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The inner ear assumes dual functionalities of auditory perception and equilibrium maintenance. The vestibule is the organ responsible for balance. This organ contains mechanoreceptors, specifically hair cells, endowed with stereocilia, which aid in deciphering information regarding the position and motion of our heads. Two intrinsic components, the utricle and saccule, help perceive head position, while the semicircular canals track head movement. Neurological messages initiated in the...
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The auditory system is essential for sound perception, utilizing various critical structures. When sound waves enter the outer ear, they travel through the ear canal and cause the eardrum to vibrate. These vibrations are then transmitted to the middle ear, where three tiny bones – the malleus, incus, and stapes – amplify the sound. This amplification is crucial, as it ensures that the sound vibrations are strong enough to be conveyed to the inner ear. These vibrations then reach the...
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Auditory sensation, commonly called hearing, involves the transformation of sonic waves into neural impulses facilitated by the structures of the auditory organ. The prominent, flesh-like structure on the side of the head, called the auricle, directs sound waves towards the auditory canal. The auricle is often mislabeled as the pinna, a term more aligned with mobile structures like a feline's external ear. The auditory canal penetrates the cranium via the external auditory meatus of the...
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Cryosectioning and Immunostaining Mouse Inner Ear Tissue: From Embryonic to Adult Stages
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Vertigo and hearing loss.

David E Newman-Toker1, Charles C Della Santina2, Ari M Blitz3

  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Otolaryngology, Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Handbook of Clinical Neurology
|July 20, 2016
PubMed
Summary
This summary is machine-generated.

For inner ear symptoms like dizziness and vertigo, imaging is often unnecessary. When neuroimaging is needed, magnetic resonance imaging (MRI) is preferred over computed tomography (CT) for suspected strokes.

Keywords:
dizzinesshearing lossneuroimagingstrokevertigovestibular diseases

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Area of Science:

  • Neurology
  • Otolaryngology
  • Radiology

Background:

  • Disorders of the inner ear and vestibulocochlear nerve (eighth cranial nerve) present with symptoms such as dizziness, vertigo, tinnitus, and hearing loss.
  • Central nervous system involvement, particularly the brainstem and cerebellum, can mimic audiovestibular disorders.
  • Appropriate imaging selection is crucial for accurate diagnosis and patient management.

Purpose of the Study:

  • To outline recommended strategies for audiovestibular imaging based on patient symptoms and clinical context.
  • To address the overuse of neuroimaging, particularly computed tomography (CT), in evaluating acute dizziness and vertigo.
  • To emphasize the superiority of magnetic resonance imaging (MRI) over CT for suspected ischemic strokes in acute vestibular presentations.

Main Methods:

  • Review of clinical presentations of audiovestibular disorders.
  • Guidelines for selecting imaging modalities (CT, MRI, angiography, venography) based on suspected pathology (bony vs. soft tissue vs. vascular).
  • Analysis of current neuroimaging practices in emergency departments for acute dizziness and vertigo.

Main Results:

  • Computed tomography (CT) is best suited for evaluating bony structures.
  • Magnetic resonance imaging (MRI) is the preferred modality for assessing soft-tissue abnormalities and is superior to CT for detecting ischemic strokes.
  • Vascular imaging (angiography, venography) is indicated for suspected vascular lesions.
  • No imaging is recommended for typical presentations of common peripheral audiovestibular disorders.

Conclusions:

  • Neuroimaging is frequently overutilized, especially CT for acute dizziness and vertigo.
  • MRI with diffusion-weighted imaging should be the primary choice when ischemic stroke is suspected in acute vestibular presentations.
  • Tailoring imaging choices to specific symptoms and clinical context is essential for effective audiovestibular disorder diagnosis.