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

Diving injury may affect all parts of the ear during all types of diving. Divers are regularly exposed to noise and 120 dB(A) is measured during ventilation of a hyperbaric chamber. Ear canal squeeze, possibly with drum perforation, may give a transient conductive hearing loss. Middle ear squeeze, possibly with drum perforation, also gives a transient conductive loss. Inner ear barotrauma, possibly with perilymph fistula, most often results in transient vertigo and lasting sensorineural high tone loss, often resembling a noise-induced loss. Decompression sickness and gas embolism can also damage the inner ear. A change of breathing gas during deep diving has damaged the labyrinth, most likely due to counter diffusion. The authors have seen two cases of over window perilymph fistula resulting from diving. One of them also suffered a burst ear drum on the same side. His hearing returned to normal after surgical repair.
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PMID:Ear damage due to diving. 28 37

Clinicians have been aware of the problem of post-stapedectomy perilymph fistulas for some time. The existence of non-surgical oval and round window fistulas has been known and was first described in detail by Fee in 1968. This paper concerns a small series of patients with spontaneous and traumatic perilymph fistulas. Five oval window fistulas and one round window fistula are reported. Clinical features, audiometric, radiographic and vestibular findings are discussed. The etiology of traumatic and spontaneous fistulas is not well understood, but seems to bear a relationship to sudden increased in intracranial pressure transmitted to the inner ear through the cochlear aqueduct. Middle ear pressure changes, as seen in acoustic or barotrauma, may also cause these leaks. Indications for surgery and techniques of perilymph fistula identification and repair are discussed in the paper. Surgical correction led to relief of vertigo in 80 percent of patients in this series, and significant hearing improvements were seen in 50 percent of the patients. In evaluating patients with sudden sensori-neural hearing loss, or persistent vestibular symptoms following head or ear trauma, the otologist should keep in mind the possibility of a perilymph fistula and actively investigate these patients. Evidence presented in this paper and in the literature suggest that identification and correction of spontaneous and traumatic perilymph fistulas can lead to resolution of vestibular symptoms and improved hearing in a significant number of patients with these lesions.
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PMID:Spontaneous and traumatic perilymph fistulas. 83 31

Disorientation and vertigo, which develops in divers during descent, is objectively demonstrated with dysbaric electronystagmographic tracings. Middle ear barotrauma of descent is verified as a valid etiology in the classification of vertigo associated with diving and may present as either a transitory or a more persistent disorder.
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PMID:Disorientation with middle ear barotrauma of descent. 122 89

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

During the years 1975 through 1981 we performed exploratory tympanotomies on 33 infants and children (44 ears) to verify the presumptive diagnosis of perilymph fistula (PLF). A PLF was identified at the round window, oval window, or both in 29 (66%) of the 44 ears explored. After surgery hearing was unchanged in 86%, improved in 5%, and worsened in 9% of the ears in which PLFs had been observed. Complaints of vertigo subsided in all children in whom a PLF was repaired. Preoperative factors determined to be highly suggestive of the presence of a PLF included the following: sudden onset of sensorineural hearing loss (SNHL), congenital deformities of the head, and abnormal findings on tomograms of the temporal bones, especially Mondini-like inner ear dysplasias. Middle ear abnormalities (primarily congenital) were observed in 20 of the 44 ears. Abnormal results of preoperative vestibular function studies, which included a fistula test, and sex were not consistently found to be associated with an observed PLF at tympanotomy.
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PMID:Perilymph fistulas in infants and children. 642 Jul 49

ENT disorders are the most common of all medical problems of diving. This review summarizes the specific conditions and ENT diseases in Scuba diving. During compression failure to equalize the pressure of air-filled cavities surrounded by bone deprives the middle ear or sinuses of aeration. Middle ear barotrauma is the most common barotrauma encountered in divers while sinus barotrauma and especially inner ear barotrauma (with rupture of the round or oval window) are less common. Decompression sickness in primarily the result of inert gas bubbles; deafness and vertigo may result if the inner ear is involved. The ENT examination necessary for assessment of diving fitness focuses on the middle and inner ear as well as the nose, sinuses and larynx. A list of ENT contra-indications is presented that mandate temporary or permanent disqualification from diving.
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PMID:[Otorhinolaryngologic aspects of diving sports]. 840 83

