Vertigo: a Review of Common Peripheral and Central Vestibular Disorders
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Definitions and Background
1 Definitions and Background Tinnitus is a surprisingly complex subject. Numer- ears.” And, in fact, the word “tinnitus” is derived ous books would be required to adequately cover the from the Latin word tinniere, which means “to current body of knowledge. The present handbook ring.” Patients report many different sounds—not focuses on describing procedures for providing just ringing—when describing the sound of their clinical services for tinnitus using the methodology tinnitus, as we discuss later in this chapter. of progressive tinnitus management (PTM). In this opening chapter we establish common ground with respect to terminology and contextual Transient Ear Noise information. Relevant definitions are provided, many of which are operational due to lack of consensus It seems that almost everyone experiences “tran- in the field. Additional background information sient ear noise,” which typically is described as a includes brief descriptions of epidemiologic data, sudden whistling sound accompanied by the per- patient data, and conditions related to reduced tol- ception of hearing loss (Kiang, Moxon, & Levine, erance (hypersensitivity) to sound. 1970). No systematic studies have been published to date describing the prevalence and properties of transient ear noise; thus, anything known about Basic Concepts and Terminology this phenomenon is anecdotal. The transient auditory event is unilateral and seems to occur completely at random without any- Tinnitus is the experience of perceiving sound that thing precipitating the sudden onset of symptoms. is not produced by a source outside of the body. The Often the ear feels blocked during the episode. The “phantom” auditory perception is generated some- symptoms generally dissipate within a period of where in the auditory pathways or in the head or about a minute. -
Noise-Induced Cochlear Neuronal Degeneration and Its Role in Hyperacusis- and Tinnitus-Like Behavior
Noise-Induced Cochlear Neuronal Degeneration and Its Role in Hyperacusis- and Tinnitus-Like Behavior by Ann E. Hickox B.A. French Arizona State University, 2006 MSc Speech and Hearing Sciences University College London, 2007 SUBMITTED TO THE HARVARD-MIT DIVISION OF HEALTH SCIENCES AND TECHNOLOGY IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN SPEECH AND HEARING BIOSCIENCE AND TECHNOLOGY AT THE MASSACHUSETTS INSTITUTE OF TECHNOLOGY FEBRUARY 2013 @2013 Ann E. Hickox. All rights reserved The author hereby grants to MIT permission to reproduce and to distribute publicly paper and electronic copies of this thesis document in whole or in part in any medium now known or hereafter created. Signature of Author: Ann E. Hickox Harvard-MIT Division of e lthSciences and Technology f/ / I / January 2, 2013 Certified by: M. Charles Liberman, Ph.D. Thesis Supervisor Director, Eaton-Peabody Laboratory, Massachusetts Eye & Ear Infirmary Harold F. Schuknecht Professor of Otology and Laryngology, Harvard Medical School Accepted by Emery Brown, MD, PhD Director, Harvard-MIT Division of Health Sciences and Technology Professor of Computational Neuroscience and Health Sciences and Technology 1 2 Noise-Induced Cochlear Neuronal Degeneration and Its Role in Hyperacusis- and Tinnitus-Like Behavior by Ann E. Hickox Submitted to the Harvard-MIT Division of Health Sciences and Technology on January 2, 2013 in partial fulfillment of the requirements for the Degree of Doctor of Philosophy in Speech and Hearing Bioscience and Technology Abstract Perceptual abnormalities such as hyperacusis and tinnitus often occur following acoustic overexposure. Although such exposure can also result in permanent threshold elevation, some individuals with noise-induced hyperacusis or tinnitus show clinically normal thresholds. -
ICD-9 Diseases of the Ear and Mastoid Process 380-389
