Hearing Impairment

Question 1

What are the types of hearing impairment?

Answer 1

• Conductive: any cause that in some way limits the amount of external sound that gains access to the inner ear
• Sensorineural: involves inner ear, cochlea, or auditory nerve
• Mixed
• Central: involving higher brain centres or auditory dyssynchrony

Question 2

List some possible causes of conductive hearing loss

Answer 2

Congenital anomalies, infection, TM perforation or tumours in middle ear

Question 3

List some possible causes of sensori-neural hearing loss

Answer 3

• Non-hereditary: intrauterine infection, medications or teratogenic toxins
• Hereditary: may be syndromic or non-syndromic
• Acquired: prematurity, infection, hyperbilirubinaemia, ototoxins, noise, trauma, tumours

Question 4

What are the possible implications of hearing impairment?

Answer 4

In developmental period: delays in speech, language, cognitive development

Question 5

What questions might you ask on a hearing impairment history?

Answer 5

• Conditions associated with hearing loss(e.g. congenital infection, prematurity, hyperbilirubinaemia, meningitis, recurrent otitis media, exposure to ototoxic drugs, noise, or barotrauma, kidney disease, cardiac dysrhythmia, or decreased visual acuity)
• FHx of hearing loss
• Onset and progression of hearing loss
• Associated Sx (pain, drainage from ear, tinnitus, vertigo, disequilibrium)
• Hx of previous ear surgery

Question 6

What are some mx options for hearing impairment?

Answer 6

• Treat underlying cause (e.g. grommets for recurrent OM with effusion)
• Referral for hearing aids at Australian Hearing - aim is to have hearing aid use established by 6 months of age
• Early intervention programme
• Ophthalmology referral
• Referral for genetic counselling
• Application for Centrelink benefits