Otology History
As with all specialities a concise yet thorough history is paramount to ensure that no important information is missed. The format you have learned from day one enables this, however, taking a focused speciality history requires specific closed questions.
There are five main otological symptoms to consider when taking an otological history:
1. Otalgia (ear pain)
S ite (Where does the pain originate. Is it definitely the ear?)
O nset (When did the pain start? Gradual or sudden)
C haracter (What is the pain like? sharp, dull, stabbing)
R adiation (Does the pain radiate anywhere?)
A ssociations (Any other symptoms associated with the pain – e.g. headaches?)
T ime course (Does the pain follow a pattern?)
E xacerbating/relieving factors
S everity
2. Otorrhoea (ear discharge)
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Colour
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Contains mucus?
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Offensive smelling
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Volume +/- bleeding
3. Hearing loss
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Duration
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Side
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Fluctuation
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Onset
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Frequency
4. Tinnitus
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Pulsatile
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Buzzing / hissing
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Side (one side or both?)
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Impact on life (sleep, concentration, irritability)
5. Vertigo / imbalance
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Timings
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Triggers
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Associations
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Presence of neurological symptoms (particularly posterior fossa)