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ear lecture
Ear lecture
Question | Answer |
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Meniere's disease dfn | Referred to Endolymphatic hydrops Chronic disorder of the labyrinth in the inner ear Labyrinth: system of cavities and canals in the inner ear that affects hearing, balance, and eye movement |
Meniere's disease stats | Characterized by unknown cause of attacks of: Vertigo Loss of hearing: one or both ears Ringing in the ear Diagnosed about 1 in every 2,000 people: 2.4 millions affected Equally affects men and women between the ages of 35 and 60 |
Meniere's disease patho | Controlled balance and position sense by Semicircular canals of the inner ear & Cranial nerve VIII. Semicircular canal is filled with fluid. Swelling of the part of the semicircular canal: endolymphatic sac. |
Meniere's disease patho | Endolymphatic sac controls the filtration & excretion of the fluid of the semicircular canal. Unclear the exact cause of the condition Ab high amount of endolymphatic fluid = Abnormal pressure within the inner ear: leads to disturbed balance & hearing. |
Meniere's disease risk factors | Middle ear infection (Otitis media) Syphilis, Head injury, Viral illness, Respiratory infection Stress, Fatigue, Smoking, Alcohol use |
Meniere's disease clinical manifestations | Repeated episodes of sudden, severe dizziness Worse with sudden mvmt Lost low frequency noises first and may have changes in the extent of hearing loss Tinnitus, Nausea/Vomiting Sweating: may be profuse Loss of balance Feeling of fullness in the e |
Meniere's disease clinical manifestations timing | CMs appear periodically and can last from a few hours to most of a day or longer. May have no symptoms at all for long periods from several hrs to yrs |
Meniere's disease triggers and timing | Most ppl experience few attacks & learn to cope with the inconvenience & discomfort associated with the s/s Commonly identified symptom triggers High salt Too much caffeine or alcohol High level of stress. |
Meniere's disease comorbidities | Some people who suffer from debilitating nausea, vertigo, and complete deafness |
Meniere's disease diagnostic tests | Neurological exam: abnormality of cranial nerve VIII. Ct scan or MRI: to rule out other problems related to head. Electroencephalogram – brain waves. Weber test: usually shows sensorineural hearing loss (both ears have poor hearing) |
Meniere's disease diagnostic tests | Auditory brain stem response: measures electrical activity in the hearing nerve and brain stem Electrocochleography: records the electrical activity of the inner ear in response to sound |
Meniere's disease diagnostic tests | Electronystagmography: measure involuntary, rapid eye movement in response to stimulation of vestibular system (most common with hot water in ear canal to watch rapid eye mvmt) |
Meniere's disease medical management | No known cure Treatment is focused on relieving symptoms by decreasing the pressure within the endolymphatic sac. |
Meniere's disease lifestyle changes | Limit daily sodium intake to 1500 mg to reduce fluid retention Reduction of stress: biofeedback, meditation, yoga, daily exercise Avoid vasoactive stimulants (caffeine and alcohol) No smoking Avoid sudden movements that may aggravate symptoms |
Meniere's disease lifestyle changes | Help may be needed with walking b/c loss of balance. Rest during severe episodes & gradually incr activity Avoid hazardous activities until 1 wk after symptoms disappear. Avoid bright lights, TV, or reading which may make symptoms worse during episodes |
Meniere's disease medications | Decrease inner ear pressure Diuretics: Dyazide, Furosemide, Methazolamide (carbonic anhydrase inhibitor commonly used for glaucoma to decrease eye pressure) by increasing fluid excretion thru kidneys |
Meniere's disease medications: Controlling vertigo, nausea, and vomiting | Valium, Antivert: sedate the vestibular sys Phenergan: help n-v & vertigo anti-histamine effect Maj of pts: success tx with conservative Txs 20-40% of patients continue to have disabling attacks of vertigo may less conservative treatment such as surger |
Conductive hearing loss | affect the outer/external or middle ear Interrupted nml trans of sound waves from the tympanic membrane to the sensory part of the middle ear neg Rinne test: BC>AC: beter bone than air conduction Not always perm treated medically or surgically. |
Risk factors for conductive hearing loss | Earwax build-up, Severe ear infections Acoustic trauma (i.e. explosion, loud noise): Harden and less mobile middle ear bones (Otosclerosis) Middle ear infections (otitis media). |
Sensorineural heaing loss | Permanent hearing loss from damage to the pathway that sound impulses take from the hair cells of the inner ear to the auditory nerve and the brain. |
Risk factors for hearing loss | Presbycusis, Drugs, Acoustic traumaAcoustic trauma by loud noise: damage hair cells. Acoustic neuromas: benign tumor affecting the auditory nerve Mumps, Meningitis: loss of hair cells or damage to auditory nerve Meniere's Disease neuro conditions |
Presbycusis | Age-related hearing loss partly due to the loss of hair cells in the cochlea progressive: starts with high-freq sound such as speech |
Drugs r/t sensorineural hearing loss | powerful antibiotics, high doses of aspirin (temporary tinnitus), anti-malarial drug (Quinine) |
CM of presbycusis | diff to hear high-pitched voices of wmn & child Distortion of sound in speech: may confuse consonants: S, F, SH, CH, C Diff understanding speech in noisy enviro |
Med management of presbycusis | no known cure; tx focused on fcnl improvement reading lips and visual cues may help Prognosis: hearing loss is pregressive may lead to deafness annual hearing test |
Noise-induced hearing loss | aka: occupational hearing loss dmg to inner ear from noise or vibration from job or entertainment max job noise exposure reg by law: prot measures taken partial, complete, or progressive hearing loss may not be corrected |
Otosclerosis | Abnml growth of bone of inner ear affects stapes: becomes fixed into the oval window and interferes with sound waves most common cause of conductive in yg adults: age 30 unknown cause 10% of pop runs in fam both ears asymmetrical rates of hearing l |
CM of otosclerosis | slow, progressive hearing loss hearing better in noisy than quiet areas ringing in ears (tinnitus) reddish or pinkish-orange tympanic membrane b/c increased vasc of middle ear Rhinne: BC= or > AC diff conversing in person, better on phone |
Diagnostic tests for otosclerosis | audiometry, CT scan of head skull x-ray: rule out other cause of hearing loss |
Med management of otosclerosis | conservative tx to communicate (hearing aid) sodium flouride stependectomy: microscopic laser surgery to remove disease stapes |
Sodium Flouride | tx otosclerosis slow bone absorption & enhance calcification of new bone, essentially to prevent further disease progression: can stabilize hearing loss in 80% reduce tinnitus & s/s of imbalance SE: rash, arthritis, and GI |
Audiogram/audiometry | measured air conduction placing earphones over both ears and tests ability to hear various sound freq hearing threshold: quietest sound heard by the person nml: 20dB or better |