A migraine can cause severe throbbing pain or a pulsing sensation, usually on just one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

Migraine attacks can cause significant pain for hours to days and can be so severe that the pain is disabling.

Warning symptoms known as aura may occur before or with the headache. These can include flashes of light, blind spots, or tingling on one side of the face or in your arm or leg.

Medications can help prevent some migraines and make them less painful. Talk to your doctor about different migraine treatment options if you can’t find relief. The right medicines, combined with self-help remedies and lifestyle changes, may help.

Symptoms

Migraines often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages: prodrome, aura, headache and post-drome, though you may not experience all stages.

Prodrome

One or two days before a migraine, you may notice subtle changes that warn of an upcoming migraine, including:

• Constipation
• Mood changes, from depression to euphoria
• Food cravings
• Neck stiffness
• Increased thirst and urination
• Frequent yawning

Aura

Aura may occur before or during migraines. Most people experience migraines without aura.

Auras are symptoms of the nervous system. They are usually visual disturbances, such as flashes of light or wavy, zigzag vision.

Sometimes auras can also be touching sensations (sensory), movement (motor) or speech (verbal) disturbances. Your muscles may get weak, or you may feel as though someone is touching you.

Each of these symptoms usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes. Examples of migraine aura include:

• Visual phenomena, such as seeing various shapes, bright spots or flashes of light
• Vision loss
• Pins and needles sensations in an arm or leg
• Weakness or numbness in the face or one side of the body
• Difficulty speaking
• Hearing noises or music
• Uncontrollable jerking or other movements

Sometimes, a migraine with aura may be associated with limb weakness (hemiplegic migraine).

Attack

A migraine usually lasts from four to 72 hours if untreated. The frequency with which headaches occur varies from person to person. Migraines may be rare, or strike several times a month. During a migraine, you may experience:

• Pain on one side or both sides of your head
• Pain that feels throbbing or pulsing
• Sensitivity to light, sounds, and sometimes smells and touch
• Nausea and vomiting
• Blurred vision
• Lightheadedness, sometimes followed by fainting

Post-drome

The final phase, known as post-drome, occurs after a migraine attack. You may feel drained and washed out, while some people feel elated. For about 24 hours, you may also experience:

• Confusion
• Moodiness
• Dizziness
• Weakness
• Sensitivity to light and sound

Causes

Though migraine causes aren’t understood, genetics and environmental factors appear to play a role.

Migraines may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway.

Imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system — also may be involved. Researchers are still studying the role of serotonin in migraines.

Serotonin levels drop during migraine attacks. This may cause your trigeminal nerve to release substances called neuropeptides, which travel to your brain’s outer covering (meninges). The result is migraine pain. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Migraine triggers

A number of factors may trigger migraines, including:

• Hormonal changes in women. Fluctuations in estrogen seem to trigger headaches in many women. Women with a history of migraines often report headaches immediately before or during their periods, when they have a major drop in estrogen.Others have an increased tendency to develop migraines during pregnancy or menopause.Hormonal medications, such as oral contraceptives and hormone replacement therapy, also may worsen migraines. Some women, however, find their migraines occur less often when taking these medications.
• Foods. Aged cheeses, salty foods and processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks.
• Food additives. The sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods, may trigger migraines.
• Drinks. Alcohol, especially wine, and highly caffeinated beverages may trigger migraines.
• Stress. Stress at work or home can cause migraines.
• Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — can trigger migraines in some people.
• Changes in wake-sleep pattern. Missing sleep or getting too much sleep may trigger migraines in some people, as can jet lag.
• Physical factors. Intense physical exertion, including sexual activity, may provoke migraines.
• Changes in the environment. A change of weather or barometric pressure can prompt a migraine.
• Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.

Scheuermann’s disease occurs most often in the upper back, also called the thoracic spine, but occasionally develops in the lower back, or lumbar spine. When the disease is in the lumbar spine, the deformity is usually not as obvious, but the lumbar deformity usually causes greater pain, more limitation on movement, and an increased likelihood of the condition continuing into adulthood.

 

 

 

 

The gradual curves of the human spine allow the body to absorb many shocks and stresses in daily life. It’s a delicate balance, though, and if part of the spine curves too much, pain and limited mobility may result.

