Hearing loss Flashcards
commonest causes?
ear wax
otitis media and externa
what is presbycusis
age related SNHL
audiometry of presbycusis?
bilateral high frequency HL
what is otosclerosis?
replacement of normal bone by vascular spongy bone
features of otosclerosis
1) Conductive/ SNHL
2) other symptom
3) 10% of pts have what on otoscopy
1) conductive
2) tinnitus
3) ‘flamingo tinge’ TM (hyperaemia)
commonest cause of conductive HL and elective surgery in childhood?
glue ear: otitis media with effusion
peak at 2 y/o
pts with glue ear may present with secondary problems such as what?
speeh developmental abonrmality
Meniere’s disease
1) more common at what age
2) features?
3) O/E?
4) duration of symptoms?
1) middle aged
2) VERTIGO, tinnitus, SNHL, aural fullness
3) nystagmus, positive Rombergs test
4) minutes- hours
ototoxic drugs?
Aminoglycosides (gentamicin)
Loop diuretics
NSAIDs
noise damage hearing loss is typically UNI/ BI -lateral and worse at frequencies of _____Hz
bilateral
3000-6000
Vestibular schwannoma (aka acoustic neuroma)
Symptoms?
CNV: loss of corneal reflex
VNVII:
CNVIII: HL, tinnitus, vertigo
B/L acoustic neuromas are seen in what hereditary condition?
NFT2
what is otosclerosis?
replacement of normal bone by vascular spongy bone
Otosclerosis
1) pattern of inheritance
2) age
3) otoscopy findings
4) Rx
1) AD
2) 20-40
3) nil (flamingo tinge TM in 10%)
4) hearing aid, stapedectomy
type of SNHL that affects the elderly
Presbycusis
Presbycusis typically progresses slowly, as sensory hair cells and neurons in the ____ atrophy over time
cochlea
T/F: Presbycusis is distinct from noise-related hearing loss
true (although accumulated noise exposure is a risk factor for Presbycusis)
patients with Presbycusis can, uncommonly, present with hyperacusis- what is this?
heightened sensitivity to certain frequencies of sound
Ix in Presbycusis
1) otoscopy
2) tympanometry
3) audiometry
4) blood inc inflammatory markers
1) normal
2) normal middle ear function with hearing loss
3) bilateral high-freq HL
4) normal
Sudden onset SN hearing loss? (SSNHL)
1) Rx
2) Ix?
3) main cause?
1) urgent referral to ENT + high dose oral corticosteroids
2) MRI (exclude vestibular schwannoma)
3) idiopathic
how is suitability for cochlear implant determined in adults?
trialled with appropriate hearing aids for at least 3 months with little to no benefit
Contraindications for consideration for cochlear implant?
Lesion of CNVIII or in the brainstem causing deafness
Chronic infective otitis media, mastoid cavity or TM perforation
Cochlear aplasia
impacted ear wax is v common and may cause of variety of symptoms including….
pain
HL
vertigo
tinnitus
main treatment in primary care for impacted ear wax?
ear drops (olive oil, sodium bicarbonate 5%, almond oil) irrigation (syringing)
