Which cranial nerve would be damaged in a patient who has a hearing impairment
Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:1260-1261. Show Larson DE, ed. Mayo Clinic Family Health Book. New York, NY: William Morrow and Company, Inc; 1996:584. JOURNAL ARTICLES Carlson ML, Martson AP, Glasgow AE, et al. Racial Differences in Vestibular Schwannoma. Laryngoscope. 2016 Feb 24. doi: 10.1002/lary.25892. [Epub ahead of print] Boahene K. Facial Reanimation After Acoustic Neuroma Resection: Options and Timing of Intervention. Facial Plast Surg. 2015:103-9. Dilwali S, Kao S, Fujita T, Landeggar LD, Stankovic KM. Nonsteroidal anti-inflammatory medications are cytostatic against human vestibular schwannomas. Translational Research 2015;166:1. Kandathil CK, Dilwali S, Wu CC, Ibrahimov M, McKenna MJ, Lee H, Stankovic KM. Aspirin Intake Correlates With Halted Growth of Sporadic Vestibular Schwannoma In Vivo. Otol Neurotol 2014;35: 353-357. Fong B, Barkhoudarian G, Pezeshkian P, Parsa AT, Gopen Q, Yang I. The molecular biology and novel treatments of vestibular schwannomas. J Neurosurg 2011;115:906–914. Hong B, Krusche CA, Schwabe K, et al. Cyclooxygenase-2 supports tumor proliferation in vestibular schwannomas. Neurosurgery 2011;68:1112–7. Agrawal Y, Clark HJ, Limb CJ, Niparko JK, Francis HW. Predictors of vestibular schwannoma growth and clinical implications. Otol Neurotol. 2010;31(5):807-812. Tan M, Myrie OA, Lin FR, et al. Trends in the management of vestibular schwannomas at Johns Hopkins 1997-2007. Laryngoscope. 2010;120:144-149. Newton JR, Shakeel M, Flatman S, Beattie C, Ram B. Magnetic resonance imaging screening in acoustic neuroma. Am J Otolaryngol. 2010 Jul-Aug;31(4):217-20. doi: 10.1016/j.amjoto.2009.02.005. Epub 2009 Jun 24 Roehm PC, Gantz BJ. Management of acoustic neuromas in patients 65 years or older. Otol Neurotol. 2007;28:708-14. Regis J, Roche PH, Delsanti C, et al., Modern management of vestibular schwannomas. Prog Neurol Surg. 2007;20:129-41. Edwards CG, Schwartzbaum JA, Lonn S, Ahlbom A, Feychting M. Exposure to loud noise and risk of acoustic neuroma. Am J Epidemiol. 2006;163:327-333. Lin D, Hegarty JL, Fischbein NJ, Jackler RK. The prevalence of “incidental” acoustic neuromas. Arch Otolaryngol Head Neck Surg. 2005;131:241-44. Bush DA, McAllister CJ, Loredo LN, et al. Fractionated proton beam radiotherapy for acoustic neuroma. Neurosurgery. 2002:50:270-75. Magnan J, Barbieri M, Mora R, et al. Retrosigmoid approach for small and medium-sized acoustic neuromas. Otol Neurotol. 2002;23:141-45. Maeta M, Saito R, Nameki H. False-positive magnetic resonance image in the diagnosis of small acoustic neuroma. J Laryngol Otol. 2001;115:842-44. Petit JH, Hudes RS, Chen TT, et al. Reduced-dose radiosurgery for vestibular schwannomas. Neurosurgery. 2001;49:1299-306, discussion 1306-07. Pothula VB, Lesser T, Mallucci C, et al. Vestibular schwannomas in children. Otol Neurotol. 2001;22:903-07. Brackman DE, Owens RM, Friedman RA, et al. Prognostic factors for hearing preservation in vestibular schwannoma surgery. Am J Otol. 2000;21:417-24. INTERNET Kutz JW, Jr., Roland PS. Skull Base, Acoustic Neuroma (Vestibular Schwannoma). Medscape. Last Update: Jan 26, 2015. Available at: http://www.emedicine.com/ent/topic239.htm Accessed March 24, 2016. Mayo Clinic for Medical Education and Research. Acoustic Neuroma. Last Update: Dec 24, 2014. Available at: http://www.mayoclinic.com/health/acoustic-neuroma/DS00803 Accessed March 24, 2016. Labyrinthitis is the inflammation of part of the inner ear called the labyrinth. The eighth cranial nerve (vestibulocochlear nerve) may also be inflamed. The inflammation of these causes a feeling of spinning (vertigo), hearing loss, and other symptoms. In most people, these symptoms go away over time. It is not a common condition. It often only affects one ear. The inner ear has a system of fluid-filled tubes and sacs called the labyrinth. Inside the inner ear, the cochlea gathers information