Conductive Hearing Loss

Question 1

Ear wax:
How can it present?

How is it managed?

Answer 1

➊ HL, discomfort, ear fullness, tinnitus

➋ Avoid cotton buds, Ear drops (Olive oil or Sodium Bicarb) to soften ear wax, Ear irrigation if drops didn’t work

Question 2

Eustachian Tube Dysfunction:
How does it present?

What is characteristic about the symptoms here?

How is it managed?

Answer 2

➊ HL, popping noise/sensation in ear, ear fullness, discomfort

➋ Symptoms tend to get worse when the outside pressure gets too high e.g. flying, scuba diving

➌ Conservative as recovery occurs once viral URTI clears, Valsalva manoeuvre (holding and blowing nose to open up the tube), Grommet insertion

Question 3

Tympanic membrane perforation:
What can cause this?

Answer 3

Effusion (Barotrauma), Acute trauma (head injury, cotton bud) or Barotrauma (scuba diving, explosive noise)

Question 4

What are 3 other causes?

What occurs in Otosclerosis?
→ How does it present?
→ What does there tend to be in the hx?

Answer 4

➊ • Infection i.e. Otitis media with effusion
• Cholesteatoma
• Otosclerosis

➋ Remodelling of ossicles in the middle ear (mainly affects base of the stapes) – Stiffens it and prevents sound transmitting as effectively
→ Lower pitch HL that improves with background noise, Tinnitus
→ Family hx of hearing loss