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Senior - ENT > 3b - Diseases Of Inner Ear (hearing Loss) > Flashcards

3b - Diseases Of Inner Ear (hearing Loss) Flashcards

1
Q

Hearing refresher?

A

Slide 57

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2
Q

Hearing loss classification

A 
Normal - soft whisper - 0-20dB
Mild - soft spoken voice - 20-40dB
Moderate - normal voice - 40-60dB
Severe - loud voice - 60-80dB
Profound - shout - >80dB
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3
Q

Weber test, hearing loss?

A

Conductive - heard better in affected ear

Sensorineural - heard better in the unaffected ear

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4
Q

4 causes of dysfunction of the external or middle ear?

A

All cause Impairment of passage of sound vibrations

  1. Obstruction (cerumen impaction)
  2. Mass loading (middle ear infection)
  3. Stiffness effect (otosclerosis)
  4. Discontinuity (ossicular disruption)
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5
Q

Transient and persistent causes of CHL?

A

Transient conduction: cerumen impaction or ETD from URI

Persistent conduction: chronic ear infection, trauma, otosclerosis

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6
Q

Tx for conductive hearing loss?

A

Medical:

  • treat infection
  • fix impaction

Surgical:

  • tympanoplasty
  • prosthesis
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7
Q

Sensorineural hearing loss is often?

A

Bilateral

Unilateral suggests lesion proximal to the cochlea (acoustic neuroma)

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8
Q

What makes Sensorineural hearing loss better?

A

Its usually Irreversible

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9
Q

Causes of sensorineural hearing loss?

A 
Presbycusuis (age related)
Noise trauma 
Physical trauma
Ototoxicity
Sudden sensory
Hereditary
Autoimmune
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10
Q

Presbycusis hearing loss affects?

A

High-freq sounds

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11
Q

MC complaint of old people with presbycus?

A

Loss of speech discrimination in noisy environments

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12
Q

2nd MCC of SNHL?

A

Noise trauma - sounds over 85dB injure the cochlea

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13
Q

Progression of noise trauma hearing loss?

A

Begins w high freq (4000 Hz)

Progresses to speech freq

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14
Q

Ototoxicity is MC caused by?

A 
Aminoglycosides
- Neomycin 
- Gentamycin 
Loop diuretics
Antineoplastic agents
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15
Q

Ototoxicity hearing loss is temporary?

A

Nope - Irreversible

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16
Q

Definition of sudden sensory hearing loss?

A

Sudden HL
Unilateral
Typically >20y/o

17
Q

Causes of sudden HL?

A

Not really sure, maybe:

  • Viral infection
  • Vascular occlusion of internal auditory artery
18
Q

Tx for sudden HL?

A

Prompt admin of corticosteroids (PO or intratympanic)

The faster tx the better
- not effective if started after 6 weeks

19
Q

Hereditary hearing loss is associated with?

A
  • Connexin-26 gene mutation (MC)

- Hereditary mitochondrial d/o

20
Q

Age and rate of progression of hereditary HL is predicted by?

A

Family hx

21
Q

Tx for hereditary hearing loss?

A

Gene therapy and stem cell stuff is in the works

22
Q

Autoimmune d/o that are associated w hearing loss?

A

SLE
Granulomatosis w polyangiitis
Cogan syndrome

(Hearing loss, keratitis, aoritis)

23
Q

The only hearing loss that involves lab tests?

A

Autoimmune

24
Q

SNHL tx?

A

Not correctible but:

  • hearing amplificaiton
  • assistive devices (improve comprehension)
  • cochlear implant
25
Q

Tinnitus diagnosis?

A

Perception of abnormal ear or heard noises

  • associated w SNHL
26
Q

Pulsatile tinnitus can be?

A 
Glomus tumor
Venmous sinus stenosis
Carotid vaso-occlusive disease
Arteriovenous malformation
Aneurysm
27
Q

Pulsatile tinnitus needs?

A

MRA

Venography

28
Q

Staccato tinnitus is?

A

Rapid series of popping noises

  • Lasts seconds - minutes
  • middle ear muscle spasm
  • palatal myoclonus - rhythmic involuntary movement of soft palate
29
Q

Tinnitis tx?

A 
Avoid noises that make it worse
Habituation - get over it
Masking - cover w noises
Antidepressant - nortriptyline
Transcranial magnetic stimulation/implantable brain stimulators
30
Q

Hyperacusis is?

A

Excessive sensitivity to sound w normal hearing

31
Q

Causes of hyperacusis?

A

Ear disease
Noise trauma
Migraines
Psych shit

32
Q

Hearing loss eval?

A

Determine

  • nature of HL
  • anatomy impairment
  • etiology
33
Q

Hearing loss history?

A

You can figure it out 79-80

34
Q

Exam of HL?

A 
Auricle 
EAC
TM insufflation
HEENT
Webber and Rinne
Audiologic assessment
Imaging
- CT/MRI
35
Q

Tests that audiology can do?

A

Audiogram:
- Pure-tone air conduction and bone-conduction thresholds

Speech reception threshold

Tympanometry

Acoustic reflexes

36
Q

Normal hearing dB?

A

0-20dB

37
Q

What does tympanometry test?

A

Basically is the ear anatomy normal

  • Eval the TM and middle ear status
  • Mobility of TM
  • Help detect middle ear fluid (if PE is unclear)
38
Q

Tympanogram patterns results?

A 
A: normal
B: fluid or perf
C: ETD
As: ossicular fixation
Ad: ossicular disarticulation

Pic on slide 97

39
Q

Bob suddenly realized his wife had fallen off her horse,

A

Which was a relief to him, as an hour before he though he had gone deaf

Senior - ENT (8 decks)

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