ENT - Hearing Loss Flashcards
What can cause hearing loss?
Congenital
- Maternal rubella or CMV during pregnancy
- Genetic deafness, autosomal recessive or dominant
- Associated with Down’s syndrome
Perinatal
- Prematurity
- Hypoxia during or after birth
After birth
- Jaundice
- Meningitis and encephalitis
- Otitis media or glue ear
- Chemotherapy
When is hearing loss first identified?
New-born hearing screening programme
How do hearing difficulties present?
- Parental concerns about hearing
Associated behavioural changes with not being able to hear
- Ignoring calls or sounds
- Frustration or bad behaviour
- Poor speech and language development
- Poor school performance
How is hearing in children under 3 tested?
By looking for basic response to sound e.g. turning towards a sound
What is used to test hearing in older children?
Audiometry, results recorded on an audiogram
What are audiograms?
Charts that document the volume at which different tones can be heard
Frequency on X-axis
Volume on y-axis
Loud at bottom, quiet at the top
What symbols are used to show air and bone conduction in the ears?
X – Left sided air conduction
O – Right sided air conduction
] – Left sided bone conduction
[ – Right sided bone conduction
When a patient has normal hearing where will the readings be between?
0 - 20 dB (at the top of the chart)
In patients with sensorineural hearing loss what does the audiogram look like?
Both air and bone conduction readings more than 20dB
Can affect only one side, or one side more than the other
In patients with conductive hearing loss what does the audiogram look like?
Bone conduction will be normal
Air will be greater than 20dB
Sound conducted through bones well but not by air
In patients with mixed hearing loss what does the audiogram look like?
Both air and bone conduction more than 20dB
Difference of more than 15dB between the two
Bone conduction > air conduction
How is hearing loss managed?
Establish diagnosis
MDT
- Speech and language therapy
- Educational psychology
- ENT specialist
- Hearing aids for children who retain some hearing
- Sign language