Such problems occur at a young age with Scheuermann’s disease, also called Scheuermann’s kyphosis. It can lead to a rounded upper back, sometimes called a hump back, in otherwise healthy adolescents. Scheuermann’s disease is among the most frequent sources of back pain in young people, with pain more likely to follow either exertion or long periods of inactivity.

Symptoms:

Symptoms generally develop between the ages of 10 and 15, a time of considerable growth in the spine. These symptoms are typical:

• Tiredness and muscle stiffness, especially after a day of sitting in class
• Redness on the skin where the curvature is most pronounced and rubs against the back of a chair
• Pain made worse by activities involving twisting, bending, or arching backward, such as when participating in gymnastics, figure skating, dancing, or other sports requiring these types of movements
• Muscle spasms or muscle cramps
• Difficulty exercising
• Back pain or backache, which may come and go
• Limited flexibility
• Tight hamstrings
• Feeling off-balance

Serious damage is rare, but it is possible for Scheuermann’s disease to develop in such a way that the spinal cord or internal organs are harmed. For example, if the lungs become compressed by severe forward posture it can lead to breathing problems.

Treatments :

Treatment for Scheuerman’s disease depends on the individual’s situation. Several factors determining the best treatment include:

• Severity of the curvature in the back
• Amount of flexibility in the area
• Whether the individual is expected to continue to grow
• Concerns about appearance
• Patient preferences

In considering treatments for Scheuermann’s disease, it’s helpful to understand the anatomy of the upper back, or thoracic spine. Human spines are designed to curve, but if the curvature reaches 45 degrees or more, it’s considered abnormal. Allowing an abnormal curvature to continue could cause considerable pain and disfigurement over time.

Observation and Bracing

A young person with a slight curvature who is still growing, shows no sign of the curvature worsening, and has mild or no pain may not require intervention. Instead, the individual could be monitored by a doctor and undergo periodic X-rays, or other tests, to track the curvature. If the curvature worsens, more active treatment would be recommended.

A patient with a more advanced curvature—but with more than a year of growth left—would typically receive more intensive treatment. A back brace would usually be prescribed. Braces can stop or reverse the extra curvature during the growing years by making the front of the vertebrae more upright, which may also reduce pain.

To be most effective, braces should be worn almost all the time, at least at first. Depending on the severity and progression of the curvature, patients may be prescribed a brace for one to two years. Braces can be helpful with curvatures of up to 75 degrees. At one time, braces were thought to be ineffective once spine growth was complete, but recent research indicates there is still a good chance of success after growth has ended.

While braces were once considered bulky and uncomfortable—and often rejected by self-conscious teens—the situation has improved considerably and braces have become less obtrusive and more lightweight. Some of these custom-molded braces can be worn undetected under clothes and allow the young person to take part in activities—including many sports.

Many doctors now recommend these kinds of braces, including the kyphologic and thoracolumbosacral (TSLO)-style Boston braces, over the older, larger Milwaukee brace.

Surgery:

Surgery is rarely needed for Scheuermann’s disease, and nonsurgical options will typically be attempted before surgery is considered.

There are certain situations in which surgery may be advised, however. It may be considered for patients with severe deformities—such as a curvature of more than 75 degrees for thoracic kyphosis, if neurological deficits are present, and occasionally if pain is caused by the deformity.

The goal of the surgery is mainly to reduce the deformity, and possibly lessen pain or neurological symptoms. Surgery will typically include:

• A front thoracotomy (approach through the chest) to release the tissues, remove the discs, and place a bone graft in the spaces to fuse the thoracic spine
• During the same surgery, the spine is then approached from the back and instrumentation, such as rods, bars, wires, or screws, to hold the spine straight during the fusion process is put in place.

After surgery, provided the fusion is successful, all the affected segments will be fused into one continuous bone that will not progress into excessive curvature, or kyphosis. Because Scheuermann’s disease usually occurs in the thoracic spine, which has almost no motion, a fusion in this area does not affect the normal motion of the spine and typically does not lead to pain later in life.

Tailbone Injury Overview

A coccyx injury results in pain and discomfort in the tailbone area (the condition is called coccydynia). These injuries may result in a bruise, dislocation, or fracture (break) of the coccyx. Although they may be slow to heal, the majority of coccyx injuries can be managed with cautious treatment.

