Dr. Simon H. W. Wong Specialist in Otorhinolaryngology



Yüklə 461 b.
tarix25.03.2017
ölçüsü461 b.



Tinnitus



Management Objective

  • Find cause

  • Treat cause

  • Treat symptom



Causes

  • Outer, Middle or Inner?

  • Central: Structural or Functional

  • Systemic: Renal, anaemia



History

  • Age

  • Duration

  • Frequency

  • Positional

  • Nasal symptoms

  • Hearing loss

  • Vertigo



Examination



Microscopic Exam

  • Ear toilet

  • Wax hook, suction, forceps

  • Culture

  • Grommet insertion



Ear Wax Impaction



Otitis Externa



Fungal Otitis Externa



Fungal Otitis Externa

  • Repeated ear toilet

  • Clotrimazole ear drop

  • Oral Nystatin



Foreign Body



Otitis Media with Effusion



Adhesive OM

  • Eustachian tube dysfunction

  • Antihistamines

  • Steroid nasal spray



Chronic Suppurative Otitis Media

  • Suction clearance

  • Topical antibiotics

  • Antihistamines

  • Tympanoplasty



Cholesteatoma

  • Keratinized epithelium in middle ear

  • Topical antibiotics

  • CT scan

  • Mastoidectomy



Nasal Endoscopy



Nasopharyngeal Carcinoma

  • Biopsy

  • Tinnitus

  • Hearing loss

  • Epistaxis

  • Cervical LN



Impedance Tympanometry



Impedance Tympanometry



Pure Tone Audiometry



Pure Tone Audiometry

  • Down sloping SNHL

  • 4 kHz dip

  • Conductive HL

  • Low frequency SNHL: Meniere’s

  • Asymmetrical SHNL



Acoustic Neuroma



Medical Management

  • Vasodilator: Betahistine, Ca2+ antagonist

  • Cerebral activator: Nicergoline (Sermion)

  • Almitrine : increase PaO2

  • Gingko



Medical Management

  • ? Vitamin B12

  • Sedatives

  • Maskers

  • Hearing aid



Medical Management



Conclusion

  • Tinnitus treatable

  • Underlying cause

  • Treat symptom




Verilənlər bazası müəlliflik hüququ ilə müdafiə olunur ©azkurs.org 2016
rəhbərliyinə müraciət

    Ana səhifə