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Otolaryngology (ENT)429 papers

Lyme disease of inner ear

Last edited: 4/13/2026

Overview

Lyme disease can affect the inner ear, leading to symptoms such as vertigo, tinnitus, and hearing loss, often presenting as Lyme-associated neurogenic disorders. 50

Diagnosis

  • Clinical suspicion based on patient history of tick exposure and characteristic symptoms.
  • Neurological examination focusing on vestibular and auditory functions.
  • Audiometry and vestibular function tests to assess hearing and balance.
  • MRI or CT scans may be considered to rule out other causes of inner ear symptoms. 50
  • Management

  • Antibiotics: First-line treatment typically involves doxycycline, amoxicillin, or ceftriaxone, depending on the stage and severity of Lyme disease. 50
  • Symptomatic Treatment: Management of vertigo with vestibular suppressants like dimenhydrinate or antihistamines.
  • Physical Therapy: Vestibular rehabilitation therapy for persistent balance issues.
  • Monitoring: Regular follow-up to assess response to treatment and manage potential complications. 50
  • Special Populations

  • Pediatrics: Similar antibiotic treatment protocols apply, with careful monitoring for side effects and adherence. 50
  • Elderly: Increased vigilance for complications and potential drug interactions; consider dose adjustments and supportive care. 50
  • Key Recommendations

  • Initiate empirical antibiotic therapy promptly in patients with suspected Lyme disease affecting the inner ear, guided by clinical presentation and exposure history. (Evidence: Strong 50)
  • Incorporate audiometric and vestibular assessments to confirm inner ear involvement and monitor treatment efficacy. (Evidence: Moderate 50)
  • Consider vestibular rehabilitation therapy for elderly patients with persistent balance issues post-treatment. (Evidence: Expert opinion 50)
  • References

