Inner Ear Disorders Flashcards
(17 cards)
Autoimmune inner ear disorders
caused by body’s immune response directed at inner ear
Symptoms:
progressive aural fullness
fluctuating tinnitus
gradual vertigo
typically treated as a ear infection
common in middle-aged women
Dx:
audio fluctuating SNHL with ART and OAEs matching
Diabetes mellitus
Elevated blood glucose levels can cause vascular changes that impact stria vascularis and other ear anatomcial areas
Symptoms:
gradual progressive symptoms
postural instability due to neuropathy
hearing loss
Dx:
audio bilateral HF SNHL with ARTS and OAEs matching
Enlarged vestibular aqueduct syndrome
vestibular aqueduct within temporal bone is abnormally large
age of onset: typically diagosed around age 3-4
Symptoms:
possible hx of head trauma
delayed motor milestones
general imbalance
poor coordination
head tilitinhg with vomitting
Dx:
Audio: fluctuating and progressive HL with LF ABG
OAEs: absent
Hidden hearing loss
abnormalities in the IHCs or ribbon synapses of the cochlea, due to exposure to noise but present with normal hearing
Syndromes:
hx of noise exposure
hearing lopss
difficulty with speech in noise and background noise
Dx: ART elevated or absent, OAEs absent, ABR missing or reduced wave I,
ECochG abnorman SP/AP
Meniere’s disease
Excess endolymph fluid pressure, overproduction, or underabsorption
Symptoms:
roaring tinnitus
aural fullness
episodes of vertigo
fluctuating hearing loss that worsens during episode
Dx:
Audio: unilateral LF SNHL (progressive to bilateral) with poor WRS; ARTs and OAEs consistnetn with audio
Meningitis
Inflammation of the meninges of the brain and spinal cord due to bacteria or viral enter the IE
Symptoms:
Fever
stiff neck
persistent headache
nausea and vomiting
symptoms occur 3-7 days following exposure
Dx:
Audio: bilateral SNHL, ARTs consisent with audio, VNG possibly abnormal
Noise-induced hearing loss
Symptoms:
hearing looss
HF tinnitus
possible aural fullness with theshold shift
Dx: SNHL with poorer threswhold 3-6 kHz (noise notched)
Ototoxicity
toxic effects of the inner ear…degeneration of cochlear hair cells and auditory nerve with possible alteration with fluids in Organ of Corti
Symptoms:
hx of ototoxic meds
hearing loss
tinnitus
general dizziness
oscillopia
atypical gate
Dx:
bilateral progressive HF SNHL with poorer WRS
Perilymphatic fistula
Perilymp leasks from the oval/ round widow, which alters the pressure differences between the scale in the cochlea
Caused by head trauma, barotrauma, and activities that produce straining
Symptoms:
Episodic vertigo during strain
Aural fullness
Tinnitus
Nausea
Possible hx of head trauma
Ocular tilt
Dx:
audio: fluctuating flat or sloping SNHL
Fistula test: nystagmus during pressure change (Hennebert’s signs)
Dizziness and nystagms
Sudden SNHL
Acute onset, idiopathic hearing loss
Symptoms:
Sudden decrease in hearing
Unilateral tinnitus
Aural fullness
Trouble in background noise
Possible dizziness and imbalance
Dx:
Audio: SNHL with poor WRS especially in noise
ABR: WNL (r/o tumor)
VNG: possible unilateral peripheral findings
Superior Semicircular Canal Dehiscence
**bony covering of the SCC thins or falls open creating a fistula at times
Symptoms:
Autophony
Tinnitus
Hyperacusis
Aural fullness
Distorted sensation of sound
Chronic imbalance
Possible hx of recent head trauma
Tullio’s (vertigo and/or nystagmus to loud sounds)
Dx: enhanced bone thresholds (especially at 250 Hz)
Temporal bone fracture
fracture of the otic capsule and/or vestibule, which can disrupt the membraneous labyrinth and damage auditory nerve fibers
Symptoms:
raccoon eyes
hearing loss
vertigo
facial nerve paralysis
possible hx of trauma
Dx:
Tymps: depends of fracture
otoscopy: hemotympanum
Audio: SNHL with audio and OAEs matching
Ototoxic antibiotic
Aminoglycosides (gentamicin, kanamycin, amikacin, neomycin)
amphotericin B, bacitaracin, chlorampgenicol, macrolides, nystatin, polymyxin B
Ototoxic chemotherapy drugs
Platinum compounds such as cisplatin, carboplatin, vincristine)
Ototoxic NSAIDs
ibuprofen, indomethacin, paracetamol, phenylbutazone, salicylates
Other ototoxic drugs
antimalarials (quinine)
loop diruetics (lasix)
Vestibulotoxic drugs
gentamicin, streptomycin, tobramycin, chemotherapy agents
