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A 24-year-old female presents after having several œattacks that last for about 24 h. She states that during these attacks she develops nausea, vomiting, vertigo, and ringing in her ears. Physical examination reveals a sensorineural hearing loss. The pathology of her condition involves ?
1. Acute suppurative inflammation
2. Dilation of the cochlear duct and saccule
3. A cyst of the middle ear filled with keratin
4. A tumor of the middle ear composed of lobules of cells in a highly vascular stroma
5. New bone formation around the stapes and the oval window
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Correct Answer is: Dilation of the cochlear duct and saccule
Explanation:
Ménière™s disease is an abnormality that is characterized by periodic episodes of vertigo that are often accompanied by nausea and vomiting, sensorineural hearing loss, and tinnitus (ringing in the ears). These symptoms are related to hydropic dilation of the endolymphatic system of the cochlea. Inflammation of the middle ear (otitis media), which occurs most often in children, may be acute or chronic. If otitis media is caused by viruses, there may be a serous exudate, but if it is produced by bacteria, there may be a suppurative exudate. Acute suppurative otitis media is characterized by acute suppurative inflammation (neutrophils), while chronic otitis media involves chronic inflammation with granulation tissue. Chronic otitis media may cause perforation of the eardrum or may lead to the formation of a cyst within the middle ear that is filled with keratin, called a cholesteatoma. The name is somewhat of a misnomer, as cholesterol deposits are not present. Otosclerosis, a common hereditary cause of bilateral conduction hearing loss, is associated with formation of new spongy bone around the stapes and the oval window. Patients present with progressive deafness. Tumors of the middle ear are quite rare, but a neoplasm that arises from the paraganglia of the middle ear (the glomus jugulare or glomus tympanicum) is called a chemodectoma. Other names for this tumor include nonchromaffin paraganglioma and glomus jugulare tumor. This lesion is characterized histologically by lobules of cells in a highly vascular stroma (zellballen). A similar tumor that occurs in the neck is called a carotid body tumor.
