Inner Ear Flashcards
What is vertigo?
Sensation that objects around you are spinning around. It can be associated with nausea and difficulties walking.
What is benign positional paroxysmal vertigo (BPPV)?
Vertigo caused by otolith material displacing form utricle into semicircular canals causing vertigo
What is the commonest cause of vertigo?
Benign positional paroxysmal vertigo (BPPV)
How does benign positional paroxysmal vertigo (BPPV) present?
Brief episodes of vertigo
Triggered by certain positions
(e.g. turning in bed, lying down, getting up, bending forward)
Without tinnitus/hearing loss or aural fullness
How can benign positional paroxysmal vertigo (BPPV) be diagnosed?
Positive Dix-Hallpike test
Nsytagmus after lying down, turning head to side and quickly lying head over couch
If the first attempt at the Dix-Hallpike test fails, can you do it again?
No, the test fatigues
How can benign positional paroxysmal vertigo (BPPV) be treated?
Epley manoeuvre (series of head movements which moves otolith material back into utricle)
How can benign positional paroxysmal vertigo (BPPV) be self managed by patients?
Brandt-Daroff exercises (series of movements which moves otolith material back into utricle)
What is Meniere’s disease?
Disease of unknown pathophysiology characterised by episodes of spontaneous vertigo
How does Meniere’s disease present?
Episodes of vertigo lasting hours
With tinnitus/hearing loss W
With aural fullness
What is required for a diagnosis of Meniere’s disease?
2 vertigo episodes with at least 1 documented sensorineural hearing loss
What can be done to prevent Meniere’s disease?
Betahistine
Salt restriction
What is labyrinthitis?
Inflammation of the inner ear which can be caused by viral infection
How does labyrinthitis present?
Prolonged (days) vertigo
With tinnitus/hearing loss
Without aural fullness
May be preceded by viral infection
How is labyrinthitis treated?
Supportive
Self limiting condition
What can be given to acutely manage an attack of vertigo?
H1 antihistamine
Cinnarizine
What is vestibular neuronitis?
Inflammation of the vestibulocochlear nerve (CN VIII) which can be caused by viral infection
How does vestibular neuronitis present?
Prolonged (days) vertigo
Without tinnitus/hearing loss
Without aural fullness
May be preceded by viral infection
How is vestibular neuronitis treated?
Supportive
Self limiting condition
What is migrainous vertigo?
Episodes of vertigo associated with migraine, phonophobia/photophobia, visual aura and motion sickness
What is the cerebellopontine angle?
Space between the cerebellum and he pons
What is the most common cerebellopontine angle tumour?
Vestibular schwanomma
What is a vestibular schwannoma?
Benign, slow growing tumour of vestibulocochlear nerve (CN VIII) myelin forming cells
How might a vestibular schwannoma present?
Sensorineural hearing loss
Vertigo
Tinnitus
What imaging modality is used to investigate sensorineural hearing loss?
MRI
What condition is associated with bilateral vestibular schwannomas?
Neurofibromatosis type 2
What is presbycusis?
Age related degeneration of inner ear hair cells causing sensorineural hearing loss
What is the treatment of presbycusis? What indications are there for this treatment?
Hearing aid
Only indication is patient complaint
What antibiotic is ototoxic and can damage CN VIII impulses causing sensorineural hearing loss?
Gentamicin
What imaging modality is used to investigate conductive hearing loss?
CT
