Vestibularcochular Disorder

Question 1

What is it

Answer 1

Dysfunction of the vestibulocochlear nerve (cranial nerve VIII), affecting balance (vestibular system) and hearing (cochlear system).

Question 2

Clinical Features

Answer 2

🌀 Vestibular symptoms (Balance-related)
Vertigo (spinning sensation) 🌪️
Dizziness & unsteady gait 🚶‍♂️⚖️
Nystagmus (involuntary eye movement) 👀
Nausea & vomiting 🤢

🔊 Cochlear symptoms (Hearing-related)
Hearing loss (unilateral or bilateral) 👂❌
Tinnitus (ringing in the ears) 🔔
Difficulty understanding speech, especially in noisy environments

Question 3

Epidemiology

Answer 3

Affects all age groups but more common in older adults
Vestibular disorders (e.g., Meniere’s disease) more common in middle-aged adults
Hearing loss is prevalent in the elderly (presbycusis)

Question 4

Age Groups Affected

Answer 4

Young adults: More likely due to infections (labyrinthitis, vestibular neuritis) or trauma
Middle-aged adults: More likely due to Meniere’s disease
Older adults: More likely due to age-related hearing loss (presbycusis), stroke, or tumors (acoustic neuroma)

Question 5

Risk Factors

Answer 5

✅ Modifiable:
Loud noise exposure (damages cochlear hair cells) 🎧🔊
Smoking & alcohol 🚬🍷
Ear infections (labyrinthitis, otitis media)
Head trauma 🏍️

🚫 Non-Modifiable:
Aging (natural hearing loss with age – presbycusis)
Genetic predisposition
Autoimmune diseases (e.g., multiple sclerosis, lupus)
Tumors (acoustic neuroma, vestibular schwannoma)

Question 6

Clinical Presentation

Answer 6

🔹 Vestibular Disorders:
Vestibular neuritis: Sudden vertigo, nausea, NO hearing loss
Labyrinthitis: Vertigo + hearing loss + tinnitus
Meniere’s disease: Episodes of vertigo + fluctuating hearing loss + tinnitus + ear fullness

🔹 Cochlear Disorders:
Presbycusis: Gradual age-related hearing loss
Noise-induced hearing loss: High-frequency hearing loss
Acoustic neuroma: Unilateral hearing loss + tinnitus + imbalance

Question 7

Prognosis

Answer 7

🔹 Depends on the cause:
• Vestibular neuritis & labyrinthitis: Usually self-limiting (weeks to months) but can recur
• Meniere’s disease: Chronic, managed with lifestyle changes & meds
• Presbycusis: Progressive, managed with hearing aids 🎧
• Acoustic neuroma: May require surgery or radiation
🔹 Prevention: Avoid loud noise, manage infections early, protect ears from trauma

Question 8

Test

Answer 8

Ask patient abut their hearing

Numbers repetition test

Weber’s (tuning fork on forehead)

Rinnes test