Is dizziness related to ears?
Be careful with these symptoms!
When I was drying clothes, I suddenly raised my head and turned around and dizzy. Is it "the cervical spine is not good"?
Turning over in bed, dizzy for a few seconds, is it "poor sleep"?
Bent over to tie your shoelaces, suddenly dizzy and crooked, is the position change caused by "blood pressure instability"?
When working at the desk, the brain "black screen" for a moment, is the brain's blood supply insufficient?
These "dizzy moments" in life add a lot of trouble to people.
In fact, it is very likely to be related to the ears!
Chief physician Zeng Xiangli, vice chairman of the Chinese branch of the International Association of Otologists and director of the Department of Otorhinolaryngology, the Third Affiliated Hospital of Sun Yat-sen University, reminds people who often experience short-term dizziness to beware of "otoliths."
For patients with recurrent otolithiasis and stubborn otolithiasis with symptoms of Meniere's disease such as deafness, tinnitus, and ear fullness, we must also be alert to the possibility of hearing loss or even deafness.
Text/Guangzhou Daily All-Media Reporter Ren Shanshan Correspondent Zhou Jinan Zhen Xiaozhou Ye Zhangxiang
Deciphering "Otolithiasis": Watch out for these red flags
What disease is "otolithia"?
Zeng Xiangli pointed out that, in fact, it is the common name of "benign paroxysmal positional vertigo (BPPV)". It is called "otolithiasis" because of the short-term dizziness caused by the loss of "otoliths" located in the inner ear.
The biggest feature of this disease is that the onset of vertigo is related to changes in head position, and symptoms can appear or worsen with changes in body position.
Outpatient clinics often encounter some patients with "otolithiasis" who mistakenly believed that the cause was cervical spondylosis, poor sleep quality, and instability of blood pressure at the beginning. There were "otoliths" behind them, and eventually they went to the otology clinic for help.
The attending physician Yin Gendi, a young member of the Vertigo Rehabilitation Professional Committee of the Chinese Rehabilitation Medicine Association, pointed out that the main clinical manifestations of "otolithiasis" include recurrences when changing the head position or body position (lying down, turning over in bed, bowing or looking up). Onset, short-lived dizziness, lasting from a few seconds to about 1 minute, and may be accompanied by symptoms such as nausea, vomiting, and sweating.
"Otolithia" is often asymptomatic in the intermittent period, and some patients may experience dizziness, fatigue, lightheadedness, and floating sensation after the onset of vertigo.
Zeng Xiangli pointed out that "otoliths" are carbonate crystals of the inner ear, which are the normal structure of the inner ear.
Under normal circumstances, the "otoliths" are attached to the otolith membrane of the utricle. When some pathogenic factors cause the "otoliths" to be detached, these shed "otoliths" move into the semicircular canals and draw the flow of lymph fluid in the semicircular canals. Stimulate the hair cells of the semicircular canals, causing the body to dizzy.
Multiple diseases
Related to "otolithiasis"
The occurrence of "otolithiasis" is related to many factors.
It is often secondary to basic systemic diseases, such as arteriosclerosis, high blood pressure, diabetes and other adverse factors that can cause blood supply disorders in the inner ear and peripheral neuropathy.
The otolith membrane on the utricle plaque becomes thin due to malnutrition, and the “otoliths” located on the otolith membrane fall off due to “instability of the foundation” and enter and deposit in the semicircular canal.
Osteoporosis
Yin Gendi pointed out that the incidence of osteoporosis in middle-aged and elderly women with otolithiasis in foreign studies is as high as 75%, while that of the normal control group is only 4%. It can be seen that osteoporosis may be related to "otolithiasis". There are inexhaustible links between the occurrence of, and its pathogenic mechanism still needs to be studied in depth.
Head trauma or ear surgery
If the head is hit by an external force or the head is accelerated, it will stop immediately, such as whiplash-like injuries can cause the disease; some middle ear and inner ear operations, such as stapes surgery, can be caused by local pressure or the stapes foot plate is inserted into the vestibular window. Otoliths fall off and cause this disease.
Other ear diseases
"I am not only dizzy, but also my tinnitus and hearing change from time to time. A doctor said that I was suffering from Meniere's disease, but now I am diagnosed with otolithia. What kind of disease do I have?" Questions asked.
This kind of disease process and experience of diagnosis and treatment has indeed brought troubles to many people.
The reason is that “otolithiasis” can be secondary to the following multiple otological diseases, in order of incidence: sudden deafness with vertigo, Meniere’s disease, vestibular neuritis, viral labyrinthitis, middle ear milk Diseases such as sudden infectious diseases and perilymphatic fistulas can easily cause otolith particles to fall off and agglomerate to induce this disease.
However, the "otolithiasis" secondary to Meniere's disease has the characteristics of both Meniere's disease and "otolithiasis", the recurrence rate is high, and the treatment course is relatively long.
Manual reduction therapy
The efficiency can be as high as 80 to 90%
In general, the treatment effect of "otolithiasis" is very good. The first choice is manual reduction, supplemented by drug treatment, which often has an immediate effect-this is the reason why it is called "benign" and is said to be "good cure" .
However, about one to two percent of patients have recurrent episodes of vertigo, especially those secondary to diabetes, Meniere's disease, and female menopause.
Zeng Xiangli pointed out that for these stubborn "otoliths" patients, the cause is more complicated.
Some people fall off too much "otoliths" at one time.
For example, “otoliths” caused by trauma are easy to repeat. It is often caused by severe trauma that causes too much otoliths to fall off, which are dispersed in the semicircular canal. It is difficult to reposition the otoliths and too many otoliths are difficult to absorb, which causes the disease to persist. Heal.
Some people are "otoliths" that continue to fall off.
Failure to improve the microcirculation of the inner ear is also the cause of repeated diseases. Insufficient blood supply to the otoliths and malnutrition, resulting in "instability of the foundation" causing the otoliths to fall off into the semicircular canals repeatedly, which can eventually cause repeated attacks of "otoliths".
Some people have persistent symptoms of "otolithiasis".
About 10% of patients continue to experience dizziness, fatigue, top-heavy, and floating sensation after reduction.
The reasons for the persistence of this residual symptom may be related to the presence of trace otolith particles in the semicircular canal, dysfunction of the utricle, and mental and psychological disorders caused by long-term dizziness.
Zeng Xiangli said that most of the "otoliths" treatment has a good effect, and the effective rate of manual reduction therapy can be as high as 79.4%-92.7%, but there are still 12.8%-15.3% of patients who require two or more reductions.
If the symptoms are alleviated after the first manual reduction treatment, but there is still a sense of spinning, instability, dizziness, and lightheadedness, you need to return to the clinic one week later to determine the treatment effect, and consider resetting again, and assist with vestibular rehabilitation training.
Vestibular rehabilitation training is a physical training method that improves the vestibular function of patients through central adaptation and compensation mechanisms, and reduces the sequelae caused by vestibular injury.
Vestibular rehabilitation training can be used as an auxiliary treatment for otolith reduction in BPPV patients, for patients with poor reduction effect and dizziness or balance disorders after reduction.