Hearing Flashcards
Four negative outcomes associated with subjective hearing loss
- Social isolation
- Cognitive impairment
- Mood disorders (depression, anxiety)
- Comorbidities (physical health)
3 age related changes that predispose to hearing loss
- Loss of cochlear hair cells (high freq deficit)
- Loss of stria vascularis (low freq deficit)
- Impaired spiral ganglion cells in vestibulocochlear nerve (mixed deficit)
Hearing loss accounts for what percentage of dementia cases?
8%
What is presbycusis? What are 3 components of this?
Bilateral symmetric sensorineural hearing loss
1. Reduced ability to understand speech
2. Impaired localization of sounds
3. Slowed central processing of acoustic information
4 types of age related hearing changes
- Difficulty locating sound
- Difficulty differentiating sounds from background noise
- May have associated tinnitus, vertigo or disequilibrium
- High frequency HL progressive to low frequency
Strategies to improve communication with pt with hearing loss
- Face to face
- Don’t have mouth covered
- Well lit room
- Speak clearly and slowly
- Turn off competing sounds
- Sound amplifier
- Confirm message received
- Have listener repeat message
What to do if HA not working?
- Check that it’s on
- Check battery level
- Blockage of ear mold
- Cerumen impaction
- Volume setting
- Physical fit
- Repeat hearing assessment
Bedside screening tests for hearing
- Whisper test
- Finger rub test
- Watch tick test
- Hand held audiometer
- Ask if they have any difficulty hearing
- Administer questionnaire ex. HHIE
CCCDTD-5 Guidelines for hearing
- Person with cognitive complaint ask if any difficulty hearing
- If report HL, confirm by audiometry
- Risk reduction: audio exam, review meds for ototoxicity, refer to ENT if chronic OM/fail otoscope
Examples of ototoxins
- Lasix
- Thiazide diuretics
- NSAID (ASA)
- Chemo
- Aminoglycosides
Management options for HL
- Amplification device like Pocket Talker
- Hearing aid
- Cochlear implant - very severe and HA no longer works
- Auditory rehab
Conductive HL findings
AC abnormal
BC normal
Gap >=15 dB
Sensorineural HL findings
AC abnormal
BC abnormal
Gap <= 15 dB
