any sound perceived in the abscence of an external stimuli
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it affects
men >women
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It normally effects
both ears (bilateral)
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if only affects 1 ear
sign something isnt quite right
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types of tinnitus
subjective, objective, contiuous
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Diagnosing tinnitus
visual exam of ear, hearing test, neurological assessment
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treating tinnitus
no pharm. treatment. sound therapy, cognitive behaviour therpay - retrain brain to pay less attention to it
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True Vertigo
rotational movements of self or surroundings , often accompanied by nausea and vom. conflicting messages between 2 ears or ears and eyes +brain. It is not just dizzyness
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Non vertigo
light headness , unsteadiness
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types of vertigo (2)
1. peripheral 2. central
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peripheral
disorder of the inner ear or 8th cranial nerve. age related and affected F>M . possible causes are menieres and begnign tumors and inflammation of the vestibular nerve --> mixed signals
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central
disorder of brainstem or cerebellum. could be due to head injury,stoke, tumor
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Treating vertigo
NSAIDs, epiley manoevre , retraining the brain
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immediate treatment of central
bucal prochloperazine (if vomitting) if not vom then prochlor. tabs or cyclizine to treat nausea
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prophylaxis
prevention
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prophylaxis of vertigo
restrict salt intake and fluid intake , stop smoking and dont take xs coffee/OH
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safety during vertigo attack
sit/lie down. risk of falling. must inform DVLA. must move around after attack to compensate
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menieres disease
build up of fluid in the ear--> mixed signals . problems with both hearing and balance
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typical attacks last
2-3 hours
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how often attacks
6-11 per year and affects F>M
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diagnosis
at least 2 vertigo episodes lasting at least 20 mins, hearing loss , tinnitus
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treatment
prochloperazine - advise to stop when attack is over
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prophylaxis
betahistine
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otoxicity
damage to hearing or balance by drugs or chemicals
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is it reverible?
yes in some cases - depends on the drug
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macrolide antibiotics
reversible
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NSAIDs
often reversible
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aminoglycozides
irreversible
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prevention of otoxicity
use smallest dose for shortest possible time
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nasal polyps
pale bags of oedematous tissue - small grape like , usually affects both nostrils , if only affects one nostril--> more sinister . affects M>F . affects 20-40%of astham suffers
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in CF?
affects 1 in 2
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in children
very rare - if see in children should get tested for CF
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symptoms of nasal polyps
blocked, runny nose, altered sense of taste, poor QOL
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treatment
corticosteroids- reduce size and growth
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oral
prednisolone
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nasally
momementasone spray
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surgery
polyps will return in 3/4 people . surgery to remove. long term use of steroids after surgery to prevent them returning
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tetracyclines
can cause tooth decolouration - not used in children u8
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