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Author: admin | 16.07.2015 | Category: One Ear Ringing

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Organ of orti? Snale shape bony tube about 3.5 cm long with 2 and one half spiral turns? The organ of orti called the end organ of hearing, transform mechanical energy into neural activity and seperates sound into diff frequencies.
Meniere’s disease? Meniere’s disease is an abnormal inner ear fluid balance caused by malabsorption in the endolymphatic sac? People with meniere’s disease may have blockage in the endolymphatic duct.CauseIncrease pressure in the system or rupture of the inner ear membranes that producing meniere’s symptoms. Diagnostic test ? Weber test- sound from a tuning fork (may lateralize to the ear opposite the hearing loss, the one affected with meniere’s disease) ? Audiogram – reveals a sensorineural hearing loss in the affected ear. Surgical management? Endolymphatic sac decompression (shunting) – equalizes the pressure in the endolyphatic space- A shunt or drain is inserted ion the endolymphatic sac through a postauricular incision.? middle ear perfusion – ototoxic medication (streptomycin or gentamicin) can be given to pt.
Clinical manifestations? Sudden incapacitating vertigo? Nausea and vomiting? Various degrees of hearing loss? Possible tinnitusManagement? Bacterial - IV antibiotic theraphy, fluid replacement and administration of vestibular suppresant (meclizine and antiemetic).
In 1861, the French physician Prosper Meniere described a condition which now bears his name.
Causes An acute attack of Meniere’s disease is generally believed to result from fluctuating pressure of the fluid within the inner ear. Meniere’s disease can cause hair cell death, as well as mechanical changes to the ear. Hair Cell Death The periodic admixture of perilymph and endolymph often kills hair cells in the inner ear.
Mechanical Changes Mechanical disruption of the inner ear is also likely, with dilation of the utricle and saccule of the ear being a well known pathological finding. There is presently no evidence that Meniere’s disease kills the cochleovestibular nerve (Kitamura et al, 1997).
Hearing tests often begin with showing a fluctuating low-frequency sensorineural hearing loss. Treatment At the present time there is no cure for Meniere’s disease, but there are ways to manage the condition and help you control symptoms.
Have you had any of the following imaging studies done as they pertain to your requested appointment?
Meniere’s disease is a condition involving the inner ear, which significantly affects the sense of hearing and equilibrium or balance. Meniere’s disease causes the characteristic condition such as hearing loss, tinnitus and vertigo.
Meniere’s disease is an idiopathic condition, meaning that there is no definite causation of the condition. Tinnitus is the presence of ringing in the ears as a result of affectation of the membranous labyrinth. Sensations of pressure may also occur in one or both ears because of increased pressure in the endolymphatic membrane.
The diagnosis of Meniere’s disease starts with a detailed medical history to study the symptoms.
These examinations involve the visualization or study of the ear structures to determine any problems or conditions in the ear. MRI of the head specifically the ear area is essential in ruling out other conditions such as superior canal dehiscence or vestibular schwannoma. Treatment for Meniere’s disease involves those that correct the disorder as well as control the symptoms. Salt restriction – Increased salt in the diet leads to increase in pressure in the inner ear because of water retention.
Avoidance of alcohol, tobacco and caffeine – These substances were also found to aggravate the symptoms of Meniere’s disease. Anti-emetics – Anti-emetics are usually given to reduce nausea and vomiting associated with vertigo attacks. Diuretics may also be given to patients to reduce fluid in the inner ear that leads to increased pressure in the labyrinth.
Antiviral medications – Antiviral drugs such as acyclovir may be given to patients with herpes infection in the eras to reduce the symptoms of the disease.


