This document discusses diseases of the inner ear, including tinnitus, vertigo, and Meniere's disease. It defines tinnitus as a noise or ringing in the ear, and describes the causes and types of both subjective and objective tinnitus. Vertigo is defined as a disturbance in equilibrium that causes feelings of rotation or surroundings moving. The mechanisms, types, causes categorized by VERTI, and treatments for vertigo are outlined. Meniere's disease is characterized by the triad of vertigo, deafness, and tinnitus, and is caused by endolymphatic hydrops, which leads to distension of the inner ear. The clinical features, investigations, and medical and surgical treatments for

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 8th 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
8th 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