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Journal of patient-reported outcomes 2024. link 9 Habib AR, Crossland G, Sacks R, Singh N, Patel H. Tele-otology for Aboriginal and Torres Strait Islander People Living in Rural and Remote Areas. The Laryngoscope 2024. link 10 Tapiala J, Iso-Mustajärvi M, Timonen T, Vrzáková H, Dietz A. Impact of virtual reality training on mastoidectomy performance: a prospective randomised study. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2024. link 11 Wong K, Gorthey S, Arrighi-Allisan AE, Fan CJ, Barber SR, Schwam ZG et al.. Defining the Learning Curve for Endoscopic Ear Skills Using a Modular Trainer: A Multi-Institutional Study. Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2023. link 12 Kwinter A, Chayaopas N, Ma A, James AL. Use of a Caprine Model for Simulation and Training of Endoscopic Ear surgery. The journal of international advanced otology 2023. link 13 Reese AD, DiNardo LA, Powers KF, Behar P, Carr MM. Parents' Opinions About Pediatric Otolaryngology on Social Media. The Annals of otology, rhinology, and laryngology 2023. link 14 Redding TS, Stephens AR, Kazmers NH, Park AH. Evaluation of factors impacting patient satisfaction in a pediatric otolaryngology clinic. International journal of pediatric otorhinolaryngology 2022. link 15 Burton LE, Navaratnam AV, Magowan DS, Machin JT, Briggs TWR, Hall AC. Litigation in pediatric otorhinolaryngology: Lessons in improving patient care. International journal of pediatric otorhinolaryngology 2022. link 16 Pourshahrokhi N, Ahmadian L. Participatory user requirements elicitation, validation, and prioritization for tele-otology app in deprived populations. International journal of medical informatics 2022. link 17 Agarwal P, Nathan AS, Jaleel Z, Levi JR. Factors Contributing to Missed Appointments in a Pediatric Otolaryngology Clinic. The Laryngoscope 2022. link 18 Seedat RY. Pioneering virtual otolaryngology specialist examinations in South Africa in the COVID-19 and post-COVID-19 era. Current opinion in otolaryngology & head and neck surgery 2021. link 19 Barber SR, Chari DA, Quesnel AM. Teaching Endoscopic Ear Surgery. Otolaryngologic clinics of North America 2021. link 20 Wu CN, Luo SD, Lin HC, Huang JT, Lee CH, Liu SY et al.. Eligibility for live, interactive otolaryngology telemedicine: 19-Month experience before and during the COVID-19 pandemic in Taiwan. Biomedical journal 2021. link 21 Binol H, Niazi MKK, Essig G, Shah J, Mattingly JK, Harris MS et al.. Digital Otoscopy Videos Versus Composite Images: A Reader Study to Compare the Accuracy of ENT Physicians. The Laryngoscope 2021. link 22 Bradley PJ. A study of a provincial ear, nose and throat service in a British city prior to the National Health Service: Nottingham and South Nottinghamshire (1886-1947). The Journal of laryngology and otology 2021. link 23 Gupta N, Baghotia KS, Rabha M, Sachdeva S, Sahai G, Bhatnagar K et al.. Comprehensive Community Screening of Otological Patients by Trained Technicians Using a Telemedicine Device: An Efficient and Cost-Effective Way to Triage Patients With Ear Diseases. Ear, nose, & throat journal 2021. link 24 Kozin ED, Lee DJ, Pollak N. Getting Started with Endoscopic Ear Surgery. Otolaryngologic clinics of North America 2021. link 25 Bradley PJ. The Nottingham and Nottinghamshire Hospital for Diseases of the Throat, Ear and Nose (1886-1947): its formation, rise and demise. The Journal of laryngology and otology 2020. link 26 Gilani S, Bommakanti K, Friedman L. Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System. The Annals of otology, rhinology, and laryngology 2020. link 27 Kraak JT, van Dam TF, van Leeuwen LM, Kramer SE, Merkus P. The Otology Questionnaire Amsterdam: A generic patient-reported outcome measure about the severity and impact of ear complaints. Validation, reliability and responsiveness. Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery 2020. link 28 Chan KH, Dinwiddie JK, Ahuja GS, Bennett EC, Brigger MT, Chi DH et al.. Advanced practice providers and children's hospital-based pediatric otolarynology practices. International journal of pediatric otorhinolaryngology 2020. link 29 Ng CL, Ong W, Ngo RYS. Otolaryngology residents' perceptions of endoscopic ear surgery during surgical training. The Journal of laryngology and otology 2020. link 30 Sparks D, Kavanagh KR, Vargas JA, Valdez TA. 3D printed myringotomy and tube simulation as an introduction to otolaryngology for medical students. International journal of pediatric otorhinolaryngology 2020. link 31 Kaur B, Clark MPA, Lea J. Anaesthesia for ear surgery in remote or resource-constrained environments. The Journal of laryngology and otology 2019. link 32 Lukama L, Kalinda C, Aldous C. Africa's challenged ENT services: highlighting challenges in Zambia. BMC health services research 2019. link 33 Lustig LR. History of Publications from the American Otological Society: A Celebration of the 150-Year History of the American Otological Society. 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Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 2018. link 38 Girma B, Bitew A, Kiros N, Redleaf M. High-Density Otologic Camps in Regions of Sparse Expertise. The Annals of otology, rhinology, and laryngology 2018. link 39 Young C, Tong A, Gunasekera H, Sherriff S, Kalucy D, Fernando P et al.. Health professional and community perspectives on reducing barriers to accessing specialist health care in metropolitan Aboriginal communities: A semi-structured interview study. Journal of paediatrics and child health 2017. link 40 Wu V, Beyea JA. Evaluation of a Web-Based Module and an Otoscopy Simulator in Teaching Ear Disease. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery 2017. link 41 Salisu AD, Jibril YN. Extending otology services to rural settings: Value of endoscopic ear surgery. 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The Journal of laryngology and otology 2010. link 58 Elliott G, Smith AC, Bensink ME, Brown C, Stewart C, Perry C et al.. The feasibility of a community-based mobile telehealth screening service for Aboriginal and Torres Strait Islander children in Australia. Telemedicine journal and e-health : the official journal of the American Telemedicine Association 2010. link 59 Wilson T, Prinsely P, Patel H, Tassone P. Are trainees being adequately taught myringoplasty? A prospective study of Eastern Deanery otolaryngology trainees' surgical experience. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2009. link 60 Hirschberg J, Lábas Z, Lellei I, Farkas Z, Sultész M, Katona G. History and development of pediatric otorhinolaryngology in Hungary. 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    Original source

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