DISEASES OF THE EAR AND MASTOID PROCESS (380-389) 380 Disorders of external ear 380.0 Perichondritis of pinna Perichondritis of auricle 380.00 Perichondritis of pinna, unspecified 380.01 Acute perichondritis of pinna 380.02 Chronic perichondritis of pinna 380.1 Infective otitis externa 380.10 Infective otitis externa, unspecified Otitis externa (acute): NOS circumscribed diffuse hemorrhagica infective NOS 380.11 Acute infection of pinna Excludes: furuncular otitis externa (680.0) 380.12 Acute swimmers' ear Beach ear Tank ear 380.13 Other acute infections of external ear Code first underlying disease, as: erysipelas (035) impetigo (684) seborrheic dermatitis (690.10-690.18) Excludes: herpes simplex (054.73) herpes zoster (053.71) 380.14 Malignant otitis externa 380.15 Chronic mycotic otitis externa Code first underlying disease, as: aspergillosis (117.3) otomycosis NOS (111.9) Excludes: candidal otitis externa (112.82) 380.16 Other chronic infective otitis externa Chronic infective otitis externa NOS 380.2 Other otitis externa 380.21 Cholesteatoma of external ear Keratosis obturans of external ear (canal) Excludes: cholesteatoma NOS (385.30-385.35) postmastoidectomy (383.32) 380.22 Other acute otitis externa Excerpted from “Dtab04.RTF” downloaded from website regarding ICD-9-CM 1 of 11 Acute otitis externa: actinic chemical contact eczematoid reactive 380.23 Other chronic otitis externa Chronic otitis externa NOS 380.3 Noninfectious disorders of pinna 380.30 Disorder of pinna, unspecified 380.31 Hematoma of auricle or pinna 380.32 Acquired -
Tinnitus & Hyperacusis
REFERENCE Tinnitus & Hyperacusis GlossarY The American Tinnitus Association (ATA) is pleased to provide our readers with a glossary of terms pertaining to tinnitus and hyperacusis. It has been adapted with permission from a document published with the Progressive Tinnitus Management program developed by researchers and clinicians at the Veterans Health Administration. The ATA Tinnitus & Hyperacusis Glossary was edited by members of the Tinnitus Today Editorial Advisory Panel. The terminology used to describe any condition is of vital importance to diagnosis and treatment of the condition. Without a commonly understood set of terms, we could not effectively communicate a diagnosis, direct treatment for conditions, or expect patients to understand and follow those treatments accurately. www.ATA.org TINNITUS TODay WIntER 2017 33 REFERENCE Acceptance and Commitment aminoglycoside antibiotics: Any by neural networks that respond to Therapy (ACT): A psychotherapeutic of a group of antibiotics derived from different levels of sound. approach similar to Cognitive Behav- various species of Streptomyces that auditory hallucinations: Usually ioral Therapy (CBT), and sometimes is inhibit bacterial protein synthesis and perceived as voices or music (and referenced as part of the third wave of are active against gram-negative bac- sometimes as environmental sounds, CBT approaches. ACT involves mind- teria, in particular. Aminoglycosides e.g., a barking dog), and have been fulness, which is aimed at reducing include streptomycin, gentamicin, studied primarily in the context of psychological distress, depressive amikacin, kanamycin, tobramycin, and mental health. Some individuals who symptoms, and anxiety by focusing on neomycin, among others. All can be experience auditory hallucinations do the present moment. -
Secondary Endolymphatic Hydrops
PO BOX 13305 · PORTLAND, OR 97213 · FAX: (503) 229-8064 · (800) 837-8428 · [email protected] · WWW.VESTIBULAR.ORG Secondary Endolymphatic Hydrops By Susan Pesznecker, RN; Legacy Clinical Research & Technology Center, Portland, Oregon with the Vestibular Disorders Association Endolymphatic hydrops is a disorder of controls are believed to be lost or the vestibular system. Although its damaged. This may cause the volume and underlying cause and natural history are concentration of the endolymph to unknown, it is believed to result from fluctuate in response to changes in the abnormalities in the quantity, body’s circulatory fluids and electrolytes. composition, and/or pressure of the endolymph (the fluid within the Symptoms endolymphatic sac, a compartment of the Symptoms typical of hydrops include inner ear). pressure or fullness in the ears (aural fullness), tinnitus (ringing or other noise Causes in the ears), hearing loss, dizziness, and Endolymphatic hydrops may be either imbalance. primary or secondary. Primary idiopathic endolymphatic hydrops (known as Diagnosis and testing Ménière’s disease) occurs for no known There is no vestibular or auditory test reason. Secondary endolymphatic that is diagnostic of endolymphatic hydrops appears to occur in response to hydrops. Diagnosis is clinical—based on an event or underlying condition. For the physician’s observations and on the example, it can follow head trauma or ear patient’s history, symptoms, and surgery, and it can occur with other inner symptom pattern. The clinical diagnosis ear disorders, allergies, or systemic may be strengthened by the results of disorders (such as diabetes or certain tests. For example, certain autoimmune disorders). -
