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
|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
|Labyrinthitis||Acute onset, vertigo + hearing loss, tinnitus of several days to a week.
TX: Diazepam or meclizine vertigo, promethazine for nausea
|Vertigo (ReelDx)||Duration and presence of hearing loss/nystagmus can help with diagnosis
Peripheral vertigo (inner ear) - sudden onset, nausea/vomiting, tinnitus, hearing loss, and horizontal nystagmus
|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
|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
|MRI of internal auditory canal||Meclizine + steroids|
|Meniere's disease||Chronic remitting and relapsing episodes||Vertigo
Tinnitus in achronic remitting and relapsing manner
|MRI of internal auditory canal||Diuretics
Unilateral CN VIII ablation (severe cases)
|Perilymph fistula||History of trauma||Vertigo from Trauma||MRI of internal auditory canal||Fix damage surgically|
Neurofibromatosis type II
Tinnitus AND ataxia
|MRI of internal auditory canal||Surgical intervention|