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Balance Disorders
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Take a detailed and thorough history. The duration of symptoms can be of great diagnostic help. ‘Dizziness’ lasting for a few seconds suggests benign paroxysmal positional vertigo (BPPV) but this is rare in children. Episodes lasting a few hours may be due to migraine, or benign paroxysmal vertigo of childhood (BPVC) which is now thought to be a variant of migraine. Vestibular neuronitis and acute labyrinthitis symptoms last for a few days, but compensation in children is much more rapid than in adults. Associated symptoms can help narrow the diagnosis; nausea and vomiting suggest vestibular pathology but may occur in migraine. Neurological features such as seizures or cranial nerve palsies are alarming and warrant urgent investigation to rule out intracranial pathology. Anxiety, depression and eating disorders may be associated with balance dysfunction. ‘Functional’ (or ‘psychogenic’ vertigo as it used to be known) is common, and the rapid hormonal changes of adolescence can often be accompanied by symptoms of ‘dizziness’ caused by postural (orthostatic) hypotension. Adolescence is also a time when young people may be subject to exam pressures, bullying, intense social media activity and sometimes family disharmony, all of which can manifest as somatic symptoms including balance disorders.
Answers
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
In acute vestibular neuronitis there is only inflammation of the vestibular nerve, so there is vertigo without hearing loss. In acute labyrinthitis there is inflammation of the entire labyrinth, so patients experience vertigo with hearing loss.
The Special Sense Organs and Their Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Labyrinthitis, or inflammation of the inner ear, can cause hearing loss along with vertigo and other types of dizziness. In peripheral vestibulopathy, also called acute labyrinthitis or vestibular neuronitis, vertigo is acute, severe, and often associated with nausea, vomiting, and nystagmus.
Bone-conduction hearing aid is effective in congenital oval window atresia
Published in Acta Oto-Laryngologica, 2021
Mengdie Gao, Chunli Zhao, Jinsong Yang, Peiwei Chen, Yujie Liu, Danni Wang, Shouqin Zhao
When preoperative BB Fastview-software assessment allows, mastoid approach is the first choice, since mastoid development, dural or sigmoid sinus compression, and use of the Lifts system did not interact and that they had no influence on the hearing outcomes after Bonebridge implantation [20]. Also, our study concurrently found that BB implantation for cases with the combination of EAC atresia or stenosis deformities is effective with simple middle-ear deformities. Patients’ hearing could be improved greatly with BB implantation without the need for external auditory meatoplasty. This ensured a safe, stable, and efficient way to improve speech comprehension, and greatly reduce the complications such as labyrinthitis. In addition, BB implantation is relatively simple, due to which it is possible to concurrently complete a bilateral implantation, providing a better and efficient choice for patients with bilateral oval window atresia.
Surgical complications of cochlear implantation in a tertiary university hospital
Published in Cochlear Implants International, 2018
Al Hussein Awad, Usama M. Rashad, Nihal Gamal, Mostafa A. Youssif
In two cases, the electrode array insertion was not possible due to total cochlear obliteration. The second surgery was successfully performed in the two patients in the contralateral ear, without any subsequent complications. Many otologists consider progressive cochlear ossification after meningitis is an emergency, and such children should be implanted as soon as possible. Ossification can take place as early as 2 months after meningitis (Nofak et al., 1990). When early scanning reveals development of ossification, early cochlear implantation should be considered. 80% of the patients with postmeningitic sensorineural hearing loss showed partial or complete ossification of the cochlear basal turns in radiological assessment (Jackler et al., 1987). Therefore, patients with postmeningitic hearing loss and potential risk for ossifying labyrinthitis must be properly counseled preoperatively about the increased risk of device insertion failure.
The impact of labyrinthine magnetic resonance signal alterations on the treatment of sudden sensory-neural hearing loss
Published in Acta Oto-Laryngologica, 2023
Edoardo Covelli, Chiara Filippi, Haitham H. Elfarargy, Luigi Volpini, Valerio Margani, Giulia Moltoni, Serena Palizzi, Andrea Romano, Alessandro Bozzao, Maurizio Barbara
Labyrinthine hemorrhage can be secondary to coagulopathy, tumor, or trauma. Viral labyrinthitis has also, on occasion, been reported to be hemorrhagic. There may be undetected patients with labyrinthine hemorrhage who do not have an apparent clinical presentation. Schuknecht made histological studies of the temporal bone in patients who died just after the onset of ear symptoms [13]. He found that inner ear hemorrhage can cause sudden hearing loss and vertigo. He also stated that spontaneous inner ear hemorrhage mainly occurs as a complication of bleeding disorders, the most common being leukemia. Animal experiments showed that perilymphatic and endolymphatic hemorrhage due to microvascular occlusion could cause hearing loss [14]. None of the subjects in our study had a history of coagulopathy or anticoagulant therapy, and the blood coagulation tests were within normal ranges in all patients diagnosed with labyrinthine hemorrhage. In the case study of Jerad et al. no abnormality was found after hematological and immunological explorations [12]. In the study by Lee et al. only three (25%) patients had histories of anticoagulation therapy, and there were no suspicious causes of labyrinthine hemorrhage in the remaining patients [15]. Poh and Tan reported that radiotherapy could cause labyrinthine hemorrhage [15]. They defined the etiology as vascular causes, inner ear membrane damage, and capillary dilation or proliferation of small-sized vessels inside stria vascularis. Chen et al. found that labyrinthine hemorrhage was unrelated to abnormal blood count findings or coagulation dysfunction, and most labyrinthine hemorrhages were spontaneous [16].