about sound. The vestibular organs gather information about motion and changes in space. These all help to create a sense of balance. The eighth cranial nerve sends all of this information from the inner ear to the brain. When one of the nerves or the labyrinth is infected, it can become inflamed and irritated. This can cause it to not work normally. It may cause hearing loss in one ear. The brain now has to make sense of the information that doesn’t match between the normal nerve and the infected one. This causes vertigo. What causes labyrinthitis?A viral infection of the eighth cranial nerve or labyrinth may cause the condition. The virus may have spread all over your body. Or it may only affect the eighth cranial nerve and labyrinth. In most cases only one nerve is affected. Viruses known to cause labyrinthitis include:
Bacterial infections of the middle ear are fairly common in children. In rare cases, an infection in the middle part of the ear can spread to the inner ear and cause labyrinthitis. This is more of a risk with middle-ear infections that are long-lasting (chronic) and not treated. In rare cases, bacterial meningitis or a head injury may cause labyrinthitis. In other cases, the cause is not known. Who is at risk for labyrinthitis?Having a viral infection that can cause labyrinthitis increases your risk. Your child’s risk may increase if they haven’t had the advised vaccines or if they have long-lasting, untreated, middle-ear infections. What are the symptoms of labyrinthitis?Symptoms of labyrinthitis may include:
Your symptoms might range from mild to severe. They may come on very quickly. In many people, these symptoms go away over several weeks. Others have symptoms that last longer. A related syndrome is called vestibular neuritis. It causes similar symptoms. But it doesn't cause hearing problems. It affects only the vestibular part of the labyrinth and nerve. Labyrinthitis doesn't cause neurological symptoms such as severe headache, speech problems, or loss of arm or leg movement. How is labyrinthitis diagnosed?Your healthcare provider will ask about your health history. You may also have a physical exam. This may include hearing and balance tests. It will also include an exam of your nervous system. Many neurological and other health conditions can cause dizziness and vertigo. Your provider may need to rule these out. There are no tests for labyrinthitis. But your provider may have you take an imaging test. This can help to rule out other causes of your symptoms, such as stroke. You may have tests such as:
How is labyrinthitis treated?Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is. Immediate treatment for labyrinthitis might include:
If your symptoms go away in a few weeks, you likely won’t need other treatment. If you have symptoms that don’t go away, you may need to do certain exercises. These are known as vestibular rehabilitation exercises. They are a form of physical therapy. These exercises may help your brain learn to adjust to the vestibular imbalance. What are possible complications of labyrinthitis?In most cases, labyrinthitis doesn't cause any problems. In rare cases, labyrinthitis causes lasting (permanent) damage to the eighth cranial nerve. This can cause lasting problems with balance, and part or total hearing loss. You might need to use a hearing aid. Get treatment right away to help reduce your risk for these complications. When should I call my healthcare provider?Call your healthcare provider if your symptoms get worse or don’t begin to go away after a few days of treatment. Also call your provider right away if you have new symptoms, such as trouble moving an arm or a leg. Key points about labyrinthitis
Next stepsTips to help you get the most from a visit to your healthcare provider:
Medical Reviewer: Ashutosh Kacker MD Medical Reviewer: Marianne Fraser MSN RN Medical Reviewer: Daphne Pierce-Smith RN MSN © 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. |