The coccyx is the triangular bony structure located at the bottom of the vertebral column. It is composed of three to five bony segments held in place by joints and ligaments.

The majority of coccyx injuries occur in women, because the female pelvis is broader and the coccyx is more exposed.

Tailbone Injury Causes

Most tailbone injuries are caused by trauma to the coccyx area.

• A fall onto the tailbone in the seated position, usually against a hard surface, is the most common cause of coccyx injuries.
• A direct blow to the tailbone, such as those that occur during contact sports, can injure the coccyx.
• The coccyx can be injured or fractured during childbirth.
• Repetitive straining or friction against the coccyx (as happens in bicycling or rowing) can injure the coccyx.
• Sometimes, the cause of coccyx injuries is unknown.
• Less common causes of coccyx injuries include bone spurs, compression of nerve roots, injuries to other parts of the spine, local infections, and tumors.’

Tailbone Injury Symptoms

• Severe localized pain and tenderness may be felt in the tailbone area.
• If the injury is traumatic, a bruise may be visible in this area.
• The pain is generally worse when sitting for prolonged periods of time, or with direct pressure to the tailbone area.
• Bowel movements and straining are often painful.
• Some women may experience pain during sexual intercourse.

Medical Treatment

In addition to home care, a doctor may be able to provide further relief of pain with other medical and, rarely, surgical interventions.

• Stronger pain medicationsmay be prescribed at the discretion of your doctor.
• Stool softeners may be prescribed to prevent constipation.
• Injections of local anesthetics into the tailbone are sometimes required for continuing pain.
• Rarely, the coccyx may be surgically removed.

Follow-up After a Tailbone Injury

Follow-up is recommended at the discretion of your doctor and depends on the severity of the injury and the progress you are making with medical treatment.

• Most people do not require follow-up if their coccyx injury is improving with medical treatment.
• People with chronic tailbone pain, for whom medical therapy has not worked, require more frequent follow-up and may be referred to other medical or surgical specialists.

• Most tailbone injuries are accidental (such as a slip on ice) and therefore cannot be entirely avoided.
• Wear proper protective padding when participating in contact sports that can potentially lead to coccyx injuries.

Cervical lordosis is a curvature of the cervical spine or the vertebrae in the neck region. There is a normal slight curve present in the cervical vertebrae that enables comfortable movement of the neck in a healthy cervical spine. However, when there is a deviation from the normal curve, it can lead to problems. Cervical lordosis is a condition occurring due to excess curvature of the cervical spine, which can lead to pain and discomfort.

The curve in the cervical spine can show great variations and result in varying degrees of complaints. Sometimes, the normal curve straightens out making it difficult to move the neck, sometimes becomes more curved than normal, while sometimes it can be deviated to right or left along with being excessively curved.

Cervical lordosis can be a present during childhood or can occur during the course of life, at any age. Some of the common causes of cervical lordosis include:

• Cervical Lordosis Caused Due to Postural Changes – Poor posture, altered ways of sitting, working at the desk or lifting weight can affect the normal curvature of the cervical spine.
• Cervical Lordosis Caused Due to Congenital Conditions – Certain conditions present since birth may cause excessive lordosis of cervical spine.
• Cervical Lordosis Caused Due to Musculoskeletal Conditions – Other conditions affecting the curvature of the spine, like kyphosis, scoliosis, etc. Weakening of the bones as in osteoporosis. Disorders affecting intervertebral discs like discitis, disc herniation or prolapse. Changes in the position of the vertebrae like spondylolisthesis.

Sometimes, injury or a long standing muscle spasm results in changes in normal curvature, which can lead to either straightening of the spine or excessive lordosis.

Cervical lordosis may be visible as an arch in the cervical spine, noticed as a swayed back neck. It is often noticed that there may be extra space in between the neck and the surface on which you are lying down. Usually people experience discomfort in making neck movements and the range of motion may be restricted.

Pain is often accompanied with difficulty in turning the neck. In some long standing cases, pain may not be felt but the excess curvature can continue to limit regular activities. The muscles around the neck, shoulders and upper back are usually tensed and may be painful to touch. Muscle spasms are commonly noted and may also cause difficulty in moving the neck, raising hands or lifting weights.

