1. Anatomy of the ear

2. 1-Vertigo
2-Deafness

3. 1- Physiological 2- Pathological
Vertigo
Vertigo is hallucination of movement
1- Physiological
2- Pathological

4. Physiology of balance

5. Physiology of balance

6. 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

7. 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

8. Repositioning (Epley manouvor)
Treatment of BPPV
Repositioning (Epley manouvor)

9. 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

10. 3- Menier’s Disease (Endo lymphatic hydropes)
A- Vestibular lesion
3- Menier’s Disease (Endo lymphatic hydropes)

11. 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

12. Hearing Loss
1-Conductive
External auditory meatus ….wax
Middle ear
Tympanic membrane Perforation
Otitis media
Ossicular disconnection

13. Normal tympanic membrane

14. Perforation of tympanic membrane

15. Otitis Media
Acute
Chronic

16. 2-Sensorineural Deafness
a-Developmental &Hereditary
b-Infectious … otitis media
c-Toxicity …. aminoglycoside
d-Trauma ….Head injury
....Noise induced

17. e-Neurologic disorder
….Multiple sclerosis
f-Immune disorders
….Polyarteritis
g-Bone disorders
….Paget ,s Disease
i-Neoplasms
.…Acoustic neuroma