From the Guidelines
Clinical findings on exam for an inner ear infection are often unremarkable, but may include spontaneous vertigo attacks, fluctuating aural symptoms such as hearing loss, tinnitus, or ear fullness, and low- to midfrequency sensorineural hearing loss on audiometric testing. When examining a patient with an inner ear infection, the physical examination findings are typically normal, and conventional imaging is usually not necessary 1. Some key points to consider when evaluating a patient with an inner ear infection include:
- Spontaneous vertigo attacks lasting 20 minutes to 12 hours
- Fluctuating aural symptoms such as hearing loss, tinnitus, or ear fullness in the affected ear
- Low- to midfrequency sensorineural hearing loss on audiometric testing
- Normal physical examination findings and conventional imaging The goals of treatment for inner ear infections, such as Ménière's disease, are to prevent or reduce vertigo severity and frequency, relieve or prevent hearing loss, tinnitus, and aural fullness, and improve quality of life 1. It is essential to note that the underlying etiology of inner ear infections is not completely clear, but it has been associated with inner ear fluid volume increases, culminating in episodic ear symptoms 1. In clinical practice, treatment approaches to inner ear infections are varied and typically include modifications of lifestyle factors, medical, surgical, or a combination of therapies 1.
From the Research
Clinical Findings for Inner Ear Infection
The clinical findings for an inner ear infection can be identified through a targeted physical examination and various diagnostic tests.
- The initial work-up of hearing loss is made by audiometry, and vertigo by electronystagmography (ENG) 2.
- Supplemental tests and MRI are obtained when clinically indicated 2.
- The clinical pattern and duration of vertigo are the most important clinical features in the diagnosis of inner ear disorders 2.
- Common inner ear causes of vertigo include: vestibular neuritis (sudden, unilateral vestibular loss), Meniere's disease (episodic vertigo), benign paroxysmal positional vertigo (BPPV), and bilateral vestibular loss 2.
- Inner ear infections can also cause symptoms such as tinnitus, hearing loss, and imbalance 2, 3.
- Migraine-related vasospasm can damage the inner ear, resulting in symptoms such as sudden sensorineural hearing loss and resultant tinnitus 3.