otolithiasis

Introduction

Introduction to Otolith "Otolith" is also called "benign paroxysmal positional vertigo". Under normal circumstances, otolith is attached to the otolith. When some pathogenic factors cause the otolith to detach, these fallen otoliths will The inner ear is called a liquid in the endolymph. When the head position changes, the semicircular canal changes its position. The accented otolith moves with the flow of the liquid, thereby stimulating the semicircular hair cells. Causes the body to be dizzy, the time of dizziness is generally shorter, often less than one minute, which is only a few points above the majority of tube stones, the stun time of the few dome stones is often above the number. The appearance of this symptom is often related to changes in position, so it is now bursting, which is "benign paroxysmal positional vertigo." More common in middle-aged patients (45-50 years old). basic knowledge The proportion of illness: 0.001% Susceptible population: more common in middle-aged patients Mode of infection: non-infectious Complications: Hypertension Otitis media

Cause

Otolith disease etiology

1. Hereditary factors Patients with otosclerosis have more common diseases in the offspring of the ancestors. About 54% have a family history. Some people think that it is autosomal dominant or recessive, and more than half of the cases can find abnormal genes.

2, endocrine disorders factors This disease is more common in the youth development period, with a high incidence of women, and pregnancy, childbirth and menopause can make the disease progress faster, is considered to be related to hormone levels.

3, the development of bone labyrinth cysts Human bone marrow labyrinth has been developed at birth, only in the endogenous cartilage layer of the vestibular anterior edge of the endogenous cartilage layer has a defect in the development and ossification process, called the window anterior fissure. There are fibrous connective tissue bundles and cartilage tissues in the fissures, which can continue to exist or ossify in adulthood to produce otosclerotic lesions. The ear and sclerosis lesions seen in clinical and tibial pathology are also started here.

4, their own immune factors and other Arslan and Rieci by histochemical staining for the study of otosclerotic lesions, found that in active lesions, there are mucopolysaccharide polymerization changes and tissue fibers, collagen fibers reduced, fracture phenomenon, and rheumatoid Pathological changes such as arthritis are similar, and Chevence has again confirmed by electron microscopy and cytochemistry that the ear sclerosis lesion is a collagen disease or an interstitial disease. In addition, some people have found that the metabolic disorder of the enzyme is the cause of the fixation of the tibia.

Prevention

Otolith prevention

Ottomanopathy itself does not prevent vertigo attacks. However, some elderly patients with cerebrovascular disease may need to be treated with infusion. Some patients with anxiety, depression, insomnia or autonomic dysfunction need to be treated with appropriate drugs to prevent the recurrence of otolith.

Complication

Otolith complications Complications, hypertension, otitis media

1, senile degenerative changes: occurred in the senile degenerative changes, the otolith film fell off and entered the semicircular canal and deposited there. 2, trauma: after head trauma or head acceleration, the otolith can fall into the semicircular canal. 3, ear diseases: middle ear mastoid infections such as viral labyrinthitis, chronic suppurative otitis media, peripheral lymphatic fistula, Meniere's disease remission period, etc., can cause otolith shedding. 4, insufficient blood supply to the inner ear: due to arteriosclerosis, high blood pressure caused by insufficient blood supply to the inner ear, the glial membrane of the capsular is thin, the otolith falls off and enters the semicircular canal.

Symptom

Otolith symptoms common symptoms dizziness dizziness eyeball tremor

1, sudden onset

The occurrence of symptoms is often associated with certain head or body activities. Dizziness occurs when the head is triggered (the ear is down), the nystagmus occurs within 3-10 s after the head position changes, and the vertigo often lasts within 60 s, which may be accompanied by nausea and vomiting.

2, nystagmus is very special

When the seat training changes to the head position, a rotatory short-term fatigue eye movement occurs. When the ear is down, the eye movement is clockwise, and when the right ear is downward, it is counterclockwise. First, it gradually increased, and then gradually weakened. When returning from the lying position to the sitting position, a short-term low-speed nystagmus in the opposite direction appeared.

3, the course of disease

It can be several hours to several weeks, and individual can reach several months or years. The vertigo can be periodically aggravated or relieved, and the vertigo becomes a big change. In severe cases, the vertigo occurs when the head is slightly active, and there is no discomfort during the intermittent period, or After dizziness and dizziness, there may be a top-heavy and floating feeling during the game.

Examine

Otolith examination

The diagnosis of otolith is based solely on typical clinical findings and positive results from the Dix-Hallpike test. Dix-Hallpike test: The patient sits on the examination table and quickly takes the supine position with the help of the examiner and is 45 degrees to one side. PC-BPPV, when the head turns to the affected side, appears a brief dizziness after a few seconds of incubation. Vertical rotatory nystagmus, fatigue test by repeated tests. Of course, the most typical clinical manifestations above are also described by some authors: a transient (lasting seconds to minutes) sudden vertigo and nystagmus induced by a certain head position, with a duration of hours or days. There are several seconds of incubation from the head position to the location of vertigo and nystagmus. May be accompanied by nausea and vomiting, but generally no hearing impairment and tinnitus. No central nervous system symptoms and signs. There is no discomfort during the remission period.

Diagnosis

Otoscope diagnosis and identification

The age of onset of cervical vertigo is more than 40 years old. Repeated episodes are related to neck movement. Dizziness may be accompanied by tinnitus, earache, headache, visual symptoms, symptoms and signs of cervical nerve root compression, and a small number of patients develop disturbance of consciousness. . Vestibular function, cervical X-ray, TCD examination can be found in cervical vertebrae or vertebrobasilar insufficiency.

Vascular vertigo occurs mostly in the elderly due to insufficient blood supply to the vestibular system. Dizziness can be accompanied by tinnitus, deafness, visual symptoms, paralysis of the limbs, and difficulty in articulation. CT, MRI, TCD examination can find abnormalities such as insufficient blood supply to the brain. The treatment of BPPV includes drug therapy, rehabilitation training, reduction techniques and surgical treatment. Many scholars recommend a reset technique.

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