Problems with hearing and balance

Question 1

What are the three parts of the ear

Answer 1

Outer ear: Pinna + EAC
Middle ear: TM, ossicles, + aircontaining space
Inner ear: Cochlea, vestibule, semicircular canals

Question 2

What are the two tuning fork tests

Answer 2

Weber: Fork placed in middle of the head . sound moves
toward a conductive loss, away from a sensorineural loss.

• Rinne: Fork on bone and then by ear
If BoneConduction>AC THEN conductive HL

Question 3

what does tympanometry measure? what are the possible results

Answer 3

movement of the eardrum
Type A = Normal
Type B (flat) = Fluid or perforation
Type C (neg pressure) = ET dysfunction

Question 4

Otitis Media

Answer 4

Can be acute or chronic. Inflammation of the middle ear

Question 5

What si the most common ear operation?

Answer 5

Myringotomy – surgical incision to drain fluid from eardrum

Question 6

What does Stapedectomy repair?

Answer 6

repairs conductive hearing loss

replace stapes with prosthesis

Question 7

Sensorineural Hearing Loss causes

Answer 7

noise, age, genetics, toxins, virus,

acoustic neuroma

Question 8

Mixed Hearing Loss

Answer 8

both conductive and sensory neural causes for hearing loss present

Question 9

Presbycusis

Answer 9

Age related hearing loss (normally a volume problem)

good retention of speech discrimination

Question 10

if speech discrimination is decreased what does that indicate

Answer 10

Neuron discrimination

Question 11

Acoustic neuroma

Answer 11

small schwannoma

Question 12

one sided hearing loss disorder?

Answer 12

think of tumor/ acoustic neuroma

Question 13

what are cochlear implants used for?

Answer 13

profound sensorineural deafness

Question 14

vertigo

Answer 14

feels like the world is moving when they are laying still

Question 15

Common vestibular syndromes (5)

Answer 15

1 Acute, unilateral vestibular loss - Viral inflammation
2 Meniere - episodic vertigo for hours
3 BPPV
4 Bilateral vestibular loss (ataxia +oscillopsia)
5 Migraine-associated dizziness

Question 16

Meniere’s syndrome

Clinical presentation

Answer 16

Unilateral hearing loss
– fluctuant
– diplacusis
• Aural fullness
• Tinnitus

Question 17

tx of meniees disease

Answer 17

Vestibular suppressants - acute
– Meclizine, etc.

• Diuretics; low salt diet chronic
• Vasodilators (betahistine) chronic
• Gentamicin (intratympanic or IM) chronic, refractory
• Dexamethasone (oral or intratympanic) acute, chronic??

Question 18

what is BPPV?

Answer 18

Benign positional vertigo
Positional vertigo, paroxysmal
• Time course: seconds
Dislodge the particle in the tubes

Question 19

what maneuver do you use to dx BPPV? maneuver for tx?

Answer 19

dx = Barany (Dix-Hallpike) maneuver
tx = eply maneuver

Question 20

p

Answer 20

as