ENT
ENT — Vertigo, Ear Infections
ENT

ENT — Vertigo, Ear Infections

Ménière, vestibular neuritis, BPPV, AOM, otitis externa.

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◆Vertigo differential

  • •Ménière disease: episodic vertigo (20 min–24 h) + SNHL + tinnitus + aural fullness; endolymphatic hydrops; ↓ salt + meclizine acute
  • •Vestibular neuritis: continuous vertigo days + post-URI + NO hearing loss
  • •Labyrinthitis: vertigo + hearing loss
  • •BPPV: <1 min triggered by head movement → Dix-Hallpike to dx, Epley to treat
  • •Acoustic neuroma: progressive unilateral SNHL + imbalance
  • •Cerebellar stroke: vertigo + focal neuro + risk factors

◆Otitis media (AOM)

  • •Bulging TM + ear pain + fever
  • •Pathogens: S. pneumoniae, H. flu, M. catarrhalis
  • •Sudden otorrhea + pain relief = TM rupture
  • •Treat: high-dose amoxicillin (Augmentin if failure or recent abx)

◆Otitis externa

  • •Swimmer + pain with pinna movement + swollen canal
  • •Pseudomonas
  • •Topical fluoroquinolone drops

◆Malignant otitis externa

  • •Elderly diabetic + severe ear pain + granulation tissue + CN VII palsy
  • •Pseudomonas → skull base osteomyelitis
  • •CT/MRI for extent; IV antipseudomonal × 6 weeks
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