NCCPA™ PANCE EENT Content Blueprint ear disorders ⇒ inner ear
Acoustic neuroma | Benign tumor of the Schwann cells (the cells which produce myelin sheath) – most commonly affects the vestibular division of the 8'th cranial nerve.
TX: Surgery or stereotactic radiation therapy |
Barotrauma | Barotrauma presents with ear pain and hearing loss that persists past the inciting event, associated with pressure changes
TX: Supportive (anti-inflammatories) then consider prophylaxis
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Dysfunction of the eustachian tube | Ear fullness, popping of ears, underwater feeling, intermittent sharp ear pain, fluctuating conductive hearing loss, tinnitus.
TX: Often no treatment is necessary
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Labyrinthitis | Acute onset, vertigo + hearing loss, tinnitus of several days to a week.
TX: Diazepam or meclizine vertigo, promethazine for nausea |
Vertigo (ReelDx) | The sensation of movement (spinning, tumbling, or falling) in the absence of actual movement or an overresponse to movement
Central vertigo
Peripheral vertigo (inner ear)
DX:
Treatment:
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Disease | Characteristics | Symptoms | Diagnostics | Treatment |
Benign positional vertigo | Changes with position | Vertigo without hearing loss, tinnitus, or ataxia | MRI of internal auditory canal | Diagnosis: Dix-Hallpike maneuver
Treatment: Epley maneuver Meclizine |
Vestibular neuritis | Vertigo without position changes | Vertigo but no hearing loss or tinnitus(inflammation of vestibular portion of CN VIII) | MRI of internal auditory canal | Meclizine |
Labyrinthitis | Acute, self-resolving episode | Vertigo
Hearing loss Tinnitus Self-limited |
MRI of internal auditory canal | Meclizine + steroids |
Meniere's disease | Chronic remitting and relapsing episodes | Vertigo
Hearing loss Tinnitus in achronic remitting and relapsing manner |
MRI of internal auditory canal | Diuretics
Salt restriction Unilateral CN VIII ablation (severe cases) |
Perilymph fistula | History of trauma | Vertigo from Trauma | MRI of internal auditory canal | Fix damage surgically |
Acoustic neuroma | Ataxia
Neurofibromatosis type II MRI findings |
Vertigo
Hearing loss Tinnitus AND ataxia |
MRI of internal auditory canal | Surgical intervention |