Inner ear pathology Flashcards
What is presbycusis?
Degenerative hearing loss of old age
What causes presbycusis?
Gradual loss of outer hair cells of cochlea
What is the presentation of presbycusis?
Gradual hearing loss bilaterally
Sound confusion in loud environments
Tinnitus
What s labyrinthitis?
Acute inflammation of inner ear
What is the cause of labyrinthitis?
Usually after URTI
What is the presentation of labyrinthitis?
Vertigo- can be disabling
What is the management of labyrinthitis?
Vestibular sedative- prochlorperazine
Rest and rehab
What are the complications of labyrinthitis?
Long recovery
Hearing loss
Total vestibular destruction
What can cause vascular events within the inner ear?
Thromboembolism
Atherosclerosis
Vasculitis
What is the presentation of a vascular event in the inner ear?
Acute hearing loss, vertigo and tinnitus
What is the management of a vascular event in the inner ear?
Steroids
LMWH
What is Meniere’s disease?
Disorder of inner ear causing episodes of hearing loss, tinnitus and vertigo
What is the presentation of MEniere’s
Episodic and progressive
Sensorineural hearing loss
Vertigo- with N&V and nystagmus
Tinnitus
Tinnitus and hearing loss become permanent
Starts unilaterally and progresses to bilat
How is Meniere’s diagnosed?
Clinical history and exam
What is the management of Meniere’s?
Acute- vestibular sedatives
Preventative- vasodilator, diuretics, low salt and caffeine diet
Severe- ablation
What causes benign paroxysmal positional vertigo?
Dislodged otoliths settling in posterior semicircular canals
What is benign paroxysmal positional vertigo?
Episodic vertigo when head is moved in certain positions classically turning over in bed or looking up
What is the presentation of benign paroxysmal positional vertigo?
Vertigo associated with nystagmus towards affected side
How is benign paroxysmal positional vertigo diagnosed?
Dix-Hallpike test
How is benign paroxysmal positional vertigo managed?
Epley’s manoeuvre
What is vestibular neuritis?
Inflammation of vestibular portion of CNVIII
What cases vestibular neuritis?
Usually viral infection
What is the presentation of vestibular neuritis?
Vertigo
Hearing disturbances
What is the management of vestibular neuritis?
Vestibular sedatives
Rest
What is an acoustic neuroma?
Schwannoma of vestibular division of CNVIII
What is the presentation of an acoustic neuroma?
Vertigo
Unilateral sensorineural hearing loss and tinnitus- growth of schwannoma caused compression of cochlear nerve
How is an acoustic neuroma diagnosed?
MRI
What is the management of an acoustic neuroma?
Slow growing- watchful waiting
Surgery
Radiotherapy
