Inner Ear Flashcards
inflammation of the labyrinth that affects the vestibular portion of CN 8
acute labyrinthitis
what is the etiology of acute labyrinthitis?
viral URI
a patient presents with history of viral URI with rapid onset of unilateral hearing loss, vertigo, N/V, and gait instability. what is this patient most likely experiencing?
acute labyrinthitis
what should I do for a patient with acute labyrinthitis?
refer to ENT
what is the short-term treatment for acute labyrinthitis? (3)
- prednisone for inflammation
- anti-emetics
- antivert
what is the long-term treatment for acute labyrinthitis?
vestibular rehab
an elderly patient presents with short episodes (secs-mins) of vertigo brought on by head movements, sudden onset N/V, tinnitus, and may be unable to walk or stand. 50% of patients have a history of ear trauma or infection. what is this patient most likely experiencing?
Benign, Paroxysmal Positional Vertigo (BPPV)
what is the treatment for BPPV?
vestibular rehab
a patient that presents with perception of noise or ringing in the ears, which is a symptom of age-related hearing loss or ear injury. what is this patient experiencing?
tinnitus
how might tinnitus be described? (5)
- roaring
- buzzing
- ringing
- clicking
- hissing
what is the management for a patient with tinnitus? (2)
- refer to ENT
- audiology
what is the treatment goal for a patient with tinnitus?
reduce the awareness of tinnitus and protect QOL
benign tumor on the myelin-making cells wrapped around CN 8
vestibular schwannoma
a patient presents with asymmetric hearing loss, tinnitus, vertigo, and (sometimes) facial numbness/weakness. what is this patient experiencing?
vestibular schwannoma
what are the 2 ways to diagnose a vestibular schwannoma?
- audiogram - asymmetric sensorineural hearing loss
- MRI of IAC
what should I perform on a patient that presents with sensorineural hearing loss?
MRI of internal acoustic canal (IAC)
what is the treatment for a young patient with a large vestibular schwannoma, and significant hearing impairment?
surgery/radiation
what is the treatment for an older patient with a small vestibular schwannoma, and limited hearing impairment?
observation with yearly audiogram and MRI
excess endolymph (hydrops) within the inner ear
meniere disease
although meniere disease has an unknown etiology, what is the most plausible cause?
sodium and water retention
a patient presents with disabling episodes that lasts mins-hrs. They have fluctuating asymmetric sensorineural hearing loss, tinnitus, vertigo, +/- ear fullness in the same ear, and N/V. what is this patient experiencing?
meniere disease
what is something I should worry about in a patient with meniere disease?
sensorineural hearing loss can become permanent within 8-10 years
what are 5 differential diagnoses to keep in mind for a patient with suspected meniere disease?
- vestibular schwannoma
- BPPV
- MS
- transient ischemia attack
- migraine
what 3 diagnostics should I perform on a patient with suspected meniere disease?
- audiogram
- vestibular testing
- MRI - rule out tumors and MS
