Hearing Loss Flashcards
How do we diagnose hearing loss?
Screenings
Patient report (History)
Family Report
Physical exam finding or discussion
When do we screen for hearing loss?
Birth Kindergarten (round-up) Early childhood Pre-employment Military
Why is hearing screening important at each of these stages?
Birth: Delayed development if child can’t hear
Beginning school: So they can hear the teacher
Occupations: Depends on what you are doing
How do we screen for hearing loss in infants?
Otoacoustic emissions
Auditory brainstem responses
What frequency region is important for speech recognition?
500-4000 Hz
Otoacoustic emission screening is very similar to what nautical technology?
Sonar
How is auditory brainstem response testing used to screen for hearing loss?
Electrodes on the scalp record electrical activity in the brain
What do you do if a baby does not pass a hearing screening?
Obtain full hearing evaluations, ASAP, no later than 3 months of age
How do you train a baby who has an abnormal hearing screening?
Visual reinforcement audiometry: used between 6 months and 2 years of age. Trained to look toward sound and receives reward for doing so
What do you use to further evaluate hearing loss in children ages 2-5 years?
Conditioned play audiometry: Trained to perform an activity when a sound is heard
How do you screen for hearing loss in older children and adults?
Scratch testing
Tuning fork
Whisper testing
Using headphones, testing at 20 and 40 dB at 2000, 4000, 6000 Hz
What do you do if hearing screening in older babies or children is abnormal?
Obtain a full hearing assessment (pure-tone audiogram)
When should children who are at risk for acquired, progressive or delayed onset hearing loss have repeat hearing tests?
By age 2 1/2
What is the pure tone audiogram used for?
Determines the faintest tones in dB a person can hear at selected frequencies
What are the limitations of PTA?
Subjective to patient behaviors
LImited to children and adults old enough and willing to cooperate with testing
What is the big advantage of a PTA test?
It is more difficult to feign
What are the three categories of hearing loss?
Conductive
Sensorineural
Mixed
What is conductive hearing loss?
Inefficient conduction of sound through the outer ear canal to the middle ear
How can you correct conductive hearing loss?
Medically or surgically
What are common causes of conductive hearing loss?
Middle ear effusion Otitis media Severe otitis externa Eustachian tube dysfunction Perforation of TM Benign tumors Cerumen impaction Foreign body Congenital malformation Trauma
What is sensorineural hearing loss?
Damage to the inner ear (cochlea) or the nerve pathways from the inner ear to the brain.
How can you correct sensorineural hearing loss?
Most commonly permanent, not easily medically surgically corrected
What are common causes of sensorineural loss?
Illnesses Ototoxic medications Genetic or hereditary losses Aging (presbycusis) Head trauma Loud noise exposure (acute and chronic)
What is mixed hearing loss?
Combination of conductive and sensorineural hearing loss
