Labyrinthine Fistula
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Labyrinthine Fistula
A labyrinthine fistula is an abnormal opening in the inner ear. This can result in leakage of the perilymph into the middle ear. This includes specifically a perilymph fistula (PLF), an abnormal connection between the fluid of the inner ear and the air-filled middle ear. This is caused by a rupture of the round window or oval window ligaments separating the inner and middle ear. Another type of labyrinthine fistula is the superior semicircular canal dehiscence, which allows the inner ear to be influenced by the intracranial pressure directly. Signs and symptoms PLF usually induces one or all the following pathological states: aural fullness, fluctuating or non-fluctuating hearing loss, tinnitus and dizziness, which may sometimes include vertigo and balance disorders. Cause Labyrinthine fistula can be both congenital or develop over time with the thinning of the otic capsule by the persistent pulsations of the intracranial pressures against the bones of the skull. Finally, diseas ...
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Cochlea
The cochlea is the part of the inner ear involved in hearing. It is a spiral-shaped cavity in the bony labyrinth, in humans making 2.75 turns around its axis, the modiolus. A core component of the cochlea is the Organ of Corti, the sensory organ of hearing, which is distributed along the partition separating the fluid chambers in the coiled tapered tube of the cochlea. The name cochlea derives . Structure The cochlea (plural is cochleae) is a spiraled, hollow, conical chamber of bone, in which waves propagate from the base (near the middle ear and the oval window) to the apex (the top or center of the spiral). The spiral canal of the cochlea is a section of the bony labyrinth of the inner ear that is approximately 30 mm long and makes 2 turns about the modiolus. The cochlear structures include: * Three ''scalae'' or chambers: ** the vestibular duct or ''scala vestibuli'' (containing perilymph), which lies superior to the cochlear duct and abuts the oval window ** the ty ...
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Tinnitus
Tinnitus is the perception of sound when no corresponding external sound is present. Nearly everyone experiences a faint "normal tinnitus" in a completely quiet room; but it is of concern only if it is bothersome, interferes with normal hearing, or is associated with other problems. While often described as a ringing, it may also sound like a clicking, buzzing, hissing or roaring. It may be soft or loud, low- or high- pitched, and may seem to come from one or both ears or from the head itself. In some people, it may interfere with concentration, and in some cases is associated with anxiety and depression. Tinnitus is usually associated with a degree of hearing loss and decreased comprehension of speech in noisy environments. It is common, affecting about 10–15% of people. Most, however, tolerate it well, and it is a significant problem in only 1–2% of all people. It can trigger a fight-or-flight response, as the brain may perceive it as dangerous and important. The word ' ...
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Ménière's Disease
Ménière's disease (MD) is a disease of the inner ear that is characterized by potentially severe and incapacitating episodes of vertigo, tinnitus, hearing loss, and a feeling of fullness in the ear. Typically, only one ear is affected initially, but over time, both ears may become involved. Episodes generally last from 20 minutes to a few hours. The time between episodes varies. The hearing loss and ringing in the ears can become constant over time. The cause of Ménière's disease is unclear, but likely involves both genetic and environmental factors. A number of theories exist for why it occurs, including constrictions in blood vessels, viral infections, and autoimmune reactions. About 10% of cases run in families. Symptoms are believed to occur as the result of increased fluid buildup in the labyrinth of the inner ear. Diagnosis is based on the symptoms and a hearing test. Other conditions that may produce similar symptoms include vestibular migraine and transient ischemi ...
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Stapedectomy
A stapedectomy is a surgical procedure of the middle ear performed in order to improve hearing. If the stapes footplate is fixed in position, rather than being normally mobile, the result is a conductive hearing loss. There are two major causes of stapes fixation. The first is a disease process of abnormal mineralization of the temporal bone called otosclerosis. The second is a congenital malformation of the stapes. In both of these situations, it is possible to improve hearing by removing the stapes bone and replacing it with a micro prosthesis - a stapedectomy, or creating a fenestra, small hole in the fixed stapes footplate and inserting a tiny, piston-like prosthesis - a stapedotomy. The results of this surgery are generally most reliable in patients whose stapes has lost mobility because of otosclerosis. Nine out of ten patients who undergo the procedure will come out with significantly improved hearing while less than 1% will experience worsened hearing acuity or deafness. Su ...
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Scuba Diving
Scuba diving is a mode of underwater diving whereby divers use breathing equipment that is completely independent of a surface air supply. The name "scuba", an acronym for "Self-Contained Underwater Breathing Apparatus", was coined by Christian J. Lambertsen in a patent submitted in 1952. Scuba divers carry their own source of breathing gas, usually compressed air, affording them greater independence and movement than surface-supplied divers, and more time underwater than free divers. Although the use of compressed air is common, a gas blend with a higher oxygen content, known as enriched air or nitrox, has become popular due to the reduced nitrogen intake during long and/or repetitive dives. Also, breathing gas diluted with helium may be used to reduce the likelihood and effects of nitrogen narcosis during deeper dives. Open circuit scuba systems discharge the breathing gas into the environment as it is exhaled, and consist of one or more diving cylinders containing breat ...
