Inner Ear Disease Flashcards
Meneire snhl sccd vertigo
Other name for meniere’s
Endolymph hydrops
Endolymph is produced from -
It is absorbed from
Stria vascularis
Endolymphatic sac
Increased production of endolymph leads to
Increased pressure and rupture of reissner membrane pressure change-vertigo
Damage to hair cell -snhl
Fluctuating hearing loss in menieres is due to
Rupture of membrane leads to pressure change-vertigo and hair cell damage but later pressure equalize and membrane heals hair cells regenerate hearing improves
Lermoyez syndrome
Hearing loss occurring before vertigo in menieres (rare)
Doubling of sound in menieres is k a why it happens
Diplacusis
As menieres is u/l diff frequency of sound heard
B/l fluctuating hearing loss
SOM
Menieres effects high frequency sound more?
No
Initially low frequency effected because it starts at apex
Effect of dilatation inside utricle and saccule
Tumarkin crisis - distortion if maccule affects linear acceleration
Effects of dilatation outside utricle and saccule in menieres
Tullio phenomenon vertigo on loud sound
Hennebert sign vertigo on pressure change even without fistula
Best investigation for menieres
Electrocochleography -SP/AP more than 45%
Glycerol test -hygroscopic action decrease fluid decrease ratio sp by ap
How to prevent menieres
Salt restricted diet
Caffeine restriction
Line of mgt for menieres
Medical mgt Transtympanic steroid Chemical Labyrithectomy Vestibular neurectomy Total Labyrithectomy if pt has complete hearing loss Endolymph sac decompression
Donaldson line
Imaginary line from LSCC to bisect PSCC ant inferior to which lies endolymphatic sac
Boundaries of trautman triangle
Ant inner ear
Post sigmoid sinus
Superior- sup petrosal sinus
Citelli angle
Angle bw dural plate (sup petrosal sinus) and sinus plate(sigmoid sinus)
Superior scc dehiscence syndrome aka
Third window syndrome
Arcuate Eminence
Bulge of scc on ant slant of petrous temporal bone
Vestibular symptoms of ssc dehiscence
Tullio phenomenon
Hennebert sign
Cochlear symptoms of ssc dehiscence
Bone conduction increase
Air conduction decrease
Ie why rinne negative weber toward same side
Abc lengthened Schwabach Lengethend pta ab gap present audiometry normal
Best investigation for diagnosis of ssc dehiscence
HRCT shows absence of bone overlying scc
Most common cause of vertigo
BPPV
Otolith dislodge in which canal most common
Posterior scc > horizontal> superior
Acute onset vertigo lasting for 20 min to 24 hrs
Suspect
Menieres
