Inner Ear 2.27.18

Question 1

What threshold is considered abnormal for hearing loss on a pulse tone hearing test

Answer 1

> 25dB

Question 2

Preferred imaging for central lesions?

Answer 2

MRI

Question 3

Who do you refer to ENT/Audiology?

Answer 3

1. Anyone with hearing loss
2. People with loud noise exposure
3. 65+

Question 4

4 Treatments for tinnitus

Answer 4

1. masking (ex. music)
2. antidepressants
3. Transcranial magnetic stimulation
4. Deep Brain stimulation

Question 5

2 Types of tinnitus

Answer 5

1. Pulsatile (could indicate a vascular abnormality)

2. Staccato (rapid series of pops or clicks with sensation of ear fluttering)

Question 6

Treatment for labyrinthitis

Answer 6

1. Vestibular suppressants: antihistamines -Dimenhydrinate, meclizine, benzodiazepines: lorazepam
2. Anti-emetic: ondansetron (Zofran)
3. Oral steroids
4. Antibiotics (if fever)

Question 7

Is Meniere’s a central or peripheral lesion

Answer 7

peripheral lesion

Question 8

What test might the ENT do for meniere’s disease?

Answer 8

Caloric testing (hot or cold water in the ear with nystagmus)

Question 9

4 treatments for Meniere’s disease

Answer 9

1. diuretics
2. low salt
3. ablation with ototoxic drug (gentamycin, aminoglycosides)
4. Surgery: vestibular nerve, labyrinthectomy

Question 10

Where do Acoustic neuromas form, where do they go and what do they cause?

Answer 10

• form in internal auditory canal
• grow to compress the pons
• cause hydrocephalus

Question 11

Acoustic neuroma: What is the most common presentation (and 2nd most)

Answer 11

1. Unilateral hearing loss

2. tinnitus or disequilibrium

Question 12

Compare and contrast central vertigo and peripheral vertigo

Answer 12

Central: gradual onset, no auditory symptoms, brain is affected, Dix-Hallpike maneuver: non-fatiguable nystagmus

Peripheral: sudden onset, severe auditory symptoms (tinnitus, hearing loss), horizontal nystagmus, delayed onset, fatiguable nystagmus with Dix-Hallpike