American Medical Association Family Medical Guide - American Medical Association [712]
If a person has vertigo that is seriously disabling, a doctor may recommend a procedure to cut the vestibular nerve (which is crucial for balance). For severe cases of hearing loss, a doctor may recommend a procedure called labyrinthectomy, in which the vestibular labyrinth (the part of the inner ear involved with balance and hearing) is destroyed.
Labyrinthitis
Labyrinthitis is inflammation of the fluid-filled chambers that control balance and hearing. The exact cause of labyrinthitis is not known, but it usually follows a viral or bacterial infection in the ear or upper respiratory tract.
Symptoms
The main symptom of labyrinthitis is a false sense that you or your surroundings are moving (vertigo; see page 1012). If you move your head even slightly, the vertigo gets worse. In most cases, the vertigo is accompanied by severe nausea and vomiting. Labyrinthitis may also cause ringing or other noises in the ear (tinnitus; see page 1020) or hearing loss (see page 1016). If you have severe vertigo, have someone take you to your doctor’s office or the nearest hospital emergency department immediately.
Diagnosis and Treatment
To diagnose labyrinthitis, a doctor will take a detailed health history and examine your ears. You may also have hearing tests and a CT scan (see page 112) or an MRI (see page 113) to rule out other possible causes of vertigo.
If the vertigo is associated with labyrinthitis, your doctor may recommend that you try to stay still and avoid sudden changes of position during episodes. He or she may prescribe medications such as meclizine or diazepam to relieve the nausea and vomiting. To treat labyrinthitis caused by bacteria, a doctor prescribes antibiotics. For labyrinthitis caused by a virus, a doctor may prescribe medication to relieve the symptoms.
Otosclerosis
Otosclerosis is an abnormal growth of bone in the inner ear that prevents the stirrup (one of the tiny bones in the inner ear) from transmitting sound waves to the inner ear, resulting in conductive hearing loss (see page 1016) in the affected ear. In most cases, both ears are affected, either simultaneously or one after the other. As the disease progresses, some sensorineural hearing loss (see page 1016) may occur.
The cause of otosclerosis is not fully understood, but it tends to run in families. The disorder occurs more often in middle-aged women than in men, and in whites more frequently than in blacks. Hormonal changes during pregnancy can accelerate the hearing loss in some women. Without treatment, otosclerosis can result in significant conductive hearing loss, requiring a person to wear a hearing aid to hear normal conversation.
Symptoms
The main symptom of otosclerosis is gradual hearing loss. In rare cases, primarily in children, the hearing loss progresses quickly. Some people may also experience a false sense that they or their surroundings are moving (vertigo; see page 1012) or hear ringing or other noises in their ears (tinnitus; see page 1020).
Otosclerosis
In otosclerosis, an abnormal growth of bone in the ear prevents the stirrup from properly transmitting sounds to the inner ear, causing hearing loss in that ear.
Noise and Hearing Loss
Sound is a series of air-pressure waves traveling through the atmosphere alternating between high pressure and low pressure. The loudness of sound is measured in units called decibels by an instrument called a decibel meter. Sounds that are softer than 10 decibels are very difficult for the human ear to hear, while sounds that are 120 decibels or more are usually painful to the ear. A sound loud enough