Meniere's Disease
ѿ What Is Meniere's Disease
.
Meniere. .
Causes
vestibular labyrinth. ( ) Hair cells . .
. endolymph. .
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Symptoms
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Diagnosis
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Electronystagmography - ENG.
MRI.
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ѡ 20 .
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Treatment
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Medications:
: Meclizine.
: prochlorperazine.
: alprazolam.
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Dietary instructions:
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Middle ear injections:
( ) . . . .
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Surgery:
:
Endolymphatic sac procedures: . .
Vestibular neurectomy: . ( ) ǡ .
Labyrinthectomy: .
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( ) .. .
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Paranasal sinuses: .
Maxillary sinuses
Ethmoid sinuses
Frontal sinuses: .
Sphenoid sinuses: .
Ciliary dyskinesia . : F. B Polyp Adenoid hypertrophy Tumor Trauma Septal deviation
.
Pneumococcus
H. influenza
Streptococcus
Staphylococcus
Clinical manifestation
( .. ) ( ) .
: .
: . Sore throat . : Sniff Snort .
: .
.!
.!
: : Bacterial: 39 .
Sub acute Or Chronic .
: Allergic rhinitis (Pale and boggy ). .. Tenderness .
O . M Peri orbital cellulitis Orbital abscess Optic neuritis . Meningitis
: :
Mucosal thickening
Air fluid level
Sinus opacification
:
Pus celles .
> Cellular debris
eosinophils Allergic rhinitis
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.
:
Amoxicillin ( ) 2nd and 3rd generation of cephalosporin
Goad dose
: 14 21 .
deconjestant Anti histamines .!
.
!
( ) .. .
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ɿ
ݡ ɡ . .
ɡ ( ɡ ) VasomotorRhinitis ɡ ߡ .
Antihistamine .
, , ͡ . Antihistamine , ɡ .
Side Effects Antihistamine , . ɡ . , , .
Antihistamine :
Claritin
Disophrol
Terfact
Hismanal
Arieus
Clarinase
Zyrtec
Polaramine Ex...
Decongestants :
, . Air Passages . Decongestants , .
Adrenaline, , ɡ , .
, Glaucoma () Decongestants Decongestants
Phenylephrine Spray(Neosynephrine)
Sudafed Tab
Ofrin Spray Gel
Vibrocil Spray gel
Clarinase Tab
Antihistamine Decongestants.
Antihistamine+ Decongestants
Antihistamine , Decongestants .
(Antihistamine + Decongestants) :
Actifed
Clarinase
Contac
Di****pp
Triaminic ex
. , . Antihistamine Decongestants .
:
Antihistamine Decongestants . .
:
Decongestants ɡ ɡ .
. Vicious Circle , .
ӡ
!
( ) .. .
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:
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acute pharyngitis
tonsillitis
angina Follicularis
angina Lacunaris
Vincent,s angina
lingual tonsilitis
agranulocytosis
lingual abcsess
peritonsillar abscess
parapharyngial abcsess
adenoiditis
Retropharyngial abcsess
laryngitis
larynx trauma
perichondritis
Varicosis
Diphtheria
Candida
herpes zoster
scarlet fever
stylohyoid S
Costen S
dysphagia lusaria
coxsakie virus
- Abt-Letterer-Siwe
(Carotidynia) Hilger Jerome
Ardmor S
herpangina
Kawasaki D.
: otogenic
furunculosis
perichondritis
diffuse external otitis
herpes zoster
acut otitis media
acut eustachian tube obstruction
mastoiditis
Syphilis
Reichert S
bullosa myringitis
impacted cerumen
neoplasm
( , , ... )
keratosis obturans
otomycosis
malignant external otitis
Chronic otitis media
postsurgical otolgia
barotrauma
:
<OL style="LIST-STYLE-TYPE: decimal">
subperiosteal abscess
extradural abscess
subdural abscess
brain abscess
petrozitis
miningitis
lateral sinus thrombophlebitis
otitic hydroencephlus
</OL>
: nonotogenic
:
<OL style="LIST-STYLE-TYPE: decimal">
.
Impaction of molar teeth
temporomandibular jointitis
Costen S
sphenopalatine neuralgia - sluder,s S
trigeminal neuralgia
</OL>
:
<OL style="LIST-STYLE-TYPE: decimal">
..
Elongated styloid process
: , ,
glossopharyngial neuralgia
tympanic neuralgia
</OL>
:
<OL style="LIST-STYLE-TYPE: decimal">
:
..
</OL>
:
<UL>
geniculate neuralgia Hunt ,s neuralgia
</UL>
:
<OL style="LIST-STYLE-TYPE: decimal">
carotidynia
postauricular lymphadenit
psychogenic otalgia
</OL>
cellulitis
Sinusitis
Temporal arteritis
Trigeminal neuralgia
Herpes Zoster
oral cavity ulcer
gingivitis
aphthous
Herpes Febrilis cold sores
(5)
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: ʡ
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C.S.F. hypotension
:
:
( ) Sinusitis
:
keratitis
asthenopia
iridocyclitis
glaucoma
- Epistaxis
:
: Glanzman ALEXANDER ..
( Baader )
.
: Timme S ..
:
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:
<OL style="LIST-STYLE-TYPE: decimal"> malory weiss
gastroesophagitis
ventriclis ulcer
ulcer duodeni
angiodysplasia
.
.
</OL>
:
<OL style="LIST-STYLE-TYPE: decimal"> embolia pulmonalis
bronchiectasis
tuberculosis
pulmonary abscess
pneumonitis
bronchogenic syst
mitral stenosis
aneurysma
:
:
: - .
