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 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