Flashcards in Ear Conditions Deck (19)
What is Menieres disease?
episodic auditory and vestibular disease charachterised by sudden onset vertigo, hearing loss, tinitus, and sensation of fullness in the ear
What is the pathophysiology of Menieres disease?
unknown cause but there is over production or under absorption of endolymph within the inner ear
Risk factors for menieres disease?
middle age, FHx and associated autoimmune conditions
Examination signs of Menieres disease?
positive Rombergs test - standing feet together and eyes closed, inability to walk toe to heel in a straight line, may have sensorineural hearing loss
Classic history for Menieres disease?
vertigo, hearing loss, tinnitus - lasts minutes to hours and may be associated with nausea and vomiting
Possible treatment options for menieres disease
decrease salt and using diuretics, vestibular suppressants, anti-emetics, tinnitus therapy, hearing aids/grommets, intratympanic gentamicin, meniette device
What possible vestibular suppressants may be used in Menieres disease?
diazepam, atropine/scopolamine (anti-cholinergics), promethazine (anti-histamines) , corticosteroids (oral or intratympanic
When can intra-tympanic gentamicin be used?
when hearing has already been lost - nothing to lose
How does intra-tympanic gentamicin work?
preferentially destroys the vestibular labrynth
What is an acoustic neuroma?
a benign, slow growing tumour which usually remains stable
What are the common symptoms of an acoustic neuroma?
unilateral sensorineural hearing loss, followed by intermittent dizziness, headaches and facial numbness
Which condition increases the likelihood of an acoustic neuroma?
NFM type 2
What investigations are used for acoustic neuroma?
How is an acoustic neuroma managed?
watch and wait, surgery or radiation - chemotherapy is ineffective
what is BPPV?
peripheral vestibular disorder manifested by sudden short-lived episodes of vertigo elicited by specific head movements
what is the pathophysiology behind BPPV?
free-floating canalith particles from the utricle moving into the semi-circular canals making them sensitive to gravity and movement.
Risk factors for BPPV
PMHx of BPPV, recent history of head trauma, viral infection, Hx of viral labyrinthitis, vestibular neuritis, migraines, inner ear surgery or menieres disease
Diagnosis involves which manouevre