adult hearing stuff Flashcards
most common type of age-related sensorineural hearing loss is…
presbycusis- gradual degeneration within the cochlea that accompanies aging
external auditory canal
collects sound waves for middle ear
middle ear
transfers sound waves for inner ear
inner ear
converts vibrations into electrical impulses. these impulses are then processed by the brain
hearing exams
-finger rub tests
-whispered voice tests
-weber and rinne testing
rinne test
vibrating tuning fork is held next to the ear and the pt reports when he or she can no longer hear the sound. the still vibrating fork is then placed on the mastoid process behind the ear.
Results of rinne test
normal: AC> BC
sensorineural: AC> BC
conductive hearing loss: BC> AC
weber test
placing a vibrating running fork at the middle of the forehead
weber test results
normal: midline
sensorineural: normal ear
conductive: affected ear
conductive hearing loss
-external ear (outer): cerumen impaction, otitis externa, foreign body
-middle ear: cholesteatoma, otitis media, Eustachian tube dysfunction
sensorineural hearing loss
issues related to the cochlea-> inner ear
-affected by genetics, age, vascular changes, environmental factors (noise exposure), ototoxic exposures
-need to consider autoimmune conditions, tumor or neoplasms, infections, stroke
tinnitus
perception of hearing a sound when there is no sound in environment
tinnitus s/s
**may be described as buzzing, rising, hissing, whistling
**important clues:
-high pitched continuous tinnitus often associated with sensorineural hearing loss: associated noise with the associated hearing loss
-low pitched tinnitus: may be associated idiopathic tinnitus or Meniere disease
-pulsating or rushing tinnitus: may be associated with vascular cause
-clicking: may be associated with TMJ dysfunction
eval of tinnitus
full ear exam
assess TMJ
auscultate for bruits
complete neuro exam
review of meds
management of tinnitus
referral for audiogram
refer to ENT or neurology depending on suspected cause
address insomnia associated w/ tinnitus
cerumen impaction
occurs when increased amounts of hard cerumen either partially or completely occlude the external ear canal
risk factors for cerumen impaction
use of q-tips, ear plugs, hearing aides, ear buds
diagnosis of cerumen impaction
(1) when patient has symptoms
(2) you are unable to assess the ear as a result of cerumen
s/s of cerumen impaction
may complain of:
fullness
hearing loss
ear pain
ear discomfort
tinnitus
vertigo or dizziness
management of cerumen impaction
prior to considering removal, ask about hx of tympanostomy tube, surgery or ruptured TM–> contraindication to irrigation
removal can be done with:
-curette
-with carmbamide peroxide drops x3-5 days
-irrigation
patient education
-clean external ear only
-avoid ear swabs/small objects into ear
-may use debris drops 1-2x per week
-individuals who use hearing aides are at increased risk for cerumen impaction
cholesteatoma
collection of skin cells in middle ear or mastoid into benign tumor
could be congenital or acquired
can cause erosion and hearing loss
cholesteatoma: primary or secondary acquired
primary acquired: most commonly due to Eustachian tube dysfuntion
secondary acquired: can occur after TM perforation
s/s of cholesteatoma
may present with malodorous drainage, hearing loss, tinnitus, vertigo
