Ears Flashcards
Cranial nerves for ear, nose, and throat (7)
1: Olfactory
5: Facial sensation
7: Facial movement, tears, taste, acoustic reflex
8: Hearing and Equilibrium Taste
9: Taste
10: Taste, swallowing
12: Tongue movements
Conductive Hearing Loss
refers to impairment of the outer and/or middle ear conductive mechanism only; caused by something blocking in the ear (wax)
Sensory hearing loss
refers to damage to the cochlea (outer hair cells or outer and inner hair cells).
Mixed hearing loss
Refers to the presence of both conductive and sensory
impairment.
Neural hearing loss
Refers to damage to the auditory neurons (spiral ganglia) and/or the auditory branch of the eighth nerve.
*Auditory Neuropathy and dysynchrony are examples of neural hearing loss.
Central hearing loss
Refers to damage to auditory structures in the brainstem, thalamo-cortex and/or cortex.
Newborn hearing loss
- Otoacoustic emission (like a tympanogram listens for action potential of the cochlea (ear talk) and that is what it picks up—picks up cochlea function
- BAER more accurate (assesses wiring of auditory pathway—misses low and high frequency loss)
- Brain stem evoked response is the diagnostic test
Otoacoustic emissions
Introduce sounds and see how baby responds
Auditory brainstem testing: more involved; baby must be asleep as sounds are introduced;
looks for the brain to show that the baby is hearing the sound
Types of hearing loss (3)
- Conductive
- Sensori-neural
- Auditory Processing (Central)
Early hearing loss
- First trimester structure of ear highly metabolic and therefore exposure to metabolic and highly susceptible to illness and exposure to medication in the mother
- - Maternal rubella
- - Cytomegalovirus
- - Genetic disorders leading to malformation of the cochlea
- - Sepsis with prolonged acidosis
- - Oxygen deprivation and hyperbilirubinemia
Anatomic Hearing Loss (4)
1 Meningitis
- Congenital hypothyroidism
- Medications—Lasix, aminoglycosides, vancomycin
- Large Cochlear Aqueduct syndrome
Large Cochlear Aqueduct Syndrome (4)
- Onset of hearing loss 6 to 7 months with progressive worsening
* Child passes newborn hearing but then develops progressive hearing loss around 6-7 months - Balance is off, progressive loss
- Tends to stabilize at 50 decibels
- They need to not play football
Reasons for Hearing Loss (5)
- Wax
- Foreign objects
- Deafness due to hyperbilirubinemia, CMV
- - Cranial facial, tags ! Genetic Syndromes - Genetic Syndromes
- Medications
Genetic Syndromes leading to hearing loss
- Waardenburg syndrome
- Deafness associated with long QT syndrome - Jervell Syndrome
- Lange Nielsen syndrome “ Ion channelopathies
- Progressive hearing loss
– 80% are recessive
– Rest are autosomal dominant
– 3% carrier rate (same of CF). Mild to moderate
hearing loss
Looking at history with hearing loss (4)
- Looking at hearing loss early on; wear a hearing aide if they are younger than 60 year
- History of renal abnormalities (8 weeks in utero develop at the same time)
*Ears andkidneys are formed at the same time in utero; if someone has a kidney anomaly
you must also check their hearing (and vice versa) - Alport’s syndrome; associated with hearing loss and hematuria
- Genetic mediation for hearing loss in old age
Hearing Loss (3)
- Can progress throughout childhood
- Both high- and low-frequency progressive hearing loss represent a wide diversity of gene mutations that are observed in a large number of syndromic and non-syndromic diseases
- Human KCNQ4 mutations known as DFNA2 cause non-syndromic, autosomal- dominant, progressive high-frequency hearing loss in which the cellular and molecular basis is unclear
Newborn hearing screening
Repeated on follow up center
-Goal: Early intervention by age 6 months
Genetic hearing loss screening (4)
- Syndromic— 1/3 of family members
- Non syndromic 2/3—mitochondrial defect
- Hereditary hearing loss may not be congenital
- Is it stable or progressive?
Conductive hearing loss causes (5)
- Eustachian tube dysfunction
- Ear fluid
- Hole in eardrum
* Hole in eardrum can occur from trauma; do tympanal plasty to fix tympanic membrane - Fixed middle ear bone
- Wax
Sensorineural hearing loss (4)
- Noise induced hearing loss
- Presbycusis
- Ménière’s Disease
- Tumors of the auditory nerve
**If hearing loss becomes preogressive, make sure there is no acoustic neuroma (tumor that can cause hearing loss)