Vestibular Disorders — MCQs

Vestibular Disorders Indian Medical PG Practice Questions and MCQs

Question 91: Which of the following is the most common morbidity associated with Meniere's disease?

A. Permanent hearing loss (Correct Answer)
B. Secondary development of a craniopharyngioma
C. Chronic otitis media
D. Chronic otitis externa

Explanation: ***Permanent hearing loss*** - **Meniere's disease** is characterized by episodes of **vertigo**, **tinnitus**, ear fullness, and fluctuating hearing loss, which often progresses to permanent hearing loss over time. - The recurrent episodes of **endolymphatic hydrops** cause cumulative damage to the **cochlea** and **vestibular apparatus**, leading to irreversible sensorineural hearing loss. *Chronic otitis media* - This is an **infection** and **inflammation of the middle ear**, typically leading to tympanic membrane perforation or cholesteatoma. - It is distinct from Meniere's disease, which is a disorder of the **inner ear** with no direct pathological link to middle ear infections. *Chronic otitis externa* - This condition involves **inflammation of the external ear canal** and is usually caused by bacterial or fungal infections. - It is an outer ear condition and bears no etiological or symptomatic relationship to the inner ear pathology of Meniere's disease. *Secondary development of a craniopharyngioma* - A **craniopharyngioma** is a benign brain tumor arising from Rathke's pouch cells, typically located near the **pituitary gland**. - There is no known direct association or increased risk of developing a craniopharyngioma in patients with Meniere's disease.

Question 92: Third window effect is seen in:

A. Perforated tympanum
B. Dehiscent superior semicircular canal (Correct Answer)
C. Round window
D. Oval window

Explanation: ***Dehiscent superior semicircular canal*** - A dehiscent superior semicircular canal creates an **abnormal opening** or "third window" between the inner ear space and the cranial cavity. - This **third window** disrupts the normal inner ear fluid dynamics, leading to symptoms like **sound-induced or pressure-induced vertigo**, autophony, and conductive hearing loss. *Perforated tympanum* - A perforated tympanum (eardrum) primarily affects the **middle ear function** and conductive hearing. - It does not create a "third window" effect within the **inner ear fluid system**. *Round window* - The round window is a normal anatomical structure that functions as a relief valve for **inner ear pressure changes** during sound transmission. - It is an **integral part of the two-window system** of the inner ear, not an abnormal third window. *Oval window* - The oval window is a normal anatomical structure where the **stapes footplate transmits sound vibrations** into the cochlea. - It is a **primary component of the normal inner ear mechanics** and not associated with the "third window effect."

Practice by Chapter

Anatomy and Physiology of Balance

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Vestibular Testing Methods

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Videonystagmography

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Rotational Chair Testing

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Vestibular Evoked Myogenic Potentials

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Video Head Impulse Test

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Benign Paroxysmal Positional Vertigo

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Vestibular Neuritis

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Ménière's Disease

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Vestibular Migraine

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Central Vertigo

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Vestibular Rehabilitation

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