Counseling for Patients with Hyperacusis Mary Maraist
Augustana College Augustana Digital Commons Communication Sciences and Disorders: Student Communication Sciences and Disorders Scholarship & Creative Works 5-2019 Counseling for Patients with Hyperacusis Mary Maraist Follow this and additional works at: https://digitalcommons.augustana.edu/csdstudent Part of the Cognitive Behavioral Therapy Commons, Sense Organs Commons, Speech and Hearing Science Commons, and the Speech Pathology and Audiology Commons HYPERACUSIS COUNSELING MATERIALS 1 Counseling for Patients with Hyperacusis Mary Maraist CSD490: Senior Inquiry, Spring 2019 Ann Perreau, Ph.D., Thesis Advisor Augustana College HYPERACUSIS COUNSELING MATERIALS 2 Acknowledgements Firstly I would to thank Dr. Ann Perreau for introducing me to the topic of hyperacusis and for being an integral part of this project. I'm very thankful for all all of the support and expertise she has lent me throughout my time at Augustana and this project. She also contacted the participants for this project, which was incredibly helpful. On that note, I would like to thank the individuals who participated in this project. Their participation and flexibility was a crucial part of this process, and I'm very appreciative of the time they took to be a part of this project. My friends and family also deserve thanks as they have helped me work through challenges and and have supported me throughout my education. Thank you to all who have made an impression on my time at Augustana and who will continue to motivate me in the future. HYPERACUSIS COUNSELING MATERIALS 3 Abstract Hyperacusis is the phenomenon of experiencing moderately loud sounds as overly loud and/or intensely annoying. -
Delayed Endolymphatic Hydrops As a Clinical Entity
International Tinnitus Journal, Vol. 10, No.2, 137-143 (2004) Delayed Endolymphatic Hydrops as a Clinical Entity Tamio Kamei Gunma University School of Medicine, Department of Otolaryngology, Maebashi, Japan Abstract: Delayed endolymphatic hydrops (DEH) is a clinical entity that can be differenti ated from Meniere's disease and is typically observed in patients who have been suffering from longstanding unilateral profound inner-ear hearing loss. DEH probably is caused by de layed atrophy or fibrous obliteration of the endolymphatic resorptive system of the membra nous labyrinth. The time that elapses between the occurrence of hearing loss and the onset of DEH can range from 1 to 74 years. The most common cause of hearing loss preceding DEH is juvenile-onset unilateral profound deafness (early childhood unilateral profound senso rineural hearing loss of unknown etiology), followed by labyrinthitis from various causes and physical and acoustic traumas to the inner ear. Two types of DEH exist: the ipsilateral type, in which the ear with profound hearing loss suffers progressive endolymphatic hydrops, and the contralateral type, in which the formation of progressive endolymphatic hydrops takes place in the ear opposite to the previously deafened ear. The incidence of the ipsilateral type is higher than that of the contralateral type, and the contralateral type is more common in older patients. When recurrent episodic vertigo cannot be remedied through conservative treatment, labyrinthectomy and vestibular neurectomy on the deaf ear are curative for ipsilateral DEH. However, no such surgical treatment is available for the contralateral type. Key Words: contralateral; endolymphatic hydrops; ipsilateral; juvenile unilateral deafness; labyrinthectomy; recurrent vertigo o matter what its cause, a prolonged case of induces fluctuating hearing loss, tinnitus, and aural full N profound inner-ear hearing loss-called de ness in the ear with good hearing and, in some cases, is layed endolymphatic hydrops (DEH)- can in also complicated by episodic vertigo. -
Endolymphatic Hydrops Meniere's
