Vestibular System ENT

Question 1

definition of dizziness

Answer 1

subjective sensation of movement

Question 2

definition of true vertigo

Answer 2

subjective sensation of ROTATION

Question 3

ddx dizziness

Answer 3

organic
non-organic
unknown

Question 4

organic causes of dizziness

Answer 4

peripheral and central

Question 5

central causes

Answer 5

• MS
• stroke
• tumor
• trauma

Question 6

peripheral middle ear causes

Answer 6

• glue ear

- AOM

Question 7

peripheral inner ear causes

Answer 7

• BPV
• mennieres
• trauma
• ototoxic drugs

Question 8

peripheral cn8 causes

Answer 8

• vestibular neuronitis
• ramsy hunt
• acoustic neuroma
• recurrent vestibulopathy

Question 9

non-vestibular neuro causes

Answer 9

• migraine
• alcohol
• peripheral neuropathy

Question 10

non-vestibular cardiac causes

Answer 10

• postural hypotension
• arrhythmia
• valvular heart disease
• vertebrobasilar insuff.

Question 11

non-vestibular metabolic causes

Answer 11

• DM
• hypothyroidism
• electrolyte imbalance

Question 12

non-vestibular medication causes

Answer 12

• hypoglycaemics
• anti-HTN
• anti-dep
• sedatives

Question 13

BPPV vertigo

Answer 13

lasts seconds
NO hearing loss
NORMAL- ENT and audiogram;
+ Dix Hallpike

Question 14

Menieres triad

Answer 14

episodic vertigo-hours
SNHL- FLUCTUATING
tinnitus

Question 15

treatment of menieres

Answer 15

• diuretics
• salt restrction
• oral betahistine

still have hearing:

• sx ablation or gentamycin
• endolymphatic sac decompression
• vestibular nerve section

have unuseful hearing:
- labrynthectomy

Question 16

acute labrynthitis= vestibular neuronitis PC

Answer 16

vertigo + NYSTAGMUS + n/v
NO hearing loss
NORMAL- ENT and audiogram

Question 17

tx of acute labrynthitis

Answer 17

spontaneously

• diazepam
• prochloperazine

Question 18

tx vertigo

Answer 18

1. underlying
2. epley– BPPV
3. dizzy meds
4. vestibular rehab
5. surgery

Question 19

dizzy meds

Answer 19

SSS-CT
Stemetil
Serc
Stugeron
Cinnarizine
Thiazide

Question 20

vestibular rehab

Answer 20

if refractory to medical tx

graduated series of exercises to promote central compression

Question 21

BPPV surgery, if refractory to above

Answer 21

posterior semi-circular canal occlusion

Question 22

dx vertigo

Answer 22

1. audiogram +/- caloric ENG–> peripheral

2. MRI–> central (MS/tumor/neuroma)