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Query: UMLS:C0042571 (vertigo)
 7,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two patients with sudden progressive profound hearing loss resulting from Ramsay Hunt syndrome are reported. Case 1: A 63-year-old woman was admitted to Jichi Medical School Hospital with sudden, progressing deafness of the left ear, vertigo, sore throat, and hoarseness. An otoscopic examination revealed the external ear and the tympanic membrane to be normal. Pure-tone audiometry revealed profound deafness in the left ear. A horizontal nystagmus in the non-affected direction was observed by gaze nystagmus test. An endoscopic examination revealed herpetic vesicles and shallow ulcers on the left side of the pharynx and the larynx. There was complete paralysis of the left recurrent nerve. Hearing acuity of the left ear did not recover at all with steroid hormone therapy. Case 2: A 75-year-old man was referred to the ENT Clinic by a dermatologist for hearing evaluation in Ramsay Hunt syndrome. The man had noticed severe otalgia and sudden progressive deafness of the right ear approximately 2 weeks prior to admission. Physical examination revealed herpetic vesicles and ulcers in the right external ear and lateral neck. Complete paralysis of the right facial nerve was noted. Profound hearing loss in the affected ear was observed by pure-tone audiometry. A gaze nystagmus test revealed a horizontal nystagmus in the non-affected direction. No recovery of the cochlear function was noted following administration of antiviral drug. The pertinent literature is briefly reviewed.
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PMID:Acute profound deafness in Ramsay Hunt syndrome. Two case reports. 285 31

Ear diseases are the most common of all occupational diseases of diving. Otitis externa is the most frequent and troublesome infection in divers especially when the environment is humid. During compression, failure to equalize the pressure of the air-filled cavities surrounded by bone (middle ear, sinus) deprives the middle ear (or sinus) of aeration. Middle ear barotrauma is the most common barotrauma encountered in divers while external ear barotrauma (reversed ear) and inner ear barotrauma (with rupture of the round or oval window) are less common. Decompression sickness (Caisson disease) is primarily the result of inert gas bubbles; deafness and vertigo may result if the inner ear is involved. The most dramatic cause of disorientation under water is that due to vertigo. This vertigo is commonly a transient effect due to unequal caloric stimulation of the two labyrinths. The physical examination of the ear and nose necessary for assessment of diving fitness are discussed. A list of ENT contra-indications is presented which mandate temporary or permanent disqualification from diving.
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PMID:[Otologic aspects of diving]. 304 72

In all infants and children who have progressive, fluctuating or sudden sensorineural hearing loss, the possibility of a congenital perilymphatic fistula should be considered. Factors determined to be highly suggestive of the presence of a congenital perilymphatic fistula as the cause of sensorineural hearing loss or vertigo, or both, include the following: mixed conductive and sensorineural hearing loss; antecedent sudden physical exertion or barotrauma; congenital deformities of the external ear and head; and abnormal findings on computed tomograms of the temporal bone, especially Mondini-like ear dysplasias. In a series of 37 children who had a congenital perilymphatic fistula treated at the Children's Hospital of Pittsburgh, 28 (76%) had had documented otitis media in the past or a history of middle ear disease. This finding should alert the clinician to the possibility of the presence of a congenital perilymphatic fistula when sensorineural hearing loss develops or progresses during an episode of otitis media. Perilymphatic fistula is caused by either congenital ossicular deformities or abnormalities of the labyrinthine windows or coexistence of both conditions. The likelihood of there being no further deterioration in hearing after surgical repair of a perilymphatic fistula is high. Every infant and child with unexplained hearing loss or disequilibrium or both deserves an attempt to uncover the cause at the earliest possible age.
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PMID:Otitis media and congenital perilymphatic fistula as a cause of sensorineural hearing loss in children. 306 38

Ear trauma, a common problem in emergency medicine is discussed in this review. Although injuries of the ear are not life threatening, they may account for significant morbidity. Patients may experience severe pain, hearing loss, tinnitus, or vertigo. Poor healing of injuries to the external ear may result in a cosmetic deformity as well. Ear trauma may occur secondary to a number of mechanisms, including loud noises, penetrating or blunt trauma, blast injury, chemical exposure, and thermal injury.
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PMID:Ear trauma. 332 73

