Ear Disorder 2 Flashcards
Conductive hearing loss
Dysfunction of external or middle ear
Sensorinueural Hearing loss
Dysfunction of inner ear
What are the possible etiologies behind Sensorineural Hearing Loss
- Presbycusis - age related and most common
- Persistent noise exposure
- Head trauma
What are the treatment recommendations for Hearing Loss
- Every patient should be referred to audiology/ENT unless the cause is obvious like otitis media
- Any patient with new onset hearing loss without an obvious pathology needs quick referral to audiology
- Everyone 65 and over needs to be referred.
What is Tinnitus. How is it characterized?
Perception of abnormal ear or head noise
High pitched, ringing or buzzing sound lasting from sec-min
Pulsatile tinnitus
Listening to ones own heart
Treatment for Tinnitus
- Avoid excessive noise
- Masking with music or hearing aids to drown out noise
- Medications- oral antidepressant
- Transcranial magnetic stimulation
Deep Brain Stimulation
What is Labyrinthisis?
Etiology?
Inflammation of the inner ear (CN VIII)
Tends to occur after a viral URI
Labyrinthitis treatments
- Antibiotics if patient is febrile or with symptoms of bacterial infection
2. Vestibular suppresents to decrease sensitivity of the inner ear Anticholinergics/Antihistamines - Dimenhydrinate/Dramimine -Meclizine/Antivert -Benzodiazepines- Lorazepam/Ativan
How is Menieres Disease diagnosed?
- Refer to ENT, audiology
- Caloric test
- blow cold/warm water in the ears and check for nystagmus
What is Vertigo
Sense of motion when there is no motion
What are the symptoms of Vertigo
- Spinning sensation
- Sense of tumbling
- Falling forward or backward.
What can you do to diagnose Vertigo?
Dix-Hallpike maneuver
Etiology behind Conductive Hearing Loss?
- Cerumen Impaction
2. Eustachian tube dysfunction
Thresholds greater than___ are considered abnormal
25 db
Staccato tinnitus
Rapid series of pops and clicks with sensation of ear fluttering.
What is the pathology of Menieres disease
Bulging of the semi-circular
How is Menieres disease clinically presented?
- Episodic vertigo (20 min - 1 hour)
- Sensorineural loss
- Tinnitus- low tone
- Unilateral ear pressure
Treatment for Menieres Disease? What is the main goal?
Main goal is to decrease endolymph fluid pressure in the inner ear.
- Diuretics
- Low salt diet
- Vestibular ablation with gentamicin
- Surgery
Acoustic Neuroma
Tumor of CN VIII
- Begins in auditory canal
- Gradually grows to compress pons and cause hydrocephalus
How can an Acoustic Neuroma present?
- Unilateral hearing loss
- Tinnitus
- Disequilibrium
What are the best ways to diagnose and treat a Acoustic Neuroma?
Diagnose: MRI scan
Treatment:
- Surgical excision
- Radiotherapy
Differentiate between Central and Peripheral vertigo?
Central (Brain):
- Gradual onset
- No auditory symptoms like tinnitus
Peripheral (Balance organs of the Ear):
- Sudden onset
- Severe, patient can’t walk or stand
- Associated with tinnitus and hearing loss
- Horizontal nystagmus
Name of the maneuver used to diagnose Vertigo?
Differentiate between a central and peripheral finding
Dix-Hallpike maneuver
Peripheral: Delayed onset of fatiguable nystagmus in most peripheral vertigo
Central : Nystagmus is non fatiguable (happens rapidly) indicates central cause
What is BPPV?
What is it commonly associated with?
Benign Paryoxysmal Positional Vertigo
Most common vestibular disorder
Most commonly associated with head changes (rolling over in bed)
How is Vertigo treated?
- PT or OT referral
- Epley Maneuver- moves rocks around
- Pharmaceutical agents
- Educate patient about risk of falls
