Deafness

Question 1

congenital causes central

Answer 1

hyperbilirubinaemia/kernicterus; hypoxia

Question 2

congenital causes conductive

Answer 2

abnormalities of pinna, external ear canal, drum ossicles; cholesteatoma

Question 3

congenital causes sensorineural

Answer 3

genetic- Alports, Turners; infections- CMV, syphilis, HIV; ototoxic drugs

Question 4

perinatal and postnatal causes

Answer 4

anoxia, birth trauma, cerebral palsy, kernicterus, meningitis, ototoxic drugs, lead, skull fracture

Question 5

what is the hearing test for new borns

Answer 5

universal newborn hearing screening- otoacoustic emissions, ABR (audiological brainstem response)

Question 6

management childhood deafness

Answer 6

hearing aids, cochlear implants

Question 7

how can you prevent post implant meningitis after cochlear implant

Answer 7

pneumococcal vaccine 2 weeks before cochlear implant

Question 8

what age can you use pure tone audiogram to test the childs hearing

Answer 8

5 years

Question 9

what type of hearing air can be used to augment bone conduction

Answer 9

BAHA- bone anchored hearing aid

Question 10

where is the anatomy for conductive hearing loss

Answer 10

pinna to oval window, foot of the stapes

Question 11

where is the anatomy for sensorineural hearing loss

Answer 11

oval window to auditory cortex

Question 12

causes of conductive loss in adults

Answer 12

external canal obstruction- wax, pus, debris, FB; drum perf- trauma, barotrauma, infection; ossicular chain- otosclerosis, infection, trauma

Question 13

causes of sensorineural loss in adults

Answer 13

ototoxic drugs, post infective (meningitis, measles, mumps, flu, herpes); Menieres, trauma

Question 14

management deafness in adults

Answer 14

hearing aid, cochlear implant, surgery

Question 15

what drugs are ototoxic

Answer 15

vancomycin, gentamicin, streptomycin, chloroquine, hydroxychloroquine

Question 16

rare causes deafness in adults

Answer 16

acoustic neuroma, B12 def, MS, carcinoma in brain

Question 17

how is sensorineural sudden deafness defined

Answer 17

> 30db loss in 3 pure tone, over

Question 18

how often is cause found in sensorineural sudden deafness

Answer 18

10% of the time

Question 19

how often is a cause found in conductive sudden deafness

Answer 19

all the time- occlusion infection trauma fracture

Question 20

what is otosclerosis

Answer 20

replacement normal bone with vascular spongy bone. autosomal dominant, FHx in 50% cases.

Question 21

symptoms otosclerosis

Answer 21

conductive hearing loss. appears early adult life, worse in pregnancy, menstruation, menopause. can get tinnitus, vertigo

Question 22

signs otosclerosis

Answer 22

10% have Schwartzs- pink tinge to the drum. Caharts notch on audiogram- dip at 2kHz

Question 23

treatment otosclerosis

Answer 23

fluoride. hearing aid or surgery, cochlear implant

Question 24

what is presbyacusis

Answer 24

age related hearing loss from accumulated environmental noise toxicity

Question 25

what do you lose in presbyacusis

Answer 25

loss of high frequency sounds starts before 30years, deafness is gradual and often don’t notice for a while. hearing aids

Question 26

what should you think of in sensrineural unilateral deafness

Answer 26

acoustic neuroma

Question 27

what is an acoustic neuroma

Answer 27

benign tumour. behave as SOL

Question 28

symptoms acoustic neuroma

Answer 28

ipsilateral tinnitus and sensorineural hearing loss. giddiness common, vertigo rare

Question 29

cranial nerves at risk in acoustic neuroma

Answer 29

V, VI,VII

Question 30

tests in acoustic neuroma

Answer 30

MRI- in all with unilateral deafness/tinnitus

Question 31

DDX acoustic neuroma

Answer 31

meningioma