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Cholesteatoma
Cholesteatoma is a destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process. Cholesteatomas are not cancerous as the name may suggest, but can cause significant problems because of their erosive and expansile properties. This can result in the destruction of the bones of the middle ear ( ossicles), as well as growth through the base of the skull into the brain. They often become infected and can result in chronically draining ears. Treatment almost always consists of surgical removal. Signs and symptoms Other more common conditions (e.g. otitis externa) may also present with these symptoms, but cholesteatoma is much more serious and should not be overlooked. If a patient presents to a doctor with ear discharge and hearing loss, the doctor should consider cholesteatoma until the disease is definitely excluded. Other less common symptoms (all less than 15%) of cholesteatoma may include pain, balance disruption, tinnitu ...
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Otic Capsule
The bony labyrinth (also osseous labyrinth or otic capsule) is the rigid, bony outer wall of the inner ear in the temporal bone. It consists of three parts: the vestibule, semicircular canals, and cochlea. These are cavities hollowed out of the substance of the bone, and lined by periosteum. They contain a clear fluid, the perilymph, in which the membranous labyrinth is situated. A fracture classification system in which temporal bone fractures detected by computed tomography are delineated based on disruption of the otic capsule has been found to be predictive for complications of temporal bone trauma such as facial nerve injury, sensorineural deafness and cerebrospinal fluid otorrhea. On radiographic images, the otic capsule is the densest portion of the temporal bone. In otospongiosis, a leading cause of adult-onset hearing loss, the otic capsule is exclusively affected. This area normally undergoes no remodeling in adult life and is extremely dense. With otospongiosis, the ...
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Congenital
A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can range from mild to severe. Birth defects are divided into two main types: structural disorders in which problems are seen with the shape of a body part and functional disorders in which problems exist with how a body part works. Functional disorders include metabolic and degenerative disorders. Some birth defects include both structural and functional disorders. Birth defects may result from genetic or chromosomal disorders, exposure to certain medications or chemicals, or certain infections during pregnancy. Risk factors include folate deficiency, drinking alcohol or smoking during pregnancy, poorly controlled diabetes, and a mother over the age of 35 years old. Many are believed to involve multiple factors. Birth defects may be vi ...
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Balance Disorders
A balance disorder is a disturbance that causes an individual to feel unsteady, for example when standing or walking. It may be accompanied by feelings of giddiness, or wooziness, or having a sensation of movement, spinning, or floating. Balance is the result of several body systems working together: the visual system (eyes), vestibular system (ears) and proprioception (the body's sense of where it is in space). Degeneration or loss of function in any of these systems can lead to balance deficits. Signs and symptoms Cognitive dysfunction (disorientation) may occur with vestibular disorders. Cognitive deficits are not just spatial in nature, but also include non-spatial functions such as object recognition memory. Vestibular dysfunction has been shown to adversely affect processes of attention and increased demands of attention can worsen the postural sway associated with vestibular disorders. Recent MRI studies also show that humans with bilateral vestibular damage (damage to bot ...
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Vertigo
Vertigo is a condition where a person has the sensation of movement or of surrounding objects moving when they are not. Often it feels like a spinning or swaying movement. This may be associated with nausea, vomiting, sweating, or difficulties walking. It is typically worse when the head is moved. Vertigo is the most common type of dizziness. The most common disorders that result in vertigo are benign paroxysmal positional vertigo (BPPV), Ménière's disease, and labyrinthitis. Less common causes include stroke, brain tumors, brain injury, multiple sclerosis, migraines, trauma, and uneven pressures between the middle ears. Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed. Other causes may include toxin exposures such as to carbon monoxide, alcohol, or aspirin. Vertigo typically indicates a problem in a part of the vestibular system. Other causes of dizziness incl ...
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Dizziness
Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to disequilibrium or a non-specific feeling, such as giddiness or foolishness. Dizziness is a common medical complaint, affecting 20-30% of persons. Dizziness is broken down into 4 main subtypes: vertigo (~25-50%), disequilibrium (less than ~15%), presyncope (less than ~15%), and nonspecific dizziness (~10%). * Vertigo is the sensation of spinning or having one's surroundings spin about them. Many people find vertigo very disturbing and often report associated nausea and vomiting. * Presyncope describes lightheadedness or feeling faint; the name relates to syncope, which is actually fainting. * Disequilibrium is the sensation of being off balance and is most often characterized by frequent falls in a specific direction. This condition is not often associated with nausea or vomiting. * Non-specific dizziness may be psychiatric in origin. It is ...
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Hearing Loss
Hearing loss is a partial or total inability to Hearing, hear. Hearing loss may be present at birth or acquired at any time afterwards. Hearing loss may occur in one or both ears. In children, hearing problems can affect the ability to Language acquisition, acquire spoken language, and in adults it can create difficulties with social interaction and at work. Hearing loss can be temporary or permanent. Presbycusis, Hearing loss related to age usually affects both ears and is due to cochlear hair cell loss. In some people, particularly older people, hearing loss can result in loneliness. Deafness, Deaf people usually have little to no hearing. Hearing loss may be caused by a number of factors, including: genetics, ageing, Noise-induced hearing loss, exposure to noise, some infections, birth complications, trauma to the ear, and certain medications or toxins. A common condition that results in hearing loss is chronic ear infections. Certain infections during pregnancy, such as cyt ...
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