</OL>
malignant neoplasms
telangioectases
hemangiomas
glossal thyroid
pertussis
Syphilis
varicosis
Osler-Weber-Rendu
syphilis
.
diphtheria
myringitis bullosa
glomus tumor
.
vascular and friabl granuloma
.
pertussis
!
( ) .. .
/
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. . ѡ ء . . , ɡ .
HLA DR4 antigen .
pathognomonic basophilia vacuolated chondrocytes .
- -
44 13-84
:
Costochondritis
Arterial and venous thromboses
DIAGNOSTIC CRITERIA
Mc Adam's Signs
( )
Non-erosive, inflammatory polyarthritis
Ocular inflammation
Respiratory tract chondritis
Cochlear and/or vestibular dysfunction
:
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Chondritis of auricles 90%
Arthropathy 80%
Chondritis of Respiratory Tract 55%
%Nasal Chondritis (Saddle Nose Deformitiy) 50
Ocular Inflammation 50%
Cochlear/VestibularDamage 50%
%Anemia 10
91% . polyarthriti polyarthralgia . scleritis or episcleritis
. Vestibular vasculiti Cogans syndrome .
imuran and cyclosporine
dapsone and pencillamine
cyclophosphamide . azathioprine or methotrexate .
Tracheostomy
Ocular Manifestations
Episcleritis 39%
Scleritis 14%
Iritis 9%
Retinopathy 9%
Muscle Paresis 5%
Optic Neuritis 4%
4% Peripheral Corneal Thinning
75% 90% myelodysplastic malignancies .
:
:
50 :
<UL> Saddle nose
Tracheolaryngeal strictures
Arthritis
Microhematuria .
</UL> :
Cardiovascular complications aneurysm .
!
( ) .. .
/
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Diseases of the external earcyst fistulae : . . .
Hillocks or accessory lobules : .
Pre-auricular sinuses : helix .
atresia of the external auditory meatus : . - .
stenosis : .
: lop ear : :
cup ear :
: helix . .
Auricular hypoplasia :
:
DARWIN'S TUBERCLE : .
condrodermatit nodularis circum******a helicis : hilix .
:
laceration : .
: +
Abrasions : +
: .
forstbite : . .
: .
: . . .
cauliflower ear : .
: .
: .
:
gout: COLCHICINE URATES
: .
:: acromegaly
Xanthomas : foam cells
:
: . . 3 microbial seborric and endogenous eczema
keratosis obturans : . . + .
ACNE VULGARIS : PAPULES 10 . .
: .
Psoriasis : . .
relapsing polychondritis : . . ѡ ء . . . ɡ .
myringitis granular : . .
SLE: .
Solar keratosis : .
cystic:
:
Exostoz: .
osteoma :
adenoma : .
hemoangioma : . 3 .
lymphangioma : .
: lipoma - ( ) fibroma ( ) chondroma ( ) papiloma ( ) mioma .
epitelioma adenoid cystic Brook : .
:
SCC
BCC
:
diffuse otitis externa : . 95 % 70% .
FURUNCLE: hair fallicles tragus ( ) . .
malignant otitis externa : pseudomonas aeruginosa . . . .
perichondritis: . .( )
( ) herpes zoster oticus: ( ) .
otomycosis : ( ) ( ) . 3
wax :
. 3% ( ) . sebaceous ceruminous gland . )
!
( ) .. .
/
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otosclerosis otospongiosis
:
Valsalva 1735 Toynbe . 1881 Von Troltsch 1893 Siebnman & Bezold otosclerosis otospongiosis . .
Kessel 1878 1890 Miot 200 62 Rosen 1892 Blake 1900 Politzer & Sibenmann 1952 Lempert .
1954 Basek & Fowler 1956 Shea
. .
:
( ) . 2000 .
: paracusis Willisy . .
. .
tympanometry As 3 ( 4 10 )
acoustic reflex : on-of
75%
25-30%
:
: ( ) ( Schwartz) periosteal 10% .
( Tillo ) ( - ) ( ) ( Fre****s ) ( ) ( )
:
1800
: MRI .
:
. ( ) ACTH
:
. . . 1944 . . .
endocrinicus . . .
. . .
trophicus atrophia otodystrophia
( ) osteoporsis mesenchyma .
1A1 Anti-antibody type 2 colagen RNA 83% ( ) Fissula Anta Fenestrum .
.
:
endeostal endochonddrial periostial endochonddrial osteoclast Maasse ostaoblast . ( ) ( ) . . periostial endeostal
:
( ) osteoclast osteoblast . . . . ( ) .
:
90% ( ) 30% . .
:
. 8-10% 12% 75-85% 60% 20%. 25% .
:
:
-
- pereost
-
-
osteogenesis imperfecta :
autosomal dominant 40-60% ( ) haematoma
:
Causse 1974 .
. 0,85 ( ) 0,78 MKM
.
:
:
stapedoplasty .
Sodium Fluoride . . :
.
. 50 / 75 / .
conraindications :
saccule
.
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( ) .. .
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:
25
( )
18-20
:
( )
5 -7 6-12 .
. chorda tempany
.
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() . . .
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:
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tragus
:
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1\2 % . cochlear aqueductus helctrema . .
:
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. 20-50% . .
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:
:
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:
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: . Fistula test ( ) Tullio's phenomen ( ) saccule .
:
2-4 % . .
:
10-20 % .
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reperative granuloma :
2% . :
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:
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:
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JUVENAIL OTOSCLEROSIS:
cochlear otosclerosis :
. FOSULA ANTI
FENESTRA 7 :
CT demineralization
:
. . :
ganglionitis
:
. . . :
:
electrocochleography .
:
. :
1,6%
:
: - + - - ( ) - .
smphalangia :
Nanse :
Robinson Faraeg : + : .
: -
- - - - - . - 20
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