If a nerve gets trapped due abnormal curvature of the spine or the tensed muscle, it can also lead to nerve related symptoms. Sometimes, numbness and tingling may be noted in the arms, hands and fingers.

While this condition and muscles spasm often subsides with proper treatment, if left unattended it can progress to cause more difficulty. If there occurs any weakness in the hands and fingers or difficulty in maintaining control, immediate medical attention may be required. Also, changes in the curvature of the spine can lead to further changes in the nearby joints, structures and cause further problems.

Treatment is mainly based on the cause of cervical lordosis, along with symptomatic treatment. Pain medications, muscles relaxants, nerve tonics and nutritional supplements including vitamin D may be given. Depending on the severity of the neck pain and difficulty in neck movements due to cervical lordosis, brace or a neck collar may be advised.

Physical therapy and exercises are often helpful in muscle strengthening, improving range of motion and flexibility. Healthy lifestyle and maintaining ideal body weight is advised to relieve excessive strain on the spine.

In extreme cases of cervical lordosis, surgery may be required.

The spinal cord extends from the base of the brain through the spinal canal to the lower back.

A tethered cord refers to a condition in which the lower spinal cord is restricted (“tethered”) and is not free to develop normally with in the spinal column. This can occur during fetal development or may be associated with build up of scar tissue after previous surgery in or around the spinal cord.

Signs and Symptoms of Tethered Spinal Cord

Signs and symptoms of tethered cord are not specific to this condition, meaning that other disorders may also result in these problems. However, if your child has any of the following, tethered cord should be considered:

• Leg or back pain
• Decrease in strength of legs or feet
• Loss of sensation in the legs
• Deformity of the legs or feet
• Stumbling or walking changes
• Difficulty or delay in toilet training
• Incomplete emptying of the bladder
• Changes in bladder and bowel control
• Curvature of the spine
• Skin abnormalities directly overlying the spinal cord – midline dimples, hairy patches, skin discoloration, skin tags or fatty lumps.

Diagnosis :

 

 

 

 

 

 

Bell’s palsy is a condition in which the muscles on one side of your face become weak or paralyzed. It affects only one side of the face at a time, causing it to droop or become stiff on that side.

It’s caused by some kind of trauma to the seventh cranial nerve. This is also called the “facial nerve.” Bell’s palsy can happen to anyone. But it seems to occur more often in people who have diabetes or are recovering from viral infections.

Most of the time, symptoms are only temporary.

If it happens to you, you may fear you’re having a stroke. You’re probably not. A stroke that affects your facial muscles would cause muscle weakness in other parts of your body, too.

What Causes It?

Most doctors believe that it’s due to damage to the facial nerve, which causes swelling. This nerve passes through a narrow, bony area within the skull. When the nerve swells — even a little bit — it pushes against the skull’s hard surface. This affects how well the nerve works.

Researchers have long believed that viral infections may also play a role in the development of Bell’s palsy. They’ve found evidence that suggests the herpes simplex 1 virus (a common cause of cold sores) may be responsible for a large number of cases.

Symptoms:

The symptoms of Bell’s palsy tend to come on all of a sudden. You may go to bed one night feeling fine. But when you look in the mirror the next morning, you see that part of your face seems to be drooping.

Some people feel pain behind their ear 1-2 days before they notice any weakness. Others say that sounds seem much louder than normal in the days before they see any other symptoms.

• You’re unable to close your eyelid or blink
• Your eye waters more or less than usual
• Drooling
• Difficulty chewing
• Decreased sense of taste
• Your facial muscles twitch
• Pain or numbness behind your ear

Facial weakness and drooping typically reach their peak within a day or two. Most people start to feel better within a couple of weeks. They usually recover completely within 3 months. Some people who develop Bell’s palsy have a longer recovery period. In rare cases, they may have some permanent symptoms.

What Are the Treatments for Bell’s Palsy?

There aren’t any that can stop it. If your doctor suggests your symptoms might be triggered by the herpes virus (herpes simplex 1) or by shingles(herpes zoster), he may give you an antiviral medication, like acyclovir. But there’s no research to show these medications work to reduce Bell’s palsy symptoms.

Your doctor may also give you a short course of corticosteroids (like prednisone). The goal is to decrease swelling of your facial nerve. This may shorten the duration of your Bell’s palsy symptoms.

