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ENT > Hearing loss > Flashcards

Hearing loss Flashcards

1
Q

What are the two main categories of hearing loss?

A
  • Conductive

- Sensorineural

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2
Q

What is meant by conductive hearing loss?

A

Problem with sound travelling from the environment to the inner ear

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3
Q

What is meant by sensorineural hearing loss?

A

Problem with sensory system/vestibulocochlear nerve in the inner ear

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4
Q

Give some examples of causes of sensorineural hearing loss

A
  • Presbycusis (age-related)
  • Sudden sensorineural hearing loss (SSNHL)
  • Meniere’s disease
  • Labyrinthitis
  • Acoustic neuroma
  • Neurological conditions, e.g. stroke, MS
  • CNS infections, e.g. meningitis
  • Medications, e.g. loop diuretics, gentamicin
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5
Q

Give some examples of causes of conductive hearing loss

A
  • Ear wax (or something else blocking the canal)
  • Infection (e.g., otitis media or otitis externa)
  • Fluid in the middle ear (effusion)
  • Eustachian tube dysfunction
  • Perforated tympanic membrane
  • Otosclerosis
  • Cholesteatoma
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6
Q

Presbycusis is defined as…

A

Age-related hearing loss

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7
Q

Describe the presentation of prescbycusis

A
  • Gradual and symmetrical hearing loss

- Loss of high pitched sounds first

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8
Q

Patients with presbycusis are at increased risk of developing…

A

Dementia

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9
Q

Describe the investigation of presbycusis

A

Audiometry

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10
Q

Describe the management of presbycusis

A
  • Hearing aid

- Cochlear implant (in patients where hearing aids are not sufficient)

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11
Q

Sudden sensorineural hearing loss is defined as…

A

Hearing loss over less than 72 hours, and no conductive cause can be found

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12
Q

In SSNHL is the presentation commonly unilateral or bilateral?

A

Unilateral

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13
Q

What is the most common cause of SSNHL

A

90% of cases are idiopathic

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14
Q

Describe the investigation of SSNHL

A

Audiometry

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15
Q

What are the diagnostic requirements on audiometry to make a diagnosis of SSNHL?

A

Loss of at least 30 decibels in three consecutive frequencies

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16
Q

Describe the management of SSNHL

A
  • Otological emergency, therefore immediate referral to ENT is required
  • If underlying cause is found then this is treated, e.g. CNS infection
  • Idiopathic SSNHL is treated with steroids (oral or intra-tympanic)
17
Q

What are the main functions of the Eustachian tube?

A

To equalise pressure and drain fluid form the middle ear

18
Q

Describe the presentation of ETD

A
  • Reduced/altered hearing
  • Sensation of fullness/discomfort in the ear
  • Tinnitus
19
Q

Describe the investigation of ETD

A
  • Tympanometry
  • Audiometry
  • Nasopharyngoscopy (using an endoscopic camera to visualise the ET)
20
Q

ETD may be related to…

A
  • Viral URTI
  • Allergies (e.g. hayfever)
  • Smoking
21
Q

Describe the management of ETD

A

Conservative:

  • No treatment (wait for it to resolve spontaneously, e.g. recovering from a viral URTI)
  • Valsalva manoeuvre

Pharmacological:

  • Antihistamines
  • Steroid nasal spray
  • Decongestant nasal spray

Interventional:

  • Grommets
  • Balloon dilatation Eustachian tuboplasty
22
Q

What is otosclerosis?

A

A condition where there is abnormal remodelling of the small bones in the middle ear (mainly affecting the stapes) leading to conductive hearing loss

23
Q

Otosclerosis usually occurs at what age?

A

Before the age of 40 years

24
Q

What causes otosclerosis?

A

Combination of environmental and genetic factors

25
Q

Otosclerosis can be inherited in what kind of pattern?

A

Autosomal dominant

26
Q

Does otosclerosis tend to affect the hearing of lower-pitched or higher-pitched sounds?

A

Lower-pitched sounds are affected more

27
Q

Describe the management of otosclerosis

A

Conservative:
- Hearing aids

Interventional:
- Surgery (stapedectomy or stapedotomy)

28
Q

What is a cholesteatoma?

A

An abnormal collection of squamous epithelial cells in the middle ear which invade local tissues/nerves and erode the ossicles, leading to conductive hearing loss

29
Q

Cholesteatoma can predispose the patient to…

A

Significant infections

30
Q

Describe the clinical features of a cholesteatoma

A
  • Unilateral conductive hearing loss

- Foul smelling discharge from the ear

31
Q

Which investigation is used to confirm the diagnosis of cholesteatoma?

A

CT head

32
Q

Describe the management of a cholesteatoma

A

Surgical removal

ENT (10 decks)

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