common Inner ear Disorders

short description of inner ear diseases for UG & PG graduates

1. Diseases of inner ear SNKDC TRUST’S NALLASOPARA AYURVED MEDICAL COLLEGE PRESENTED BY DR. VARSHA DHAGE ASSISTANT PROFFESSOR SHALAKYATANTRA DEPT.

2. TINNITUS Noise or ringing sound in the ear It may be unilateral or bilateral. It may be subjective or objective. Subjective tinnitus- heard by patient only. Objective tinnitus- can be heard by examiner also.

3. CAUSES OF TINNITUS SUBJECTIVE OBJECTIVE Abnormality in ext ., midle , inner ear or 8 th CN, CNS along with systemic disorders e.g anaemia, arteriosclerosis, HTN certain ototoxic drugs,allergy etc. Aneurysm Intracranial vascular tumors Clonic contraction of tympanic muscles Abnormal patent Eustachian tube etc.

4. investigations Depending upon the cause Ear examination Autoscopy Tunning fork test Pure tone audiometry CT mastoid /brain Blood investigation to rule out systemic cause.

5. TREATMENT Treat the cause Psychotherapy Mild sedatives Vasodilators Tinnitus masking device.

6. VERTIGO Disturbance in the sense of equilibrium cause vertigo. It may be mild or severe and patient feels that either his surrounding are moving around him or he himself is rotating.

7. mechanism Equilibrium is mainntained by proprioceptic mechanism and vestibule is one of the important proprioceptive organ along with eyes,muscles,tendons,joints and skin. All these organs are connected to cerebellum and cerbrum , where the ultimate perception occurs.

8. Types of Vertigo Depending upon this physiological aspect, the cause of vertigo are divided into two types. Peripheral – defect in internal ear or 8 th nerve. Central- lesions of brainstem and other cns pathways.

9. types Mild vertigo- mild imbalance/ dizziness Severe vertigo- may be accompanied by nausea, vomiting, perspiration,diarrhoea due to vagal stiulation .

10. causes V- vascular-stroke, anaemia, hypotension etc. E- epilepsy, endocrine diseases,DM,hypogycemia R- remedies- antibiotics , cardiac drugs,sedatives,anti-htn drugs. T-trauma , tumors,thyroid (hypo) I- infections of inner ear G- gilal disease- multiple sclerosis O- ophthalmic causes-refractive errors,glaucoma,other-miniere’s disease.

11. Investigations Complete ear examination Csf examination, EEG. Cerebral angiography CT scan , MRI Routine blood urine investigations\

12. TREATMENT To treat the cause Labryinthine sedatives – prochlorperazine Sedatives vasodilators- cinnarizine,betahistine Low salt diet,avoid excess water intake if vertigo is due to minier’s disease. Reassurance-explain to patient that its not dangerous.

13. MINIERE’S DISEASE It is disorder od internal ear Triad of VERTIGO, DEAFNESS AND TINNITUS Also called Endolymphatic hydrops .

14. causes Exact cause is unknown. Sympathetic overactivity causes vasospasm which leads to reduced blood supply to the labyrinth. Distension of endolymphatic system caused due to increased production of endolymph or its reduced absorption.water and salt retention caused distension. May be allergic

15. Clinical features 30-60 yrs of age.more common in males Vertigo Deafness Tinnitus Fullness Nausea vomiting during acute attack. Emotional disturbance-anxiety nystagmus

16. investiagations Same as vertigo and tinittus

17. TREATMENT MEDICAL SURGICAL Vestibular sedatives Vasodilator nicotinic acid 50mg TDS,betahistine 8mg Diuretics Decompression of endolymphatic sac, Endolympphatic shunt Labryinthectomy Treat cause reassaurance .

18. THANK YOU