Anatomy of the ear
1-Vertigo 2-Deafness
1- Physiological 2- Pathological Vertigo Vertigo is hallucination of movement 1- Physiological 2- Pathological
Physiology of balance
Physiology of balance
Pathology Causes: A- Central: B- Peripheral: Stroke Migraine Multiple Sclerosis Cerebrum degeneration Head injury. Meningitis. Brain abscess B- Peripheral: Vestibular lesion Visual lesion Somatosensory lesion
1- Benign Paroxysmal Positional Vertigo (BPPV) A- Vestibular lesion 1- Benign Paroxysmal Positional Vertigo (BPPV) Most common Causes, it may develop after: * Ear infection * Ear surgery * Head injury: Prolonged bed rest for ex. while recovering from an illness Pathophysiology: Otolith in the posterior semicircular cannal (canalolithiasis) Clinical Picture: Sudden vertigo in certain head position No hearing loss Latent period Fatigable on reposition
Repositioning (Epley manouvor) Treatment of BPPV Repositioning (Epley manouvor)
2- Vestibular Neuronitis Causes: Viral Clinical picture: A- Vestibular lesion 2- Vestibular Neuronitis Causes: Viral Clinical picture: Vertigo – lasting days No hearing loss No other neurological signs or symptoms Nystagmus – horizontal Treatment: Only Symptomatic: Vestibular sedation (Betaserc) Antiemetics
3- Menier’s Disease (Endo lymphatic hydropes) A- Vestibular lesion 3- Menier’s Disease (Endo lymphatic hydropes)
Treatment: Possible treatments include: 3- Menier’s Disease Causes: Unknown Clinical picture: Vertigo – the sensation that you, or the environment around you, is moving or spinning Tinnitus – hearing sounds from inside your body, rather than from an outside source Hearing loss, with a particular difficulty hearing deep or low sounds Sense of pressure or fullness deep inside the ear Treatment: Possible treatments include: Dietary advice, particularly a low-salt diet Medication: Betahistine (Betaserc) for treatment and prevention Treatment called vestibular rehabilitation to cope with balance problems Surgery
Hearing Loss 1-Conductive External auditory meatus ….wax Middle ear Tympanic membrane Perforation Otitis media Ossicular disconnection
Normal tympanic membrane
Perforation of tympanic membrane
Otitis Media Acute Chronic
2-Sensorineural Deafness a-Developmental &Hereditary b-Infectious .… otitis media c-Toxicity …. aminoglycoside d-Trauma ….Head injury ....Noise induced
e-Neurologic disorder ….Multiple sclerosis f-Immune disorders ….Polyarteritis g-Bone disorders ….Paget ,s Disease i-Neoplasms .…Acoustic neuroma