36.2 Hearing Loss and Deafness

Question 1

normal hearing loss dB?

Answer 1

up to 20dB

Question 2

normal conversation ranges between?

Answer 2

50-75 dB

Question 3

types of hearing tests?

Answer 3

physiologic (any age)

• tympanometry
• otoacoustic emissions
• auditory brainstem response
• electrocochloeography (under GA)

Question 4

what kind of hearing test for 6-9 month olds?

Answer 4

behavioural testing

Question 5

tympanograms type A,B,C?

Answer 5

A - normal peak
B: flat line: middle ear disease
C: shifted peak to left: eustachian tube dysfunction

Question 6

what do they use for newborn hearing screening?

Answer 6

automated auditory brainstem response (AABR)

Question 7

when ordering MRI for hearing loss, what to specify?

Answer 7

MRI of internal auditory meatus

Question 8

most important practical management of hearing interventions?

Answer 8

keeping hearing aids on

Question 9

what’s the most common non-syndromic cause of hearing loss?

Answer 9

connexion 26, genetics, can be progressive

recessive

Question 10

environmental hearing loss accounts for how many %?

Answer 10

50%

Question 11

what imaging is best for middle ear anomalies?

Answer 11

CT of petrous temporal bones

Question 12

aetiology Ax approach?

Answer 12

history:

• perinatal
• postnatal
• development
• family history

Question 13

examination Ax approach?

Answer 13

syndromic features
growth
neurological exam

Question 14

standard Ix for bilateral hearing loss?

Answer 14

kidney/thyroid
-TORCH serology (rubella, CMV, toxo)
-Connexin 26
-MRI
family audiometry
-ECG
-ophthal r/v

Question 15

what can you miss on a VROA?

Answer 15

unilateral hearing loss

Question 16

unilateral hearing loss risk of?

Answer 16

speech language disorders
social/emo problems
-academic problems (48%)

Question 17

connexion 26 hearing loss is bilateral or unilateral?

Answer 17

bilateral

Question 18

amplification for permanent conductive hearing loss?

Answer 18

bone conductor aids

Question 19

what investigations for permanent conductive hearing loss?

Answer 19

renal U/S

• spine x-ray
• ophthal
• CT petrous bones (>age 5)

Question 20

what investigations for permanent conductive hearing loss?

Answer 20

renal U/S

• spine x-ray
• ophthal
• CT petrous bones (>age 5)

Question 21

if new born screening is normal and you ge these things, may need audiological f/u?

Answer 21

meningitis
major head trauma
mumps and other infections
noise-induced hearing loss

Question 22

consideration of hearing test post bacterial meningitis, when?

Answer 22

early (as soon as well enough/before discharge)

- due to risk of labyrinthitis ossificans, calcified cochlea, rules out possibility of cochlear implant