Selective low frequency Sensorineural Hearing loss occurs in-
Ans. is 'a' i.e., Meneire's disease Clinical features of Meniere's diseaseo Meniere's diseases usually affects adults (35-60 years) and men are affected more often than women. Disease is usually unilateral. The clinical features are:-1) Episodes of vertigo# Usually accompanied by nausea and vomiting with ataxia and nystagmus. Severe attacks may be accompanied by other symptoms of vagal disturbances such as abdominal cramps, diarrhea, cold sweats, pallor and bradycardia. Some cases of Meniere's disease show Tullio phenomenon, i.e. loud sounds or noise produce vertigo. It is due to the distended saccule lying against stapes footplate.2) Fluctuating hearing loss# Fluctuating nature of hearing loss is quite characteristic. Initially there is loss of low frequency sound, later both low and high frequencies are involved. Distortion of sound occurs in some patients, e.g. a tone of a particular frequency may appear normal in one ear and of higher pitch in the other leading to diplacusis. Intolerance to loud sounds occurs due to recruitment phenomenon.3) Tinnitus (Ringing in the ears)# It is low-pitched roaring type and is aggravated during acute attacks. Sometimes, it has hissing character.4) Feeling of fullness or pressure in the ear# Like other symptoms it also fluctuates.5) Emotional upset, headache, anxiety In early stages of disease most patients are well in between the attack. As the disease progresses patients may have persistent hearing loss, tinnitus and postural imbalance between the attacks of vertigo.
Meneire's disease
BPPV
Glomus tumour
Schwannoma
Hearing Loss