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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 vestibular system is a set of inner ear structures that provide a sense of balance and spatial orientation. This system is comprised of structures within the labyrinth of the inner ear, including the cochlea and two otolith organs—the utricle and saccule. The labyrinth also contains three semicircular canals—superior, posterior, and horizontal—that are oriented on different planes.
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Sensory impulses related to touch, pressure, vibration, and proprioception from various body parts, such as the limbs, trunk, neck, and posterior head, travel to the cerebral cortex through the posterior column-medial lemniscus pathway. The pathway’s name derives from the two white-matter tracts that convey the impulses: the spinal cord's posterior column and the brainstem's medial lemniscus. First-order sensory neurons extend their axons into the spinal cord, forming 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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A Case of Vertigo with TORP in Inner Ear.

Ramraj Yadav1, Rajesh Kumar1, Sunil Kumar1

  • 1Department of Otorhinolaryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, U.P. India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
|May 19, 2023
PubMed
Summary

A displaced total ossicular replacement prosthesis (TORP) after ear surgery caused persistent vertigo, hearing loss, and ear pain. Removing the dislodged TORP from the inner ear resolved the patient's debilitating symptoms.

Keywords:
Continuous vertigoInner earOssiculoplastyStapedotomyTORP

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Medical device complications

Background:

  • A patient presented with a two-year history of continuous vertigo, aggravated by loud noise, hearing loss, aural fullness, and otalgia.
  • The patient had a prior history of tympanoplasty with ossiculoplasty utilizing a total ossicular replacement prosthesis (TORP).

Purpose of the Study:

  • To investigate the cause of persistent vertigo and associated symptoms in a patient with a history of ear surgery and TORP implantation.
  • To evaluate the impact of a displaced prosthesis on inner ear function and patient symptoms.

Main Methods:

  • Clinical examination and patient history review.
  • Surgical exploration under local anesthesia to identify the cause of symptoms.
  • Removal of the displaced prosthesis.

Main Results:

  • Exploration revealed a displaced TORP lodged within the inner ear.
  • Following the removal of the dislodged prosthesis, the patient experienced a significant and rapid resolution of vertigo, hearing loss, and otalgia.

Conclusions:

  • Displacement of a TORP into the inner ear can cause significant vestibular and auditory symptoms.
  • Surgical exploration and removal of a displaced TORP can effectively alleviate symptoms, restoring patient quality of life.