Hearing Flashcards
What is a normal result in Weber’s test?
Heard equally both sides
May also suggest sensorineural hearing loss affecting both sides equally
What is a positive Rinne’s test?
AC better than BC
SNAC-RIP: in SensoriNeural hearing loss Air Conduction is better- Rinne’s is Positive
What does a Weber’s test that localises to the right ear suggest?
Weber’s localizing- suggests ipsilateral conductive hearing deficit or contralateral sensorineural hearing deficit.
Therefore right conductive deficit or left sensorineural deficit
Which cranial nerves affect hearing?
CN VIII- vestibulocochlear
CN VII- facial. LMN supply to the muscle to stapedius (patients with a facial nerve palsy may complain of hyperacusis)
What tuning fork should you use for Rinne’s and Weber’s test?
512Hz (small one)
What questions should you ask every patient when you assess their hearing?
Do you wear hearing aids?
Have you noticed any change in your hearing?
What is a normal Rinne’s test?
AC better than BC
What does a positive Rinne’s test suggest?
Normal hearing
Sensorineural hearing loss
How would you complete a hearing exam?
Take a full history
Full neurological examination
Otoscopy
Audiometry
What is conductive hearing loss?
Impaired conduction anywhere between the auricle and round window
What are some causes for conductive hearing loss?
Canal obstruction: wax, foreign body
Tympanic membrane perforation: trauma, infection
Ossicle defects: otosclerosis, infection
Fluid in middle ear: OM with effusion (?)
What is sensorineural hearing loss?
Defects of cochlea, cochlear nerve or brain
What are the causes of sensorineural hearing loss?
Congenital:
Alports syndrome
Jewell-Lange-Nielsen syndrome
Acquired: Presbyacusis Iatrogenic: Drugs- gentamicin, vancomycin Infection: Meningitis, measles Tumour: Vestibular schwannoma
What are causes of unilateral sensorineural hearing loss?
Cerebellopontine angle tumour
