Hearing loss/ Dizziness Flashcards
in conductive hearing loss, where does weber’s test localise to
will be louder in the deaf ear
in sensorineural hearing loss, where does webers test localise to
will be louder in normal ear
if AC>BC what type of hearing loss is there
normal hearing
if BC > AC what type of hearing loss is there
conductive hearing loss
causes of conductive hearing loss
outer or middle ear abnormalities
ear infections
middle ear fluid
perforated ear drums
what does an audiogram show for conductive hearing loss
significant gap between air and bone conduction with bone being low
causes of sensorineural hearing loss
damage to hair cells in cochlea
damage to vestibulocochlear nerve
sound exposure raging ototoxic drugs birth defects rubella benign tumours on auditory nerve (schwannoma) genetic predisposition
what does the audiogram show for sensorineural hearing loss
no gap between bone and air conduction
what is mixed hearing loss
both conductive and sensorineural
what are the vertigo causing ENT conditions
Labrynthitis vestibular neuritis Benign paroxysmal positional vertigo Meniere's disease Acoustic neuroma/vestibular schwannoma
how does BPPV present
most common cause of vertigo
short lasting vertigo on specific movement
-looking up
-turning over in bed
episodes last seconds - mins
cause of BPPV
otolith crystals from the utricle get displaced into the semicircular canals (most commonly posterior)
this stimulates hair follicles during certain movements making your brain think you’re moving
how do you diagnose BPPV
dix-hallpike manoeuvre
treatment of BPPV
Epely manoeuvre
what is labrynthitis
inflammation of the inner ear (labyrinth) usually caused by infection
symptoms of labrynthitis
vertigo (prolonged - days) nausea/vomiting hearing loss nystagmus tinnitus flu-like symptoms
(mainly hearing loss and tinnitus)
how do you diagnose labrynthitis
history
audiogram - sensiruneural hearing loss
weber’s test - sensorineural hearing loss
Rinne’s test - sensorineural hearing loss
treatment of labrynthitis
viral
-vestibular suppressants
benzodiazepines + anti-emetics + corticosteroids
bacterial
-vestibular suppressants, anti emetics
what is vestibular neuronitis
infection of the vestibular nerve in the inner ear causing it to be inflamed and a loss of balance
usually viral
main difference between vestibular neuritis and labrynthitis
vestibular neuronitis has NO tinnitus or hearing loss
presentation of vestibular neuronitis
prolonged vertigo (days)
no tinnitus or hearing loss
prodromal symptoms
treatment of vestibular neuronitits
vestibular suppressants - benzodiazepines
anti-emetics
corticosteroids
how does meniere’s disease present
sensorineural hearing loss
profound vertigo (at least 2 episodes >20 mins)
comes in clusters - few times a week/month/year
worsening on affected side
sense of aural fullness on affected side
cause of meniere’s disease
end-lymphatic high drops - overproduction or impaired absorption of endolymph - leads to mixing of endolymph and perilymph
management of meniere’s disease
supportive treatment during episodes tinnitus therapy hearing aids intratympanic steroids/gentamicin surgery - end-lymphatic system surgery
preventions for meiere’s disease
anti-vertigo medications -betahistine diuretics low salt diet reduce alcohol/caffeine consumption stress reduction
what is acoustic neuroma/vestibular schwannoma
benign tumour that grows from the superior vestibular component of the vestibulochoclear nerve
grow 1-2mm per year
only cause serious problems if 2.5-2mm
most common side of vestibular schwannoma
cerebellopontine notch
presentation of vestibular schwannoma/acoustic neuroma
vertigo hearing loss tinnitus facial numbness loss of balance absent corneal reflex
histological finding of vestibular schwannoma
verocay bodies
nuclear palisading
spindle needles
how do you diagnose vestibular schwannoma
MRI scan
audiogram - shows sensorineural loss
treatment of vestibular schwannoma
observation - as they’re v slow growing
radiation and surgery if they get v big
what causes nystagmus
impairment of vestibulo-occlear reflex
what is otosclerosis
fixation of the stapes footplate to the oval window of the cochlea
how does otosclerosis present
gradual onset conductive hearing loss
more common in females - progresses more rapidly in pregnancy
treatment for otosclerosis
stapedectomy
what is seen in audiometry for otosclerosis
Carhart’s notch at 2kHz
