Anatomy of the ear Anatomy of the ear

• 1-Vertigo 1-Vertigo

• 2-Deafness 2-Deafness

VertigoVertigo

1- Physiological1- Physiological

2- Pathological2- Pathological

Vertigo is hallucination of movement

Physiology of balancePhysiology of balance

Physiology of balancePhysiology of balance

Causes:Causes:

A- Central:A- Central:1.1.StrokeStroke

2.2.MigraineMigraine

3.3.Multiple SclerosisMultiple Sclerosis

4.4.Cerebrum Cerebrum degenerationdegeneration

5.5.Head injury.Head injury.

6.6.Meningitis.Meningitis.

7.7.Brain abscessBrain abscess

B- Peripheral:B- Peripheral:1.1.Vestibular lesionVestibular lesion2.2.Visual lesionVisual lesion3.3.Somatosensory lesion Somatosensory lesion

Pathology

• A- Vestibular lesionA- Vestibular lesion

1- Benign Paroxysmal Positional Vertigo1- Benign Paroxysmal Positional Vertigo

(BPPV)(BPPV)• Most common Most common

• Causes,Causes, it may develop after: * Ear infection * Ear surgery * Head injury: Prolonged bed

rest for ex. while recovering from an illness

• Pathophysiology:Pathophysiology:- Otolith in the posterior semicircular cannal Otolith in the posterior semicircular cannal

(canalolithiasis)(canalolithiasis)

• Clinical Picture:Clinical Picture:- Sudden vertigo in certain head positionSudden vertigo in certain head position

- No hearing lossNo hearing loss

- Latent periodLatent period

- Fatigable on repositionFatigable on reposition

Treatment of BPPVRepositioning (Epley manouvor)

A- Vestibular lesion A- Vestibular lesion 2- Vestibular Neuronitis2- Vestibular Neuronitis• Causes: ViralCauses: Viral• Clinical picture:Clinical picture:- Vertigo – lasting daysVertigo – lasting days- No hearing lossNo hearing loss- No other neurological signs or symptomsNo other neurological signs or symptoms- Nystagmus – horizontalNystagmus – horizontal

• Treatment: Only Symptomatic:Treatment: Only Symptomatic:- Vestibular sedation (Betaserc)Vestibular sedation (Betaserc)- AntiemeticsAntiemetics

A- Vestibular lesion3- Menier’s Disease (Endo lymphatic hydropes)

3- 3- Menier’s DiseaseMenier’s Disease•Causes: Causes: UnknownUnknown

•Clinical picture:Clinical picture:Vertigo – the sensation that you, or the environment around you, is moving or spinningTinnitus – hearing sounds from inside your body, rather than from an outside sourceHearing loss, with a particular difficulty hearing deep or low soundsSense of pressure or fullness deep inside the ear

•Treatment: 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

Hearing LossHearing Loss

1-Conductive 1-Conductive

• External auditory meatus ….wax External auditory meatus ….wax

• Middle earMiddle ear

- Tympanic membrane PerforationTympanic membrane Perforation

- Otitis mediaOtitis media

- Ossicular disconnectionOssicular disconnection

Normal tympanic membrane

Perforation of tympanic Perforation of tympanic membranemembrane

Otitis MediaOtitis Media

Acute Chronic

2-Sensorineural Deafness2-Sensorineural Deafness

a-Developmental &Hereditary a-Developmental &Hereditary

b-Infectious .… otitis media b-Infectious .… otitis media

c-Toxicity …. aminoglycosidec-Toxicity …. aminoglycoside

d-Trauma ….Head injuryd-Trauma ….Head injury

....Noise induced ....Noise induced

e-Neurologic disorder e-Neurologic disorder

… ….Multiple .Multiple sclerosis sclerosis

f-Immune disorders f-Immune disorders

… ….Polyarteritis .Polyarteritis

g-Bone disorders g-Bone disorders

… ….Paget ,s Disease.Paget ,s Disease

i-Neoplasms i-Neoplasms

.…Acoustic .…Acoustic neuromaneuroma