Hearing Impairment Lecture Powerpoint

Question 1

By age 65-84, almost __% of adults with have a degree of hearing loss

Answer 1

50%

Question 2

Important history questions regarding hearing loss (5)

Answer 2

• Gradual or sudden onset
• low or high frequency
• unilateral or bilateral
• situational?
• conductive or sensorineural

Question 3

Components of outer, middle, and inner ear

Answer 3

Outer: auricle and external auditory canal
Middle: tympanic membrane, ossicles, middle ear space
Inner: cochlea, semicircular canals, vestibulocochlear nerve

Question 4

Cerumen impactation (what type of hearing loss is it?)

Answer 4

Natural product of external auditory canal composed of secretions and sloughed epithelial cells and hair that is the most common ENT procedure performed in primary care, conductive hear loss

Question 5

Microtia, Anotia

Answer 5

Congenital malformation of pinna, complete absence of pinna

Question 6

Atresia

Answer 6

Absence or closure of the external auditory canal sometimes seen alongside microtia/anotia

Question 7

Otittis externa and treatment options (3)

Answer 7

Infection caused by local trauma and bacteria also known as swimmers ear, treated with proper cleaning, topical agents, or oral antibiotic

Question 8

Most common malignant tumor of the external auditory canal

Answer 8

Squamous cell carcinoma

Question 9

Exostosis

Answer 9

Multiple benign bony growths of the external auditory canal arising from compact bone commonly in individuals exposed to repeated cold water (surfer’s ear) can be removed surgically if too large

Question 10

Osteoma

Answer 10

Solitary benign bony growth commonly attached to the tympanosquamous suture line that arises from cancellous bone and can be removed surgically if too large

Question 11

The external and middle ears see ___ hearing loss, while the inner tends to be ____

Answer 11

conductive, sensorineural

Question 12

Congenital malformation of the ossicular chain

Answer 12

Diagnosed by CT with most often the stapes being abnormal and often requiring surgery

Question 13

Treacher collin’s syndrome (TCS), Robin sequence, Crouzon syndrome

Answer 13

• TCS is a genetic disorder characterized by deformities of eyes, ears, mouth, cheekbones, and chin that may result in complications
• Pierre Robin sequence is a condition where an infant has a smaller than normal jaw with the tongue often falling back into the throat creating difficulty breathing often alongside cleft palate that can be treated surgically
• Crouzon syndrome is a genetic disorder characterized by the premature fusion of certain skull bones (craniosynostosis). This early fusion prevents the skull from growing normally and affects the shape of the head and face sometimes needing surgery to treat
• All often see microtia, anotia, atresia, or congenital malformation of the ossicular chain

Question 14

Most common cause of conductive hearing loss in children and how is it generally treated?

Answer 14

Otitis media (fluid filling middle ear space preventing tympanic membrane from vibrating adequately, treated via oral antibiotics

Question 15

Otosclerosis and how is it treated (2)

Answer 15

Bony overgrowth causing benign conductive hearing loss that involves the footplate of the stapes, overgrowth causes it to stop rocking back and forth eventually becoming totally fixated, treated with hearing amplification or surgical replacement with prosthesis

Question 16

Jugulotympanic paragangliomas (glomus tumor) and how is it treated (2)

Answer 16

Highly vascular benign conductive middle ear tumors that spontaneously hemorrhage or cause paralysis of CN IX, X, and XI, treated with surgical resection or radiation therapy

Question 17

Middle ear barotrauma mechanism of action (ascent and descent)

Answer 17

A sudden large change in ambient pressure often from flying or diving where middle ear pressure increases during ascent until eustachian tube forced open or by descent ambient pressure exceeding middle ear pressure until swallowing forces open eustachian tube, equalization prevented by mucosal edema resulting in symptoms including sensation of pressure/rupture

Question 18

Nonhereditary congenital sensorineural inner ear hearing loss that occurs shortly after birth is typically ___ in origin, while hereditary is typically ____

Answer 18

infectious, genetic

Question 19

Presbycusis and treatments (2)

Answer 19

Age related hearing loss leading to progressive symmetric loss of high frequency hearing caused by loss of inner ear sensory structure hair cells, can cause tinnitius, noise exposure affects degree caused by metabolic overload due to overstimulation and is treated by hearing aids or cochlear implants

Question 20

OSHA regulations require monitoring employees exposed to noise at or above ___ dB avg over __ hours of work

Answer 20

85, 8

Question 21

Hearing conservation protocol hierarchy of most to least efficient

Answer 21

• Eliminate
• Substitute
• engineering controls
• administrative controls
• PPE

Question 22

Most common inner ear infection in adults

Answer 22

Viral cochleitis

Question 23

Viral cochleitis symptoms (3) and treatment (1)

Answer 23

Sudden hearing loss, vertigo, facial paralysis, or pain, treated with oral steroids

Question 24

Most common inner ear infection in children

Answer 24

Meningitis

Question 25

Meniere disease

Answer 25

Episodic vertigo and hearing loss that lasts for hours, fullness, and tinnitus, hearing loss is usually low frequency but can progress and is usually unilateral

Question 26

Meniere disease treatment options (3)

Answer 26

Diet/lifestyle, pharmacotherapy/diuretic therapy, surgery

Question 27

Acoustic neuroma

Answer 27

Most common benign tumor that originates from the vestibular portion of the 8th cranial nerve presenting with unilateral or asymmetrical hearing loss, tinnitus, dizziness, headaches, and disequilibrium

Question 28

Ototoxic inner ear sensorineural affecting antibiotics (5)

Answer 28

• Oral aminoglycosides
• Erythromycin
• Tetracycline
• High dose ASA
• Chemotherapeutic agents