Deafness Flashcards
______ is defined as impairment of hearing,
regardless of its severity
Deafness
Fifty per cent of people
over ______ years have deafness severe enough to be
helped by a hearing aid.
80
The threshold of normal hearing is from ________ about the loudness of a soft whisper
0 to 20 decibels (dB),
Degrees of hearing impairment with vocal equivalent: 2, 3 — mild = \_\_\_\_\_\_\_ — moderate = \_\_\_\_\_\_\_\_\_ — severe = \_\_\_\_\_\_\_ — profound = loss of over 90 dB (shout
loss of 20–40 dB (soft-spoken voice)
loss of 40–60 dB (normal-spoken voice)
loss of 70–90 dB (loud spoken voice)
________ is caused by an
abnormality in the pathway conducting sound waves from the outer ear to the inner ear, as far as the
footplate of the stapes
Conductive hearing loss
__________is a defect
central to the oval window involving the cochlea
(sensor), cochlear nerve (neural) or, more rarely,
central neural pathways
Sensorineural hearing loss (SNHL)
The commonest acquired causes of deafness are 1 2 3
impacted cerumen (wax), serous otitis media and otitis externa
People with mild hearing loss notice only subtle
differences and may have trouble hearing certain
high-frequency sounds, such as______
‘s’, ‘f’ or ‘th
Hair-rubbing method to assess hearing loss
If this sound
cannot be heard, a________ loss is likely
(usually about 40 dB or greater).
moderate hearing
Audiometric assessment includes the following:
1
2
3
4
- pure tone audiometry
- impedance tympanometry
- electric response audiometry
- oto-acoustic emission testing
_______is a graph of frequency expressed
in hertz versus loudness expressed in decibels. The
tone is presented either through the ear canal (a test
of the conduction and the cochlear function of the ear)
or through the bone (a test of cochlear function
Pure tone audiometry
_______ measures the mobility of the tympanic
membrane, the dynamics of the ossicular chain and
the middle-ear air cushion
Tympanometry
How is tympanometry done?
The test consists of a sound
applied at the external auditory meatus, otherwise
sealed by the soft probe tip.
Deafness may be associated with what syndromes?
Deafness may be associated with Down syndrome
and Waardenburg syndrome.
________,
which is dominantly inherited, is diagnosed in a
patient with a white forelock of hair and different
coloured eyes
Waardenburg syndrome
_____ and ______ are common causes of
temporary conductive deafness
Purulent otitis media
and secretory otitis media
Permanent deafness in the first few years of life may be due to 1 2 3
virus infections, such as mumps or
meningitis, ototoxic antibiotics and several other
causes.
The aim of screening should be to recognise every
deaf child by the age of 8 months to 1 year—before
______
the vital time for learning speech is wasted
When are the optimal times to perform hearing screening
- 8 to 9 months (or earlier)
* school entry
The average age at which
these deaf children were diagnosed was _____
26 months
Hearing milestones
_______ Should notice sudden constant sounds
(e.g. car motor, vacuum cleaner) by pausing and listening.
_______ Should respond to loud noise (e.g. will stop
crying when hands are clapped).
_______Should turn head to look for source of
sound, such as mother speaking behind
the child
1 month
3 months
4 months
Hearing milestones
______ Should turn instantly to voices or even to
quiet noises made across the room.
_______ Should listen out for familiar everyday
sounds.
_______Should show some response to familiar
words and commands, including his or
her name.
7 months
10 months
12 months
_________is essential to exclude middleear
effusions
Pneumatic otoscopy
_________ is unreliable in children
under 4 years of age, so special techniques such as
tympanometry are required
Pure tone audiometry
All children with
SNHL (even those with profound deafness), as well
as children with conductive losses not correctable by
surgery, benefit from ________
amplification
T or F, There appears to be a genetic predisposition
to presbyacusis
T
Features of Presbycusis 1 2 3 4
- loss of high-frequency sounds
- usually associated with tinnitus
- intolerance to very loud sounds
- difficulty picking up high-frequency consonants
________ is a disease of the bone surrounding the
inner ear and is the most common cause of conductive
hearing loss in the adult with a normal tympanic
membrane.
Otosclerosis
Pathology of otosclerosis
The normal middle ear bone is replaced
by vascular, spongy bone that becomes sclerotic
Otosclerosis
affects the ______ of the stapes
may progress rapidly during _____
begins in_______ frequencies, then progresses
footplate
pregnancy
lower
Otosclerosis
• impedance audiometry shows characteristic
features of ___ and ______
• may be associated with ____
conductive loss with a mild sensorineural loss
Ménière syndrome
A ______ is a sac of keratinising squamous
epithelium that arises from a perforation involving
the periphery of the TM
cholesteatoma
Cx of cholesteatoma
destroy adjacent structures, including the TM, ossicular chain and cochlear.
______ occurs in about 5% of the normal
population but is more prevalent in older people
especially with the use of hearing aids
Ear wax impaction
The average wax
production is ______mg/week. Most ear wax clears
spontaneously without treatment.
2.81
Examples of cerumenolytic drops
— carbamide peroxide (Ear Clear) — docusate sodium (Waxsol) — hydrogen peroxide — sodium bicarbonate — oil based (e.g. olive oil, almond oil)
Sounds exceeding _____ are potentially injurious
to the cochlea, especially with prolonged exposures.
85 dB
__________ is defined as a sound perceived by the
ear that arises from an internal source
Tinnitus
When
pathology in the inner ear is the cause, the tinnitus
is _______
non-pulsating, continuous and may have variable
frequencies and intensity.
_______ are most useful in conductive deafness.
This is due to the relative lack of distortion, making
amplification simple
Hearing aids
Modern aids selectively amplify ________
and ‘cut out’ excessive volume peaks that would cause
discomfort
higher frequencies
The _________is used in adults
and children with severe hearing loss unresponsive
to powerful hearing aids
cochlear implant or ‘bionic ear’
T or F
Near normal speech and
hearing may be achieved in children with congenital
or acquired deafness with early implantation
T
Cochlear implants
The device is most suitable for children over_______s and
adults with severe deafness.
2 year
Red flags for priority referral
- Asymmetrical sensorineural hearing loss
- Cranial nerve defects
- Ear canal or middle-ear mass
- Deep ear pain
- Discharging ear
Suspect deafness in an infant with
1
2
3
delayed
development and in children with speech defects or
behavioural problems
Sounds tend to be softer in a ______
loss and distorted with ____
conductive hearing
sensorineural loss
