DM- audiology tympanometry Flashcards
provides objective info about middle ear integrity
tympanometry
how tympanometry works
induces pressure change in ear canal & makes graphic representation of acoustic compliance of TM
bell shaped tympanometry means…
normal compliance/middle ear integrity
3 parts of middle ear
malleus
incus
stapes
flat tracing on tympanometry means (3)
no change w/ change in pressure
middle ear fluid w/ small equivalent volume
TM perforation or patent PT tube w/ large equivalent
negative pressure on tympanometry means..
retracted TM
2 newborn screenings
ABR & OAE
formed by synchronous electrical activity of neurons in various parts of the auditory nervous sys; 35dB presentation level
ABR
records evoked potential and waves from low brainstem; pass or refer
ABR
what does it mean if response present result with ABR
r/o significant amount of hearing loss
sound introduced in ear, response generated from cochlear outer hair cells & emission recorded in external auditory canal
OAE
what does the OAE tell you- does it tell you about if there is hearing loss?
NO. it tells how the cochlea is functioning
what happens to babies who refer on ABR or OAE or can’t perform behavioral testing?
they move on to diagnostic OAE or ABR
CONFIRMS function through level of cochlear outer hair cells
diagnostic OAE
ESTIMATES degree of hearing
diagnostic ABR
duration of diagnostic OAE vs diagnostic ABR
diagnostic OAE takes less than 20 mins while the ABR one takes hours
which diagnostic new born hearing thing requires sedation in kids over 3 months old
diagnostic ABR
4 pediatric hearing screening
tympanometry
visual reinforcement audiometry (VRA)
conditioned play audiometry (CPA)
conventional audiometry
pediatric hearing screen for age 10-12months & up
Visual reinforcement audiometry (VRA)
pediatric hearing screen for 2.3-4 yrs of age
conditioned play audiometry (CPA)
which pediatric screening involves kids sitting in lap and turning in direction of sound w/ toy lighting up if they get it right
visual reinforcement audiometry (VRA)
which pediatric screening requires kid to perform action in response to sound but requires flexibility bc of kids short attention span
conditioned play audiometry (CPA)
pediatric hearing screen for 5+ years old/kindergartners
conventional audiometry
one con about the conventional audiometry
its in less than ideal environment
3 adult hearing screens
pure tone audiometry w/ air & bone conduction
word recognition testing
acoustic immittance measures (tympanograms and acoustic reflex threshold)
what is otosclerosis
fixation of the stapes footplate
type of hearing loss with otosclerosis
conductive or mixed
natural hx of otosclerosis
gradual onset and progression– adult onset (middle aged women)
fam hx of hearing loss
which condition can rapidly progress in pregnancy or after labor?
otosclerosis
how is otosclerosis diagnsoed?
audiometric findings, hx, imaging
ear exam is normally normal
tx of otosclerosis
stapedectomy (surgery)
hearing aid
what causes meniere’s dz
malfunction in endolymph volume regulation mechanism in inner ear
endolymphatic pressure increases in sac
menieres involves distinct episodes of.. (4)
aural pressure/fullness
unilateral tinnitus (roaring sound)
prolonged rotational vertigo
low frequency fluctuating sensorineural loss
sx of idiopathic endolymphatic hydrops
several variations of classic sx and can be BILATERAL
cochlear or vestibular hydrops
how to control attacks of idiopathic endolymphatic hydrops (4)
diet– low salt, caffeine, chocolate, alcohol
meds
endolymphatic sac decompression
labryinthectomy
hair cells in cochlea are damaged d/t exposure to excessive noise
noise induced deafness
type of hearing loss with noise induced deafness
sensorineural loss
2 things that result in noise induced deafness
chronic exposure to noise ove 85 dB SPL
acoustic trauma from one exposure to high intensity noise (gun, firecracker)
what frequency is hearing loss often worse with noise induced deafness
4000 hz
tx of noise induced deafness
nothing available but hearing aid may help
what causes sensorineural loss & duration of this kind of loss vs. what causes conductive loss
sensorineural: cochlea or nerves related to it; usually permanent
conductive: middle or external ear pathology
on audiogram graph, what does it mean when x and < line up?
bilateral hearing loss
4 common causes of sensorineural loss
presbycusis
noise
ototoxicity
menieres dz
sudden viral or vascular insult
what causes sudden sensorineural hearing loss
disruption of vascular supply to cochlea via stroke or surgery (can also be viral, MS, autoimmune, unknown)
tx for sudden sensorineural loss?
its emergent
steroids & antivirals ASAP to increase chance of recovery
some hearing loss improves spontaneously
which is more amendable to intervention– sensorineural or conductive loss
conductive
if no medical intervention, what can you do for conductive loss
refer to ENT for possible amplification
audiometric results of both conductive loss & mixed hearing loss
air-bone gap of 15 dB or more
audiometric results of sensorineural loss
bone and ear conduction lines up
common causes of conductive loss (5)
wax impaction
ear drainage
otitis externa/media
ossicular pathology (otosclerosis, congenital, trauma)
cholesteatoma
tx of mixed hearing loss
surgery or amplication
common causes of mixed hearing loss (3)
presbycusis + cerumen
congenital sensorineural + otitis media
otosclerosis + noise exposure
what are the tuning fork tests used for
figure out type of loss
what does it mean if bone > air with rinne test
conductive loss— it will be abnormal in affected ear
unilateral sensorineural vs conductive loss, what side does weber lateralize
sensorineural: unaffected side
conductive: affected side
