Inner Ear Conditions

Question 1

Presentation of Vestibular Neuronitis

Answer 1

Prolonged vertigo (days-weeks)
NO hearing loss or tinnitus

Question 2

Pathogenesis of Vestibular Neuronitis

Answer 2

Inflammation of vestibular nerve, usually viral in origin

Question 3

Management of Vestibular Neuronitis

Answer 3

May need an anti-emetic

Question 4

Presentation of Labyrinthitis

Answer 4

Prolonged vertigo (days-weeks)
MAY HAVE hearing loss and/or tinnitus

Question 5

Management of Labyrinthitis

Answer 5

Anti-emetic e.g. cyclizine

Question 6

Causes of BPPV

Answer 6

Head trauma
Ear surgery
(Idiopathic)

Question 7

Pathogenesis of BPPV

Answer 7

Otolith material from the utricle is displaced semi-circular canals

Question 8

Presentation of BPPV

Answer 8

Vertigo on movement

NO tinnitus or hearing loss

Question 9

Investigation of BPPV

Answer 9

Dix-Hallpike Test

Question 10

Dix Hallpike Test

Answer 10

Turn the head to a 45 degree angle and lower quickly
Observe for nystagmus
Repeat on the right and left sides

Question 11

Management of BPPV

Answer 11

Epley Manouvre

Question 12

Considerations for Vestibular Schwannoma

Answer 12

Bilateral and young

Consider NF II (autosomal dominant, chromosome 22)

Question 13

Presentation of Vestibular Schwannoma (4)

Answer 13

Vertigo
Hearing Loss
Tinnitus
Absent Corneal Reflex

Question 14

Investigation of Vestibular Schwannoma

Answer 14

MRI

Audiometry

Question 15

Management of Vestibular Schwannoma

Answer 15

Surgery

Radiotherapy

Question 16

Presentation of Meniere’s Disease (5)

Answer 16

History of recurrent vertigo lasting at least 20 minutes 
Tinnitus 
Nausea
Aural fullness 
Sensorineural hearing loss

Question 17

Investigation of Meniere’s Disease

Answer 17

Electrocochleagraphy

Question 18

Management of Meniere’s Disease

Answer 18

Prochlorperazine - nausea
Cutting out caffiene and reducing salt intake
Consider labyrinthectomy