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Labyrinthitis

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Labyrinthitis

  1. 1. Labyrinthitis Dr. Rajal Sukhiyaji (M.PT. in Sports Science)
  2. 2. Labyrinth (Inner Ear) :- Definition :-  It is the inner most part of the ear.  Lying within the petrous part of the temporal bone. Parts :- 1. Bony labyrinth 2. Membranous labyrinth
  3. 3. 1) Bony labyrinth :- • Consists of series of bony cavities connected with one another. • It is filled with a fluid called “ Perilymph “. • It consists of the following : 1. Semicircular canals 2. Vestibule 3. Cochlea
  4. 4. 2) Membranous labyrinth :- • It lies in the perilymph of the bony part. • It consists of sacs and tubes connected with each other and contains a fluid called “ Endolymph “. • It consists of the following : 1. Semicircular ducts 2. Utricle and Saccule 3. Cochlear duct
  5. 5. • ..Structure of the Inner Ear.mp4 • ..Model- Inner Ear and the Bony Labyrinth.mp4
  6. 6. Labyrinthitis :- • The infection may affected the labyrinth in 3 stages. 1. Fistula formation (Para labyrinthitis) :- o Without active clinical features. o At this stage the infection does not reach the membranous labyrinth. 2. Serous labyrinthitis (Reversible condition) 3. Purulent labyrinthitis :- o With permanent deafness and loss of vestibular function.
  7. 7. Causes :- • Infections • Secondary to acute otitis media, dangerous chronic otitis media. • TB • Syphilitic otitis media • Secondary to meningitis • Viral ( due to mumps, measles, herpes zoster ) • Vascular causes ( thrombosis, embolism ) • Acoustic neuroma of internal auditory meatus • Ototoxic drugs (like streptomysin) • Meniere’s syndrome/disease (vertigo, deafness, tinnitus)
  8. 8. Clinical features :- • Sensory – neural deafness • Tinnitus • Giddiness • Vomiting • Nystagmus • Loss of balance • Hearing is not markedly affected in serous labyrinthitis. • Fistula test positive • Purulent labyrinthitis (dead ear) leads to permanent total sensory neural deafness. While the giddiness usually settles down in 3 to 4 weeks, as the labyrinth of the other side takes over its function.
  9. 9. Treatment :- • Mastoidectomy ( For first 2 stages ) • Labyrinthectomy ( For 3rd stage to drain pus ) • Antibiotics in full dose
  10. 10. • ..How labyrinthitis develops.mp4
  11. 11. Mastoidectomy • Surgical removal of some or all of the mastoid process. • Classification :- 1. Simple mastoidectomy 2. Radical mastoidectomy 3. Modified radical mastoidectomy
  12. 12. 1) Simple mastoidectomy ( Conservative or Schwartze mastoidectomy ) :- • This operation aims at draining the mastoid air cells by postaural approach. • It does not disturb the structure of the middle ear, hence the hearing is unaffected. Indication :- 1. Acute coalescent mastoiditis 2. Complications of mastoiditis 3. Tympanoplasty as a part of surgery 4. Decompression of the facial nerve 5. Decompression of the endolymphatic sac 6. Excision of an acoustic neuroma
  13. 13. • Complication :- Immediate :- 1. Haemorrhage : primary 2. Injury to surrounding structures  Sigmoid sinus  Tegmen plate  Facial nerve  Labyrinth  Incus : dislocation
  14. 14. Late :- 1. Haemorrhage : secondary 2. Infection 3. Mastoid fistula 4. Persistence of otorrhoea 5. Stenosis of external auditory canal Delayed :- 1. Thrombophlebitis 2. Meningitis 3. Facial nerve paralysis 4. Labyrinthitis :giddiness, sensorineural deafness 5. Conductive deafness
  15. 15. 2)Radical mastoidectomy :- • It is an operation in which the mastoid, middle ear and the external auditory canal are converted into a single cavity by lowering the wall between the mastoid and the external ear, and removal of the remnants of the ear drum, malleus and incus. • The stapes is not removed as the labyrinth gets exposed and may be damaged. • Conductive deafness may be a sequelae of this operation.
  16. 16. Indication :- 1. Cholesteatoma 2. Chronic osteitis of the mastoid 3. Chronic osteomyelitis of the mastoid 4. Tumors of the middle ear :benign 5. Labyrinthectomy Complication :- • Same as above , except conductive deafness is a sure sequelae. • Reoccurrence of the condition
  17. 17. 3)Modified Radical Mastoidectomy :- • Which is similar to radical mastoidectomy, with the following differences. 1) The following structures are not removed. a) Tympanic membrane b) Lower portion of malleus and incus. 2) There is no disease in the middle ear, and hence there is no need for removal of any structures from there.
  18. 18. Indication :- 1. Cholesteatoma 2. As an adjunt to fenestration operation for otosclerosis. Complication :- • No deafness
  19. 19. • ..Start of mastoidectomy.mp4 • ..mastoidectomy.mp4 • ..modified radical mastoidectomy3gp.mp4 • ..Ear Surgery for Chronic Ear Infection-About Mastoid and Tympanoplasty-DrKOPaulose FRCS.mp4
  20. 20. Thank You

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