1. Inner Ear Disorders

2. Cochlear or Sensory hearing loss • Sensorineural hearing loss - cochlea • Neural or retrocochlear hearing loss • Auditory nerve lesion • Central hearing loss • Lesion of the central auditory pathway

3. Symptoms of Inner Ear Disorder • Hearing impairement • Hearing loss or hypoacusis • Distortion of hearing or dysacusis • Tinnitus • Vestibular symptoms • Dysequilibrium • Vertigo

4. Diagnostic Evaluation • History • Noise exposure, cranial trauma, family history, history of chronic otitis media, use of ototoxic medications • Clinical Examination • Inspection, otoscopy, Weber’s test, Rinne’s test, whispered speech test • Audiometry • Imaging Studies • CT scan, MRI

5. Diagnostic Evaluation • Audiometry • Imaging Studies

6. Cochlear Hearing Loss with a Known Cause • Hereditary Sensorineural Hearing Loss • Noise-Induced Hearing Loss • Traumatic Injury to the Inner Ear • Labyrinthitis • Ototoxicity • Other Acquired Inner Ear Disorders • Immunologic Causes, Decreased Blood Flow, Metabolic Disorders, Cochlear Otosclerosis

7. Hereditary Sensorineural Hearing Loss • Syndromic • Present at birth • Autosomal recessive • Non-syndromic • Congenital form or Later-onset form • Autosomal dominant • Symmetrical • Treatment • Prevention of further acquired damage • Rehabilitation with hearing aids and other assistive devices

8. Noise-Induced Hearing Loss • Acute acoustic trauma • Blast injury • Acute noise-induced hearing loss • Chronic noise-induced hearing loss

9. Noise-Induced Hearing Loss • Symptoms • Muffled sensation and tinnitus • Irreversible, chronic noise-induced hearing loss = sensorineural hearing loss • Loss of speech discrimination and tinnitus • Prophylaxis • Reduction of voice emissions • Hearing protection and control of noise levels • Regular screening

10. Traumatic Injury to the Inner Ear(Labyrinthine concussion and contusion; Labyrinthine trauma) • Temporal bone fracture • Barotrauma • Symptoms • Non-specific vertiginous complaints and hearing impairement that are usually obscured by symptoms of craniocerbral trauma or other injuries • Treatment • Protection from additional harmful influences

11. Labyrinthitis • Tympanogenic • Meningeal • Hematogenous • Symptoms • Cochlear hearing loss • Tinnitus • Vestibular symptoms (vertigo, dysequilibrium, nystagmus) • Treatment • Decompression with myringotomy tube • Mastoidectomy

12. Ototoxicity • Symptoms • Cochlear damage accompanied by tinnitus • Symmetrical hearing loss • Vestibular symptoms (oscillopsia, dysequilibrium) • Ototoxic substances • Drugs: Aminoglycosides, Cisplatin, Loop diuretics, Quinine, Salicylates • Industrial toxins: Aminobenzenes, Lead, Mercury, Arsenic, Alcohol, Heroin, Tobacco, Cocaine

13. Ototoxicity • Prophylaxis • Patient’s cochlear function should first be tested if at all possible • Special attention to dosage, renal function, adequate hydration