conditions of the inner ear
acoustic neuroma
pathophysiology
An acoustic neuroma (also known as vestibular schwannoma or acoustic neuroma) is a benign (nonmalignant), usually slow-growing tumor that develops from the balance and hearing nerves supplying the inner ear.
The tumor comes from an overproduction of Schwann cells—the cells that normally wrap around nerve fibers to help support and insulate nerves.
The tumor comes from an overproduction of Schwann cells—the cells that normally wrap around nerve fibers to help support and insulate nerves.
defination
Acoustic neuroma, also known as vestibular schwannoma, is a noncancerous and usually slow-growing tumor that develops on the main (vestibular) nerve leading from your inner ear to your brain
clinical manifastation
Hearing loss, usually gradual — although in some cases sudden — and occurring on only one side or more pronounced on one side
Ringing (tinnitus) in the affected ear
Unsteadiness, loss of balance
Dizziness (vertigo)
Facial numbness and very rarely, weakness or loss of muscle movement
causes
The cause of acoustic neuromas appears to be a malfunctioning gene on chromosome 22. Normally, this gene produces a tumor suppressor protein that helps control the growth of Schwann cells covering the nerves.
management
medical
Stereotactic radiotherapy. Fractionated stereotactic radiotherapy (SRT) delivers a small dose of radiation to the tumor over several sessions in an effort to curb the growth of the tumor without damaging surrounding brain tissue
Stereotactic radiosurgery, such as Gamma Knife radiosurgery, uses many tiny gamma rays to deliver a precisely targeted dose of radiation to a tumor without damaging the surrounding tissue or making an incision
surgical
surgery to remove an acoustic neuroma. Your surgeon may use one of several techniques for removing an acoustic neuroma, depending on the size of your tumor, hearing status and other factors.
Surgery for an acoustic neuroma is performed under general anesthesia and involves removing the tumor through the inner ear
Purulent Labyrinthitis
causes
acute otitis media
purulent meningitis.
trauma causing a labyrinthine fracture with a subsequent infection.
or an enlarging cholesteatoma.
Vestibular neuronitis
pathophysiology
The labyrinth is the bony cavity that contains the inner ear
Purulent labyrinthitis usually occurs when bacteria enter the inner ear during the course of a severe infection of the middle ear (acute otitis media) or some forms of meningitis, or as a complication of a fracture of the temporal bone of the skull.
It also may develop as a complication of a chronically perforated eardrum (as may occur in people who have repeated episodes of otitis media), particularly when people have a
symptoms
Varying degrees of hearing loss
Pain and fever
nasea and vomiting
tinnitus
loss of hearing in the high-frequency range in one ear.
vertigo.
management
medical
Treatment is with IV antibiotics appropriate for meningitis
an antiemetic (vestibular sedative) – can help relieve the symptoms of nausea and vomiting.
corticosteroids – to reduce inflammation. antibiotics – may be prescribed if labyrinthitis is thought to be caused by a bacterial infection.
surgical
A myringotomy (and sometimes tympanostomy tube placement) is done to drain the middle ear. Mastoidectomy may be required.
Some people may need a more extensive surgical procedure to remove all or part of the bone behind the ear (mastoidectomy).
causes
The causes of labyrinthitis and vestibular neuritis are not clear. They can happen after a viral infection or, more rarely, after an infection caused by bacteria
The trigger may be an upper respiratory infection, such as the flu or a cold. Less often, it may start after a middle ear infection
pathophysiology
It happens when the labyrinth, a part of the inner ear that helps control your balance, gets swollen and inflamed
an inflammation of the vestibular nerve. The nerve is located in the inner ear. It carries signals that help with your balance from the inner ear to the brain.
This inflammation disrupts the transmission of sensoryinformation from the ear to the brain
clinical manifastation
The main symptom of both labyrinthitis and vestibular neuritis is vertigo. Vertigo is not the same as feeling dizzy
They can also include nausea and vomiting,.
unsteadiness and imbalance
difficulty with vision
impaired concentration
management
Drugs such as prochlorperazine to relieve vomiting
Sometimes corticosteroid drugs such as prednisone
Intravenous fluids if vomiting persists
Physical therapy