Ear problems

Question 1

What causes BPPV?

Answer 1

Head movement disrupts otoliths in semicircular canals

Question 2

What is used to diagnose BPPV?

Answer 2

Hallpike manouevre

- fatigueable nystagmus

Question 3

What is used to treat BPPV?

Answer 3

Epley manouevre - clears debris

Question 4

What are the symptoms of labyrinthitis (vestibular neuronitis)?

Answer 4

Vertigo (UL) and vomiting, prostration
NO deafness/tinnitus

Nystagmus away from the affected side

Question 5

How is labyrinthitis treated?

Answer 5

Vestibular suppressent - cyclizine

Question 6

What causes meniere’s?

Answer 6

Increased pressure in endolymphatic system

Question 7

What are the symptoms of meniere’s?

Answer 7

vertigo attacks - 2-4hrs
Tinnitus
Sensorineural hearing loss
Aural fullness

Question 8

How is meniere’s managed?

Answer 8

Prochloperazine

Question 9

What is an acoustic neuroma?

Answer 9

Schwannoma arising from the vestibular nerve

Question 10

What are the symptoms of acoustic neuromas?

Answer 10

UL hearing loss
Vertigo (later onset)

May eventually impact IP CN - V, VI, IX, X

Question 11

What is the Rinne test?

Answer 11

1. hold tuning fork behind ear until no noise hear (BC)
2. move infront of ear (AC)

Rinne +ve = normal (AC louder than BC)
Rinne -ve = conductive deafness (BC loader than AC)

Question 12

What is the weber test?

Answer 12

Tuning fork in middle of forehead

Louder in one ear indicates:

• IL conductive loss OR
• CL sensorineural loss

Result is confirmed with Rinne test