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Ent > Inner Ear Disease > Flashcards

Inner Ear Disease Flashcards

Meneire snhl sccd vertigo

1
Q

Other name for meniere’s

A

Endolymph hydrops

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2
Q

Endolymph is produced from -

It is absorbed from

A

Stria vascularis

Endolymphatic sac

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3
Q

Increased production of endolymph leads to

A

Increased pressure and rupture of reissner membrane pressure change-vertigo
Damage to hair cell -snhl

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4
Q

Fluctuating hearing loss in menieres is due to

A

Rupture of membrane leads to pressure change-vertigo and hair cell damage but later pressure equalize and membrane heals hair cells regenerate hearing improves

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5
Q

Lermoyez syndrome

A

Hearing loss occurring before vertigo in menieres (rare)

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6
Q

Doubling of sound in menieres is k a why it happens

A

Diplacusis

As menieres is u/l diff frequency of sound heard

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7
Q

B/l fluctuating hearing loss

A

SOM

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8
Q

Menieres effects high frequency sound more?

A

No

Initially low frequency effected because it starts at apex

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9
Q

Effect of dilatation inside utricle and saccule

A

Tumarkin crisis - distortion if maccule affects linear acceleration

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10
Q

Effects of dilatation outside utricle and saccule in menieres

A

Tullio phenomenon vertigo on loud sound

Hennebert sign vertigo on pressure change even without fistula

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11
Q

Best investigation for menieres

A

Electrocochleography -SP/AP more than 45%

Glycerol test -hygroscopic action decrease fluid decrease ratio sp by ap

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12
Q

How to prevent menieres

A

Salt restricted diet

Caffeine restriction

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13
Q

Line of mgt for menieres

A 
Medical mgt
Transtympanic steroid 
Chemical Labyrithectomy 
Vestibular neurectomy
Total Labyrithectomy if pt has complete hearing loss 
Endolymph sac decompression
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14
Q

Donaldson line

A

Imaginary line from LSCC to bisect PSCC ant inferior to which lies endolymphatic sac

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15
Q

Boundaries of trautman triangle

A

Ant inner ear
Post sigmoid sinus
Superior- sup petrosal sinus

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16
Q

Citelli angle

A

Angle bw dural plate (sup petrosal sinus) and sinus plate(sigmoid sinus)

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17
Q

Superior scc dehiscence syndrome aka

A

Third window syndrome

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18
Q

Arcuate Eminence

A

Bulge of scc on ant slant of petrous temporal bone

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19
Q

Vestibular symptoms of ssc dehiscence

A

Tullio phenomenon

Hennebert sign

20
Q

Cochlear symptoms of ssc dehiscence

A

Bone conduction increase
Air conduction decrease
Ie why rinne negative weber toward same side
Abc lengthened Schwabach Lengethend pta ab gap present audiometry normal

21
Q

Best investigation for diagnosis of ssc dehiscence

A

HRCT shows absence of bone overlying scc

22
Q

Most common cause of vertigo

A

BPPV

23
Q

Otolith dislodge in which canal most common

A

Posterior scc > horizontal> superior

24
Q

Acute onset vertigo lasting for 20 min to 24 hrs

Suspect

A

Menieres

25
Q

Vertigo only during loud sound and pressure changes

A

SSCC dehiscence

26
Q

Episodic vertigo on change of head position

A

BPPV

27
Q

Test done for diagnosis of vertical canal BPPV

A

Dix Hallpike maoeuvre

28
Q

Investigation for horizontal scc bppv

A

Supine roll test

29
Q

Treatment of posterior scc bppv

A

Epleys manoeuvre

30
Q

Geotropic nystagmus

A

Nystagmus dir towards ear facing ground

31
Q

Nystagmus in bppv

Characteristics

A

Latency
Vertical horizontal with torsion
Fixed direction towards affected side
Limited duration

32
Q

Vertigo alone without hearing loss suspect
Acute onset
For 3-7 days

A

Vestibular neuritis

33
Q

Diff bw sudden snhl and severe snhl

A

Sudden snhl
More than 30db loss in 3 consecutive freq within 3 days
Severe snhl
More than 70bd loss in 3 consecutive freq occurring suddenly

34
Q

Most common cause of sudden snhl

A

Idiopathic

35
Q

Mgt of sudden snhl

A

Steroids high dose
Transtympanic steroids when normal steroids shows no response
Antiviral
Carbogen hyperbaric O2

36
Q

Rinne test in severe snhl?

A

BC>AC

FALSE NEGATIVE

37
Q

Normal recommended sound level

A

Less than 85db for 8hrs/day for 5 days

38
Q

How to distinguish whether pt has permanent or temporary hearing loss

A

Temporary will recover within 24 hrs

Permanent occurs when sound >140 dB

39
Q

Pure tone audiometry finding in noise induced hearing loss

A

High frequency pta done

Down sloping audiogram

40
Q

Earliest finding in nihl

A

Acoustic dip at 4000Hz

41
Q

Ear muffs and plugs provide protection upto

A

30-40 dB respectively

42
Q

Age related hearing loss

A

Presbycusis

43
Q

Most common cause of presbycusis

A

Neural presbycusis atrophy of nerves

44
Q

Audiogram finding of presbycusis

A

Down sloping audiogram

B/L progressive SNHL

45
Q

Cochleotoxic drugs

A

Kanamycin
Amikacin
Neomycin

46
Q

Drugs causing irreversible hearing loss

A

Aminoglycosides

Cytotoxic drugs like cisplatin

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