In the meantime, your doctor will tell you to take extra care to protect your eye on the affected side. He may suggest you wear an eye patch, since you won’t be able to blink. If your eyes are tearing less than normal, you may have to use eye drops to keep them from drying out.

Finally, your doctor may suggest massage of your facial muscles. In very rare cases — where symptoms don’t improve after some time — he may suggest surgery to reduce pressure on your facial nerve.

WHAT IS A PERILYMPH FISTULA?

A perilymph fistula (PLF) is an abnormal connection (a tear or defect) in one or both of the small, thin membranes (the oval window and the round window) that separate the air filled middle ear and the fluid filled perilymphatic space of the inner ear. This small opening allows perilymph (fluid) to leak into the middle ear.

Changes in air pressure that occur in the middle ear (for example, when your ears “pop” in an airplane) normally do not affect your inner ear. However, when a fistula is present, changes in middle ear pressure will directly affect the inner ear, stimulating the balance and/or hearing structures within and causing PLF symptoms.

The perilymphatic space of the inner ear is connected to the cerebrospinal fluid (CSF) that surrounds the brain. Perilymphatic fluid, which is high in sodium (Na+), is similar in composition to CSF. When an abnormal connection between the membranes between the middle and inner ear exists, perilymph in the inner ear escapes, driven by the hydrostatic pressure of the CSF, and is replaced by CSF. This can also result in lower than normal levels of CSF fluid around the brain and spinal cord, which may result in symptoms such as mild headache.

Patients with PLF often feel frustrated and depressed because, while they don’t feel well, they look fine to others. PLF patients specifically and vestibular patients in general often have a challenging time explaining to friends and family what they are going through. Sometimes it is enough to ask your support network for patience and understanding while you explore diagnosis and treatment options and learn to cope with the symptoms brought on by persistent dizziness.

SYMPTOMS :

The symptoms of a PLF most commonly include ear fullness, fluctuating or “sensitive” hearing, dizziness without true vertigo (spinning), and motion intolerance. Vertigo or sudden hearing loss can occur from a PLF. Most people with fistulas find that their symptoms get worse with changes in altitude (fast elevators, airplanes, and travel over moun¬tain passes) or increased CSF pressure resulting from heavy lifting, bending over, and coughing or sneezing.

CAUSES :

Head trauma is the most common cause of fistulas, usually involving a direct blow to the head or in some cases a “whiplash” injury. Other common causes include ear trauma, objects perforating the eardrum, or “ear block” on descent of an airplane or SCUBA diving. Fistulas may also develop after rapid increases in intracranial pressure, such as

may occur with weightlifting or childbirth.

Fistulas are infrequently present from birth. A long-running controversy has surrounded the idea of a “spontaneous PLF.” Instead, what may occur is that a patient has a causative event but does not see an ear specialist right away. The passage of time blurs the memory of such an event so that the PLF might seem to have been spontaneous. Rarely, PLF’s occur in both ears, and only after a severe head injury.

TREATMENT:

When a traumatic event results in sudden onset of hearing loss or dizziness, the patient is advised to severely restrict physical activity for 7-14 days. If the symptoms do not improve or they plateau, testing is ordered. If the tests are compatible with the diagnosis of PLF, a surgical intervention may be considered. Persons with diagnosed fistulas who are awaiting surgery should avoid lifting, straining and bending over as these activities can cause a worsening of the symptoms.

A PLF repair involves an operation, often under general anesthesia, working through the ear canal. The eardrum is lifted up and minute soft tissue grafts are placed around the base of the stapes (stirrup) and in the round window niche. The operation usually takes about 45-60 minutes to complete. There is very little, if any, pain. Some patients are kept overnight to restrict activity. Once discharged the patient is advised to spend three days at home with limited activity. After three days the patient may return to sedentary work activities. The patient is advised to avoid lifting more than 10 lbs. for one month and avoid sporting activities. After one month there are additional restrictions suggested on activities such as contact sports, diving, weight lifting, and roller coasters. All of these activities have resulted in recurrent PLF’s after an initial successful repair.

Hearing loss can be caused by many different causes, some of which can be successfully treated with medicine or surgery, depending on the disease process.