Medical management of Meniere's disease is successful in approximately 70% of patients. Surgical intervention is the treatment option when medication fails. Middle ear installation of aminoglycosides provides significant control of vertigo. This article addresses the role of aminoglycoside ablation of vestibular function in Meniere's disease.
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PMID:Role of chemical labyrinthectomy in the treatment of Meniere's disease. 938 40

The use of intratympanic gentamicin is currently a popular and easily performed office procedure for the conservative treatment of the Meniere's disease patient who has failed medical therapy or who is not a candidate for surgical therapy. The procedure provides excellent control for the symptom of vertigo. Despite this success, there remains a significant risk of hearing loss irrespective of administered dose. In the future, antioxidant [42,43] or salicylate therapy may prevent aminoglycoside toxicity [44]. These prophylaxis methods have shown promise in the laboratory. Current methods do not allow for accurate drug delivery to the inner ear. Middle ear mucosal status, round window thickness or adhesion, patency of eustachian tube, and the effect of endolymphatic hydrops on ototoxicity are factors simply out of the control of the operator's hands. Judging by the number of recent articles, intratympanic gentamicin instillation will continue to be an area of interest for the otologist. Users should be encouraged to be consistent and conservative in gentamicin dosing. It is clear that vestibular ablation is not necessary for adequate control of vestibular symptoms and that larger doses may increase the risk of hearing loss. American Academy of Otolaryngology-Head and Neck Surgery guidelines [45] should be used and adhered to for reporting on the treatment of Meniere's disease, so that the literature may be more comparable. In the same light, a prospective standardized trial would be helpful in determining ultimate efficacy and risk to the patient. Transmastoid labyrinthectomy remains the surgical standard for extirpating the offending labyrinth when hearing preservation is not an issue. In appropriate patients, the procedure is a safe and effective method for relieving patients of vertiginous attacks. Most patients tolerate the procedure very well and are able to compensate fairly well over the course of several weeks to months.
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PMID:Chemical and physical labyrinthectomy for Meniere's disease. 1248 47

We describe the case history of a 70-year-old female patient presenting with bilateral hearing disturbance, facial paralysis, and vertigo. Radiological tests of temporal bone revealed soft tissue in the mastoid and tympanic cavities, and T1 weighted MRI revealed prominent Gd enhancement of the middle skull basal meninges. Middle ear inflammation appeared to induce pachymeningitis and to exacerbate associated symptoms, leading to a decline in the patient's overall condition. Bilateral mastoidectomies were effective in improving her general condition. Her hearing improved only on the right side because ossiculoplasty was performed only on that side. Her facial movement progressively improved and pachymeningitis diminished over time. We speculate that removal of the infectious granulation within the middle ears and mastoids ameliorated the acute inflammation. The etiology remains unknown in this case.
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PMID:Hypertrophic chronic pachymeningitis associated with chronic otitis media and mastoiditis. 1512 Dec 25

Superior canal dehiscence syndrome is a recently described condition resulting in noise- or pressure-induced vertigo. We review the case of a 50-year-old woman who presented with debilitating pressure and noise-induced vertigo as well as a low-frequency conductive hearing loss. Imaging was consistent with superior semicircular canal dehiscence syndrome. An extradural middle fossa approach was used to approach the dehiscent superior canal. Intraoperatively, our patient was found to have extensive idiopathic skull base dehiscence of the temporal floor. Middle ear and mastoid mucosa was exposed with focal areas of dura prolapsed into the mastoid cavity. Because of these findings, temporalis fascia and bone pate were used to cover the dehiscent canal as well as a large area of the temporal floor. Additionally, a temporalis muscle flap was rotated between the dura and the dehiscent temporal floor to reconstruct the middle fossa skull base and prevent encephalocele.
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PMID:Management of superior canal dehiscence syndrome with extensive skull-base deficiency. 1600 90


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