ENDOLYMPHATIC HYDROPS MENIERE’S DISEASE Introduction: Meniere’s Disease, or endolymphatic hydrops, is a disorder of the inner ear. This condition occurs because of abnormal fluctuations in the inner ear fluid called endolymph. A system of membranes, called the membranous labyrinth, contains a fluid called endolymph. This fluid bathes the inner ear balance and hearing system sensory cells and allows them to function normally. The membranes can become dilated like a balloon when pressure increases. This is called "hydrops". The amount of fluid is normally kept constant by altering the production and absorption of the fluid. Endolymph also contains a specific concentration of sodium, potassium, chloride, and other electrolytes. If the inner ear is damaged by disease, injury, or other causes, the volume and composition of the inner ear fluid can fluctuate with changes in the body’s fluid and electrolyte levels. This fluctuation in inner ear fluid can cause the symptoms of hydrops, including pressure or fullness of the affected ear, tinnitus, hearing loss, and imbalance or dizziness. Treatment of this condition is geared towards stabilizing the body fluid levels so that fluctuations in the endolymph volume can be avoided. Meniere's episodes may occur in clusters in which several attacks may occur within a short period of time. On the other hand, years may pass between episodes. Between the acute attacks, most people are free of symptoms or note mild imbalance, tinnitus, and/or hearing loss. Meniere’s affects roughly 0.2% of the population, about 200 out of 100,000 people (or in other words, 2/1000). -
NL0313A Hearing Loss – Introduction and Overview Printed with Permission from Better Hearing Institute
NL0313A Hearing Loss – Introduction and Overview Printed with Permission from Better Hearing Institute http://www.betterhearing.org The Better Hearing Institute (BHI) is a not-for-profit corporation that educates the public about the neglected problem of hearing loss and what can be done about it. Founded in 1973, we are working to: Erase the stigma and end the embarrassment that prevents millions of people from seeking help for hearing loss. Show the negative consequences of untreated hearing loss for millions of Americans. Promote treatment and demonstrate that this is a national problem that can be solved. 1. HOW WE HEAR Patricia E. Connelly, PhD, CCC-A, FAAA, New Jersey Medical School, NEWARK, NJ The Hearing System The anatomy of the hearing system can be divided into four components for our convenience in remembering the parts and associating these parts with their function. These divisions are the: 1. outer ear 2. middle ear 3. inner ear 4. central auditory pathways The Outer Ear (1) Several structures comprise the outer ear. The most readily seen is the pinna, also called the auricle. The pinna is made up of a frame of cartilage that is covered with skin. The pinna has obvious folds, elevations, depressions and a prominent bowl - all of which vary somewhat from person to person but a basic pattern in these features is fairly universal among all people. The pinna acts as a funnel to collect and direct sound down the ear canal. It also serves to enhance some sounds through its resonance characteristics. Finally, it helps us to appreciate front-back sound localization. -
Giant Congenital Cholesteatoma of the Temporal Bone
Global Journal of Otolaryngology ISSN 2474-7556 Case Report Glob J Otolaryngol Volume 18 Issue 5 - January 2019 Copyright © All rights are reserved by Cristina Laza DOI: 10.19080/GJO.2019.18.555998 Giant Congenital Cholesteatoma of the Temporal Bone Cristina Laza* and Eugenia Enciu Clinical county hospital for emergencies Constanta, Romania Submission: December 15, 2018; Published: January 03, 2019 *Corresponding author: Cristina Laza, Clinical county hospital for emergencies Constanta, Romania Abstract Congenital or primitive cholesteatoma is a benign disease with slow progressive growth that destroys neighboring structures. It is a rare disease considered an epidermal cyst originating from the remnants of squamous keratinized epithelium, in several regions of the temporal bone such as in the middle ear (most frequent) as well as in the petrous apex, cerebellopontine cistern, external acoustic meatus and mastoid process. In this case report, we present a giant congenital cholesteatoma, occupying a part of the petrous part of the temporal bone, including middle ear and mastoid process discovered at a 12-years-old girl as an acute right otomastoiditis complicated with retro auricular abscess. There were no history of ear infections, trauma or previous surgeries on this area, the eardrum was intact, all the accusing starts after an infection of the naos- pharynx –typical for congenital cholesteatoma. In emergency using a retro auricular approach we drain the abscess located sub-periosteal a minutia’s excision of the cholesteatoma and a permanent follow up recurrence was discovered after 4 years at 16 years old –without signs of infectionand finally but we with remove tinnitus the andcholesteatoma vertigo and usingwe explore a radical the mastoidectomycavity and remove with the canal new wallcholesteatoma. -
