• bacterial invasion into labyrinth, associated with permanent hearing loss and vestibular dysfunction, can cause meningitis
• Pathophysiology: bacterial invasion from the middle ear space through the round window membrane or oval window niche or bone erosion with spread though the otic capsule (may occur secondarily from meningitis from invasion through the cochlear aqueduct)
• SSx: sudden vertigo and permanent hearing loss, typically in the presence of a middle ear infection, tinnitus
• Dx: clinical history and exam, audiogram (SNHL)
• Rx: high-dose parenteral antibiotics, vestibular suppressants, surgical management of middle ear infection (if indicated)
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