By coll.
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Example text
60). In severe cases the eardrum may rupture. The aetiology is an inability to ventilate the middle ear due to abnormal function of the Eustachian tube. g. descent in flight or scuba diving. Treatment comprises a repeated Valsalva manoeuvre to open up the Eustachian tube, in addition to topical nasal decongestants. Myringotomy may be needed in some cases. g. topical nasal decongestants and repeated swallows). Occasionally insertion of a ventilation tube overcomes the problem. Head injuries Head injuries may be associated with temporal bone fractures (p.
Acoustic neuromas may result in a sense of imbalance. Disorders of balance – introduction and otological causes ■ Ascertain ■ The the precise nature of the imbalance. duration of symptoms gives vital clues to the aetiology. ■ All patients with vertigo should have an otoscopic examination to exclude middle ear pathology. ■ All patients should have their hearing assessed to exclude a unilateral deficit and the presence of an acoustic neuroma. ■ Otological causes of imbalance improve with time due to central compensation if the brain is normal.
The typical injury produces a tympanic membrane rupture. The cochlea may be damaged, resulting in a sensorineural hearing loss and tinnitus, both of which may be permanent. Imbalance occurs if the vestibular apparatus is affected. Otitic barotrauma Otitic barotrauma can produce otalgia with some extravasation of blood into the middle ear so that a haemotympanum occurs (Fig. 60). In severe cases the eardrum may rupture. The aetiology is an inability to ventilate the middle ear due to abnormal function of the Eustachian tube.
Throat and Head and Neck Surgery - by coll.
by Anthony
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