A Review of Hyperacusis and Future Directions: Part I. Definitions and Manifestations
AJA Review Article A Review of Hyperacusis and Future Directions: Part I. Definitions and Manifestations Richard S. Tyler,a Martin Pienkowski,b Eveling Rojas Roncancio,a Hyung Jin Jun,a Tom Brozoski,c Nicolas Dauman,d Claudia Barros Coelho,a Gerhard Andersson,e,f Andrew J. Keiner,a Anthony T. Cacace,g Nora Martin,a and Brian C. J. Mooreh Purpose: Hyperacusis can be extremely debilitating, and at Results: Hyperacusis encompasses a wide range of present, there is no cure. We provide an overview of the reactions to sound, which can be grouped into the field, and possible related areas, in the hope of facilitating categories of excessive loudness, annoyance, fear, and future research. pain. Many different causes have been proposed, and it will Method: We review and reference literature on be important to appreciate and quantify different subgroups. hyperacusis and related areas. We have divided the Reasonable approaches to assessing the different forms of review into 2 articles. In Part I, we discuss definitions, hyperacusis are emerging, including psychoacoustical epidemiology, different etiologies and subgroups, and measures, questionnaires, and brain imaging. how hyperacusis affects people. In Part II, we review Conclusions: Hyperacusis can make life difficult for many, measurements, models, mechanisms, and treatments, forcing sufferers to dramatically alter their work and social and we finish with some suggestions for further habits. We believe this is an opportune time to explore research. approaches to better understand and treat hyperacusis. yperacusis can be devastating for those who suf- refereed publications, books, and conference proceedings. fer from it. This review is intended to clarify what We highlighted what we believe are key issues that are im- H is known at present about hyperacusis and its portant to move forward, sometimes even drawing from underlying mechanisms to focus research and to promote areas not normally associated with hyperacusis. -
Facial Paralysis: Objectives: • Discuss the Anatomy of the Facial Nerve
Facial Paralysis: Objectives: • Discuss the anatomy of the facial nerve • Look at common patterns of facial nerve palsy • Discuss imaging appearance of lesions that lead to facial paralysis. Lindell R. Gentry, M.D. Facial Nerve Anatomy: Facial Nerve Anatomy: Facial Nerve Anatomy: Facial Nerve Anatomy: Facial Nerve Anatomy: Facial Nerve Anatomy: Motor Root Branchial Motor (Main Facial Nerve) - Muscles of facial expression Sensory Root Greater Superficial Petrosal Nerve Greater Petrosal Nerve Facial Nerve - Autonomic (parasympathetic) Chorda Tympani Nerve Nerve to Stapedius - Taste to anterior 2/3 tongue Posterior Auricular Nerve Chorda Tympani - Periauricular region Muscles of Facial Expression Facial Nerve: Symptoms Facial Nerve: Symptoms • Loss of Function • Facial Weakness (Muscles of Facial Expression) – Central Facial Palsy – Peripheral Facial Palsy • Loss of Taste – Anterior 2/3 of the tongue • Hyperactive Function • Hyperacusis – Hemifacial Spasm • Loss of Lacrimation Facial Nerve Palsy: Location Facial Nerve Palsy: Location Central Palsy Central Facial Palsy Peripheral Facial Palsy 1. Suprabulbar - Supranuclear – Sparing of the upper face Optimal imaging workup: 2. Brainstem - depends on location of offending lesion – Other CN Palsies (CN 5-6) - depends on pathology – May or may not spare upper face - depends on acuity Peripheral Palsy 1. Intratemporal – Loss of lacrimation – Hyperacusis – Loss of taste to anterior 2/3 of tongue 2. Intraparotid – Pure motor Facial Nerve Palsy: Location Facial Nerve Palsy: Location Central Palsy Central Palsy 1. Suprabulbar - Supranuclear 1. Suprabulbar - Supranuclear – Sparing of the upper face – Sparing of the upper face 2. Brainstem 2. Brainstem – Other CN Palsies (CN 5-6) – Other CN Palsies (CN 5-6) – May or may not spare upper face – May or may not spare upper face Peripheral Palsy Peripheral Palsy Lymphoma 1.