG results showing this percentage of degeneration or greater of the facial nerve is generally considered to be an indication for surgical exploration and decompression (Fisch criteria) 50% 75% 90% 95% 100%

Enter Question Text Question 10 The best initial treatment for acute posttraumatic CSF otorrhea is: Bed rest Serial lumbar punctures Lumbar drain Surgical exploration with closure of the ear canal Surgical exploration with mastoid obliteration

Chapter 129 Physiology of the Auditory System Quinton Gopen, M.D. UCLA Medical Center

Enter Question Text Question 1 What is the resonant frequency of the external auditory canal? 5300 Hz 3000 HZ 1200 Hz 800 Hz 100 Hz

Question 2 What is labeled as “ Question 2 What is labeled as “?” in the adjacent histopathologic slide? ? Helicotrema Scala Tympani Scala Media Scala Vestibuli Organ of Corti

Question 3 A patient presents with a mixed hearing loss Question 3 A patient presents with a mixed hearing loss. The vestibular evoked myogenic potential response is recorded at a sound threshold of 120dB? What is the most likely diagnosis Otosclerosis Superior semicircular canal dehisence Meniere’s Disease Connexin 26 gene mutation Usher’s syndrome

Question 4 Type I spiral ganglion cells: Less common than type II spiral ganglion cells Are myelinated Project to between 3 and 5 inner hair cells Project to between 3 and 5 outer hair cells None of the above

Question 5 The auditory cortex is located within the Temporal lobe Occipital lobe Parietal lobe Brainstem Midbrain

Question 6 The speed of sound waves in air is roughly 120 meters per second 340 meters per second 630 meters per second 1220 meters per second 1500 meters per second

Question 7 The cochlear duct is filled with Endolymphatic fluid Perilymphatic fluid Dense collagen like material Cerebrospinal fluid Loose fibrous tissue

Question 8 What is considered the first relay station for all ascending auditory information Lateral lemniscus Auditory nerve Medial geniculate body Cochlear nucleus Heschyl gyrus

Question 9 Binaural squelch refers to The ability of the brainstem auditory nuclei to increase the signal to noise ratio Signal received by both ears is greater in amplitude than the signal received by a single ear Outer hair cell control over the inner hair cells Uncomfortable feedback created by hearing aids The sound in your mind created by reading this question

Question 10 The primary auditory cortex is tonotopically tuned such that the highest frequencies are at the medial aspect lateral aspect superior aspect inferior aspect Central aspect