Auditory Problems

Question 1

Normal Hearing Range

Answer 1

0-15 dB

Question 2

Profound Deafness

Answer 2

greater than 91 dB

Question 3

Risk factors for hearing loss

Answer 3

Aging population: changes in external, middle, and inner ear. Increased ear wax production that’s harder.

Environmental noise: acoustic trauma, chronic noise induced, noise greater than 85 db (this needs hearing protection)

Ototoxicity: from ASA, some antibiotics like vancomycin, chemotherapy, lasix (furosemide)

• these may damage CN VIII (auditory nerve)
• Sx: tinnitus (buzzing, ringing, roaring - intermittent or pulsatile)

Genetics: most common birth defect in US with 1/1000 newborns and 2-3/1000 have partial hearing loss

Bacterial resistance

Question 4

Conductive Hearing Loss: Definition

Answer 4

anything that disrupts the transmission of sound from the external auditory meatus to the inner ear

Question 5

Conductive Hearing Loss: Common Causes

Answer 5

• cerumen
• foreign body
• TM perforation
• acute or chronic middle ear infections
• growths
• otosclerosis

Question 6

Otosclerosis

Answer 6

most common cause of hearing loss in young adults

hereditary disorder with abnormal bone formation in ear

progressive hearing loss that is bilateral but can be asymmetrical (meaning deafness in one ear is progressing faster than the other)

bone conduction is normal so people may hear ok on phone but have difficulty talking to someone in person

Question 7

Sensorineural Hearing Loss: Definition

Answer 7

caused by disorders that affect the inner ear, auditory nerve, or the auditory pathways of the brain
-CN VIII

sound waves are transmitted to the inner ear but there the ability to receive and interpret the stimuli has been decreased or distorted

Question 8

Sensorineural Hearing Loss: Common Causes

Answer 8

• presbycusis: seen with aging, hair cells of cochlea degenerate, gradual, progressive, bilateral, symmetrical hearing loss (lose high tones first)
• noise induced (most preventable cause of hearing loss)
• meniere’s disease: inner ear disease, sudden severe, cause unknown
• Ototoxicity
• trauma
• infections: viruses, meningitis
• congential
• acoustic neuroma (slow growing benign tumor in inner ear that is observed until removal needed and radiation)
• Vascular insufficiency: nicotine (2x more likely to have hearing loss), HTN, cholesterol

Question 9

Which is more concerning bilateral or unilateral hearing loss?

Answer 9

Unilateral hearing loss

Question 10

Conductive Hearing Loss: Interventions

Answer 10

conductive is usually correctable:

• removal of FB or cerumen
• tympanoplasty: removal and replacement of TM with a metallic prosthesis
• stapedectomy: removal and replacement of stapes with metallic prosthesis (used with otosclerosis)
• PE (pressure equalization) tubes
• atresia reconstruction: absence of external ear canal (congenital)

Question 11

Sensorineural Hearing Loss: Interventions

Answer 11

uncorrectable

• amplification (hearing aides)
• educate about hearing aide care

Question 12

Primary Preventions of Hearing Loss

Answer 12

• avoid Q-tips
• use ear plugs during swimming and diving
• protection from sports injuries
• protect from damage by intermittent or frequent exposure to noise
• MMR vaccine (need at least 2)
• ear protection with noise exposure greater than 85 dB