Tinnitus and vertigo, two common neurological complaints, often challenge the physician's ability with respect to possible etiology. Objective tinnitus can result from an abnormally patent eustachian tube, from tetanic contractions of the muscles of the soft palate, or from vascular abnormalities within the head or neck. Subjective tinnitus refers to lesions involving the external ear canal, tympanic membrane, ossicles, cochlea, auditory nerve, brainstem, and cortex. As many as 50% of patients with tinnitus do not exhibit associated hearing loss; in these patients, the cause of the tinnitus is rarely identified. An illusion of movement is specific for vestibular system disease--a peripheral or central location depending upon associated audiologic and neurologic symptoms, respectively. However, a presyncopal, light-headed sensation is most commonly associated with diffuse cerebral ischemia: in the young patient, this may be caused by a hyperventilation syndrome; in the aged individual, this can result from diffuse atherosclerotic cerebrovascular disease and decreased cardiac output. Postural and gait imbalance associated with acute vertigo indicates a unilateral peripheral vestibular or a central vestibular lesion; if vertigo is absent, either a cerebellar, proprioceptive, or bilateral peripheral vestibular lesion is likely. Transient oscillopsia suggests unilateral peripheral vestibular lesions. Permanent oscillopsia indicates a bilateral peripheral vestibular lesion or--in the absence of severe vertigo--brainstem or cerebellar damage.
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PMID:[Differential diagnosis of tinnitus and vertigo. A review]. 406 94

To determine the characteristics of sudden deafness associated with slow blood flow (SBF) within the vertebrobasilar arteries, we evaluated 57 patients with sudden deafness using magnetic resonance imaging (MRI). We detected SBF in 12 (21%) patients, predominantly men over 50 years of age. A second MRI performed in 5 patients 2 months after the onset of symptoms showed recovery of blood flow. All 12 patients complained of vertigo. Audiological and neurotologic tests suggested that hearing loss mainly involved the inner ear. Our findings suggest that unless central lesions are detected, headache, hypoesthesia of the external ear canal, and electronystagmographic abnormalities are signs of SBF. Because sudden deafness may recur in patients who have SBF, they should be monitored and treated to prevent recurrence.
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PMID:Sudden sensorineural hearing loss associated with slow blood flow of the vertebrobasilar system. 823 50

Surgical treatment of petrous cholesteatoma is difficult, especially in infected cases, since it often involves vital structures. We report the case of a patient successfully treated for an infected petrous cholesteatoma by staging the surgical procedures to reduce the risk of intracranial complications. The patient, a 53-year-old man, was referred to our hospital because of vertigo during coughing or strenuous effort. The left side mastoid cavity was open to the external ear canal and wholly covered with cholesteatoma epithelium with purulent discharge. The superior basal turn of the cochlea, superior and posterior semicircular canals, and roof of the internal auditory canal were eroded. Conservative treatment was not effective in eradicating the otorrhea. Four weeks after the first operation (radical mastoidectomy), the second operation was conducted following a combined middle cranial fossa and transmastoid approach. The postoperative course was uneventful. Normal facial nerve function was preserved and unsteadiness disappeared, but hearing could not be preserved. The MRI examination, performed one year after surgery, did not reveal any evidence of residual cholesteatoma.
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PMID:A case of acquired petrous cholesteatoma associated with insidious middle ear infection treated by staging the surgical procedures. 856 1

Primary care physicians are influential in diagnosing and initiating treatment of most pathologic conditions in patients with a history of hearing loss, chronic ear infection, diabetes, immunosuppression, or otologic symptoms with excessive exposure to sunlight. Lesions of the external ear and the external auditory canal (external acoustic meatus) are significant and common. Patients with such a history should have a thorough basic examination, which can be done with simple tools. Symptoms of hearing loss, otalgia, otorrhea, tinnitus, aural fullness, vertigo, and facial weakness may warrant referral of the patient to an otolaryngologist. The crux of preventing worsening otologic sequelae is early detection and treatment.
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PMID:Pathologic conditions of the external ear and auditory canal. 879 56

In Ramsay Hunt's syndrome (herpes zoster of the head and neck in combination with facial palsy), the vesicles often appear on the external ear (herpes zoster oticus) but they can also be found on the exterior of the neck. Serologically verified cases without vesicles occur (zoster sine herpeticum). Complications from the eighth cranial nerve (hearing loss and vertigo) are common. MR and PCR studies show a more extensive viral attack than was earlier believed to be the case. Due to the risk of remaining cranial nerve dysfunctions, as exemplified in a case report, antiviral treatment is indicated, in severe cases combined with corticosteroids. The potential value of varicella vaccination to reduce zoster complications is discussed.
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PMID:[Diagnosis of Ramsey Hunt syndrome is both simple and difficult. The viral attack is more extensive than expected earlier]. 1075 Mar 83

A patient with a postoperative fistula of the left posterior semicircular canal is presented. Negative pressure in the external ear canal produced upbeat-torsional nystagmus, which was recorded in three dimensions using binocular scleral search coils. The nystagmus was conjugate, without skew deviation, and its trajectory corresponded to the anatomic axis of the left posterior canal. The current study helps validate Ewald's first law in humans: the axis of nystagmus should match the anatomic axis of the semicircular canal that generated it. This law is clinically useful in diagnosing pathology of the vestibular end-organ, such as benign paroxysmal positional vertigo or the superior semicircular canal dehiscence syndrome.
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PMID:Posterior semicircular canal nystagmus is conjugate and its axis is parallel to that of the canal. 1082 50


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