Vertigo Flashcards
What is BOV? Benign Paroxysmal Positional Vertigo
Short episodes of intense dizziness with positional changes, caused by tiny solid fragments in the inner ear labyrinth
What are the features of BPV?
Intense vertigo, especially in older people
Recurring sudden episodes
Triggered by positional changes
No hearing loss or tinnitus
How do you treat B’+?
Gets better on its own after several weeks, Dix Hallpike manoeuvre
What are the pinna abnormalities of the ear?
Chondrites, Ramsay Hunt (shingles affecting the facial nerve), pinna haematoma, otitis externa
What is otosclerosis?
Most common cause of acquired hearing loss in young adults
Ossicles are fused at articulations due to abnormal bone growth (particularly between states and oval window)
Sound vibrations cannot be transmitted effectively to the cochlear
You get gradual unilateral or bilateral CONDUCTIvE hearing loss
What is the role of the pharyngotympanic tube?
the middle airpressure equilibriates with the atmospheric pressure
Allows ventilation and drainage of mucus from middle aid
Mucous membranes of middle ear continuously reabsorb said in middle aid causing negative pressure
What is a Cholesteatoma?
A sac of trapped epithelial cells which proliferate and erode the tympanic membrane
You get painless, often smelling ottorhoea
Usually secondary to chronic Eustachian tube dysfunction
What is otitis media with effusion?
Build up of fluid and negative pressure in middle ear, due to Eustachian tube dysfunction
What is acute otitis media?
Acute middle ear infection which is more common in children due to the shorter Eustachian tube and it being more horizontal
What does acute otitis media look like?
Red bulging tympanic membrane
Otalgia
Temp
What is otitis media usually caused by and how would you treat?
Strep pneumonia
Amoxicillin- delayed prescription
What is mastoiditis?
Potential route for middle ear infections to spread into the mastoid
What is the presentation and treatment of mastoiditis?
Swollen, red area behind the ear and ear turned forward
Give them IV ABx
WhT is 5e treatment of BPPV?
Epley manoeuvre
What does Ménière’s disease present like?
Vertigo Tinnitus Hearing loss Feeling of fullness Recurrent episodes, 20 mins to several hours
What is labyrinthitis?
Infection affecting the inner ear, usually viral
What does labyrinthitis present with?
Acute onset and persistent vertigo, tinnitus and hearing loss
N and V
Fever
It is self limiting
What is acute vestibular neuritis?
It is similar to labyrinthitis however it is inflammation of only the vestibular nerve, often after a viral infection
It is acute, spontaneous and prolonged vertigo
N and V
Hearing isn’t affected
Self limiting
What is presbyacusis?
Most common type of sensorineural hearing loss n people over the age of 55
It is progressive and usually bilateral sensorineural hearing loss that occurs in older people as they age
What is noise related hearing loss?
Loud nose damages the cochlea
Can result in permanent hearing loss and tinnitus
Prevention with protective ear wear
Decreased listening to loud music etc…
What can you use for congenital hearing loss
Hearing aids
Cochlear implants
Sign language
What is chronic suppurative otitis media?
Chronic inflammation of the middle ear and mastoid cavity
Recurrent ear discharges (otorrhoea) through a tympanic perforation with conductive hearing loss
No otalgia or fever
It is safe if it doesn’t involve chOlesteatoma
It is not safe if involving Cholesteatoma
What can a perforated tympanic membrane be caused by?
Trauma, middle ear infection, sudden load noise, barotrauma (air pressure)
Will heal by itself in 6-8 weeks (avoid water initially) if infected use ABx
What is a wet perforTed tympanic membrane?
Perforation which occurs in wet. On dictions like surfing and waterskiing
Infection and purulent discharge
Often caused by a pseudomonas species
Heals spontaneously and can take up to 9 months
What are they causes of conductive hearing loss?
Wax
Acute otitis media
Otitis media with effusion
Otosclerosis
What are the causes of sensorineural hearing loss?
Presbyacusis noise related hearing loss Ménière’s disease Labyrinthitis Ototoxic meds Acoustic neuroma
