ear disease and hearing loss

Question 1

consequences of hearing loss

Answer 1

• speech and language
• social isolation
• self esteem
• work force

Question 2

history

Answer 2

• age
• severity
• duration
• onset
• precipitating factors
• associated symptoms e.g. tinnitus, vertigo

Question 3

investigations

Answer 3

• audiogram
• otoacoustic emissions
• Auditory brainstem response (ABR)
• CT, MRI
• bloods
• ENG, electrocochleography
• genetic testing

Question 4

examination

Answer 4

• clinical test of hearing (whisper)
• tuning fork testing (weber and Rinne tests)
• otoscopy
• neurological examination: cranial nerves, special tests

Question 5

causes of conductive hearing loss

Answer 5

• inflammation e.g. otitis medias
• metabolic e.g. arthritis
• congenital e.g. ossicles
• tumour
• trauma

ear canal
congenital e.g. stenosis
acquired e.g. stenosis, exostoses

Question 6

describe weber test

Answer 6

place tuning fork on forehead.
CONDUCTIVE disorder – bad ear is louder.
SENSORINEURAL disorder – good ear is louder.

Question 7

describe rinnes test

Answer 7

place tuning fork on mastoid process, then by ear.
CONDUCTIVE disorder – mastoid is louder. SENSORINEURAL disorder – no difference between the two

normal (air>bone)
- when placed over the ear is should sound louder than when placed on the mastoid process

Question 8

describe sensorineural causes of hearing loss

Answer 8

congenital

• hereditary
• acquired e.g. medications, birth trauma

acquired
 - noise induced
 - ototoxicity
 - temporal bone trauma
 - infection
etc