Three Types of Hearing Loss

• Conductive hearing loss - when hearing loss is due to problems with the ear canal, ear drum, or middle ear and its little bones (the malleus, incus, and stapes).
• Sensorineural hearing loss (SNHL) - when hearing loss is due to problems of the inner ear, also known as nerve-related hearing loss.
• Mixed hearing loss – refers to a combination of conductive and sensorineural hearing loss. This means that there may be damage in the outer or middle ear and in the inner ear (cochlea) or auditory nerve.

Conductive Hearing Loss

Causes:

• Malformation of outer ear, ear canal, or middle ear structures
• Fluid in the middle ear from colds
• Ear infection (otitis media – an infection of the middle ear in which an accumulation of fluid may interfere with the movement of the eardrum and ossicles
• Allergies
• Poor Eustachian tube function
• Perforated eardrum
• Benign tumors
• Impacted earwax
• Infection in the ear canal
• Foreign body in the ear
• Otosclerosis

Treatments of Conductive Hearing Loss:

Types of conductive hearing loss include congenital absence of ear canal or failure of the ear canal to be open at birth, congenital absence, malformation, or dysfunction of the middle ear structures, all of which may possibly be surgically corrected. If these are not amenable to successful surgical correction, then the hearing alternatively may be improved with amplification with a bone conduction hearing aid, or a surgically implanted, osseointegrated device (for example, the Baha or Ponto System), or a conventional hearing aid, depending on the status of the hearing nerve.

Other causes of conductive hearing loss are: infection; tumors; middle ear fluid from infection or Eustachian tube dysfunction; foreign body; and trauma (as in a skull fracture). Acute infections are usually treated with antibiotic or antifungal medications. Chronic ear infections, chronic middle fluid, and tumors usually require surgery. If there is no response to initial medical therapy, infectious middle ear fluid is usually treated with antibiotics — while chronic non-infectious middle ear fluid is treated with surgery (or pressure equalizing tubes).

Conductive hearing loss from head trauma is frequently amenable to surgical repair of the damaged middle ear structures, performed after the patient’s general medical status is stabilized following acute traumatic injuries.

A genetic form of conductive hearing loss is otosclerosis, in which there is bony fixation of the stapes (the third little bone of hearing in the middle ear), where sound can’t get to the middle ear. Otosclerosis usually presents with hearing loss in early adulthood. Otosclerosis can successfully be managed with surgery to replace the immobile stapes with a mobile stapes prosthesis or with a hearing aid. Research suggests that the measles virus may contribute to stapes fixation in those with a genetic predisposition to otosclerosis. The incidence of otosclerosis may be decreasing in some communities due to measles vaccination. Otosclerosis (a hereditary disorder in which a bony growth forms around a small bone in the middle ear, preventing it from vibrating when stimulated by sound) usually causes a conductive hearing loss, a hearing loss caused by a problem in the outer or middle ear. Less frequently, otosclerosis may cause a sensorineural hearing loss (damaged sensory cells and/or nerve fibers of the inner ear), as well as a conductive hearing loss.

Sensorineural Hearing Loss

Causes:

• Exposure to loud noise
• Head trauma
• Virus or disease
• Autoimmune inner ear disease
• Hearing loss that runs in the family
• Aging (presbycusis)
• Malformation of the inner ear
• Meniere’s Disease
• Otosclerosis – a hereditary disorder in which a bony growth forms around a small bone in the middle ear, preventing it from vibrating when stimulated by sound.
• Tumors

Treatment of Sensorineural Hearing Loss:

• Sensorineural hearing loss can result from acoustic trauma (or exposure to excessively loud noise), which may respond to medical therapy with corticosteroids to reduce cochlea hair cell swelling and inflammation to improve healing of these injured inner ear structures.
• Sensorineural hearing loss can occur from head trauma or abrupt changes in air pressure such as in airplane descent, which can cause inner ear fluid compartment rupture or leakage, which can be toxic to the inner ear. There has been variable success with emergency surgery when this happens.
• Sudden sensorineural hearing loss, presumed to be of viral origin, is an otologic emergency that is medically treated with corticosteroids.
• Bilateral progressive hearing loss over several months, also diagnosed as autoimmune inner ear disease, is managed medically with long-term corticosteroids and sometimes with drug therapy. Autoimmune inner ear disease is when the body’s immune system misdirects its defenses against the inner ear structures to cause damage in this part of the body.
• Fluctuating sensorineural hearing loss may be from unknown cause or associated with Meniere’s Disease. Symptoms of Meniere’s disease are hearing loss, tinnitus (or ringing in the ears), and vertigo. Meniere’s disease may be treated medically with a low-sodium diet, diuretics, and corticosteroids. If the vertigo is not medically controlled, then various surgical procedures are used to eliminate the vertigo.
• Sensorineural hearing loss from tumors of the balance nerve adjacent to the hearing nerve, generally are not reversed with surgical removal or irradiation of these benign tumors. If the hearing loss is mild and the tumors are very small, hearing may be saved in 50 percent of those undergoing hearing preservation surgery for tumor removal.
• Sensorineural hearing loss from disease in the central nervous system may respond to medical management for the specific disease affecting the nervous system. For example, hearing loss secondary to multiple sclerosis may be reversed with treatment for multiple sclerosis.
• Irreversible sensorineural hearing loss, the most common form of hearing loss, may be managed with hearing aids. When hearing aids are not enough, this type of hearing loss can be surgically treated with cochlear implants.

Mixed Hearing Loss

Treatments for Mixed Hearing Loss

Audiologist Mark Ross, Ph.D., recommends taking care of the conductive component first. There have been times when the addition of the conductive component made the person a better hearing aid candidate, by flattening out the audiogram for example, while the underlying sensorineural component presented a high-frequency loss. However, still the emphasis would be on treating medically what can be treated. He says that, generally, you would expect positive results.

The term cauliflower ear refers to a deformity of the ear caused by blunt trauma or other injury, such as what may occur during a boxing or wrestling match. Left untreated, the injury leads to a blockage that prevents blood flow and damages tissue. This results in a bumpy or lumpy appearance on part of the ear,similar to a cauliflower. Early treatment can help prevent permanent deformity.

 

Fortunately, the types of injuries that cause cauliflower ear are often preventable by wearing the right type of protective head gear.

 

Causes of Cauliflower Ear

The most common cause of cauliflower ear is a hit to the ear — or repeated hits to the ear — that leads to hematomas, or small collections of bloodthat clot and block the flow of blood and nutrients. These can also occur when skin is pulled away from cartilage, the semi-rigid tissue that gives the ear its shape.

Usually, cauliflower ear is related to sports injuries, but not always. Any trauma to the ear can cause it. Cauliflower ear can even be the result of an infection in the ear lobe.

When blood flow is blocked, the affected cartilage may die and, without the supportive tissue, fold in on itself. Scar tissue may form, contributing to a swollen and deformed look. Over time, the effects may become more prominent, and they may be permanent. The good news is that cauliflower ear can usually be prevented, even after such an injury occurs.

Risk Factors for Cauliflower Ear

Cauliflower ear occurs most frequently in people who participate in close-contact sports, such as wrestling or boxing. In wrestling, for instance, trauma can result from opponents’ heads rubbing or hitting one another during matches or from contact with the wrestling mat. Cauliflower ear is also common among rugby players and people who practice martial arts. People who participate in these activities are at higher risk than others. Protective head gear has long been commonplace in these sports.

But these injuries can also occur in non-athletes. They may be the result of accidents or physical altercations. They also can be a complication of “high” piercings in the upper area of the ear, through the cartilage, if the piercing becomes infected.

Symptoms of Cauliflower Ear

The initial symptoms of the types of injuries that lead to cauliflower ear are similar to the symptoms one might experience from blunt trauma elsewhere in the body. You may have swelling, and the area may be red or bruised. So it’s important not to shrug off such symptoms if you have received a blow, or multiple blows, to the ear. Prompt treatment can prevent the development of cauliflower ear. But it must be performed before the tissue is compromised by lack of blood flow.

Treatment of Cauliflower Ear

If you experience an injury that causes a blockage in the tissues of your ear, there’s still a chance you can avoid developing cauliflower ear. The goal of treatment is to ease the blockage so that blood can again flow to the affected tissues.

A doctor can accomplish this by making a small incision and draining accumulating blood or removing a clot and preventing further bleeding. He or she may need to reconnect tissues using stitches and apply a special bandage to put pressure on the area. This pressure dressing may need to stay in place for several days to a week. The site will require monitoring for signs of infection or signs that additional treatment may be needed. Your doctor may also prescribe antibiotics.