Steroid injections – Dexamethasone may also be injected in the middle ear in order to reduce inflammation and improve ear circulation. Physiotherapy – Physiotherapy may also employ to gain more balance through balance exercises. Surgery – Surgery is the last treatment for patients who do not respond to conventional management. Endolymphatic sac decompression – This procedure involves the decompression of the endolymphatic sac to reduce pressure and provide temporary relief from symptoms. Vestibular neurectomy – This procedure involves the resection of the vestibular nerve to relieve symptoms. This electrochemical impulse travels through the acoustic nerve to the temporal cortex of the brain. Cochlear Meniere’s Disease ? Is recognized as fluctuating, progressive sensory neural hearingloss, tinnitus and aural pressure. Meniere’s disease is a disorder of the inner ear that causes episodes of vertigo, ringing in the ears (tinnitus), a feeling of fullness or pressure in the ear, and fluctuating hearing loss.
These are called otolithic crisis of Tumarkin, from the original description of Tumarkin (1936). There is some controversy about this statistic however; some authors suggest that the prevalence of bilaterality is as low as 17% (Silverstein, 1992).
A low-frequency sensorineural pattern is commonly found initially, but as time goes on, it usually changes into either a flat loss or a peaked pattern (click here for more information about hearing testing). This is a gradual process over years, but frequently resulting in unilateral functional deafness. The saccule may dilate so that, in later stages, it is adherent to the underside of the stapes footplate. Questions related to surgery scheduling, cancellation, rescheduling or pre-operative exams must be conducted via telephone or in-person with our surgical scheduling staff during normal business hours.
Patients may experience hearing loss that come and go and some may develop permanent hearing loss. However, there has been a link to endolymphatic hydrops in the inner ear characterized by excess fluid.
The area may become dilated when there is increased pressure in the area and may also dilate as a result of obstruction in the flow of the fluid. It is characterized as rotational, severe, unpredictable, and incapacitating and may last up to minutes or hours.
Some patients may have problems in the distortion of sounds and some may experience unusual sensitivity to noise.
The absence of any possible cause for Meniere’s disease ascertains the diagnosis because it is considered idiopathic.
These drugs may include meclozine, trimethobenzamide, dimenhydrinate, betahistine, ginger root and diazepam. However, antiviral drugs may not be able to correct the permanent damage the virus has caused in the inner ear. However, this may lead to permanent hearing loss to the affected ear because of the removal of the tissue.
It requires overnight stay because imbalance that last several weeks.? Intraotologic catheter- to provide a conduit from the outer ear to the inner ear. In Figure 1, the area of the ear affected is the entire labyrinth, which includes both the semicircular canals and the cochlea. A Meniere’s episode generally involves severe vertigo (spinning), imbalance, nausea and vomiting. These are attributed to sudden mechanical deformation of the otolith organs (utricle and saccule), causing a sudden activation of vestibular reflexes. Between the acute attacks, most people are free of symptoms or note mild imbalance and tinnitus.
We suspect that this lower statistic is due to a lower duration of follow-up and that the 50% figure is more likely to be correct.


It is most often attributed to viral infections of the inner ear, head injury, a hereditary predisposition, and allergy. This mechanical disruption and distortion of normal inner ear structures may result in the gradual onset of a chronic unsteadiness, even when patients are not having attacks. The differential diagnosis is broad and includes perilymph fistula, recurrent labyrinthitis, migraine, congenital ear malformations of many kinds, syphilis, tumors, Multiple Sclerosis, etc.
The condition arises from bursts in the endolymphatic channels that allow the fluid to flow into the inner ear and other areas, which causes damage.
Increase in the pressure in the endolymphatic membrane may also be due to swelling of other tissues such as the vestibular system, the inner ear structure responsible for the sense of balance. The vertigo attacks are usually less than 24 hours, but some patients may have prolonged vertigo of more than a day. Betahistine is an important medication for Meniere’s disease because it is the only drug that helps prevent symptoms because of vasodilation of the blood vessels in the inner ear.
Chemical labyrinthectomy with the use of gentamicin injections may also be performed in order to preserve the hearing.
Vestibular Meniere’s Disease ? Occurrence of episodic vertigo associate with aural pressure but no cochlear symptoms.
Patients suddenly feel that they are tilted or falling (although they may be straight), and bring about much of the rapid repositioning themselves.
Other possibilities, however, are selection bias and different patterns of the disease in different countries.
Vestibular (motion sensing) hair cells seem more resilient but there is also a slow decline in the caloric response in the diseased ear over roughly 15 years (Stahle et al, 1991).
The periodic dilation and shrinkage of the utricle is also a reasonable explanation for periodic attacks of another inner ear disorder, BPPV. The process of diagnosis usually includes hearing testing (audiometry), an ENG test, several blood tests (ANA, FTA), and an MRI scan of the head. Vertigo happens because of problems in the vestibular system, causing conditions affecting the balance.
Following a severe attack, most people find that they are exhausted and must sleep for several hours. This is a very disabling symptom as it occurs without warning and can result in severe injury. Silverstein suggested that 75% of persons destined to become bilateral do so within five years.
One way for this to happen is when the drainage system, called the endolymphatic duct or sac is blocked.
Finally, it also seems likely that there may be a rupture of the suspensory system for the membranous labyrinth.
In addition, increased secretion of endolymphatic fluid by the stria vascularis may also lead to increased pressure in the inner ear.
Often destructive treatment (for example labyrinthectomy or vestibular nerve section) is the only way to manage this problem.
In some cases, the endolymphatic duct may be obstructed by scar tissue, or may be narrow from birth. This might create some mechanical instability of the utricle and saccule and consequently some chronic unsteadiness.
The majority of people with Meniere’s disease are over 40 years of age, with equal distribution between males and females.



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