Ear Conditions (as causes of Vertigo)

Examine the Ear in patient with Vertigo.  Deal with anything you find

Otitis Media:  If you see it, Dx and Tx it

Cerumenosis
  • If canal full of wax, lavage it to see if vertigo resolves
Cholesteatoma:  refer to ENT for surgery
  • Pearly-white growth, usually on superior aspect of  TM
Clues to rare surgical disorders (send to ENT):
  • Vertigo induced by Loud Noises
  • Vertigo provoked by pressure on canal (push on tragus, look for nystagmus)
  • Vertigo accompanied by pulsatile tinnitus
  • Pt notes, “I can hear my eyes moving”
Pulsatile tinnitus alone often due to Eustachian Tube Dysfunction
  • Consider URI of Allergic Rhinitis

See posting Vertigo – 2.