Hearing Loss Flashcards
Two categories of hearing loss
Conductive and sensorineural
What is conductive hearing loss
Relates to a problem with the sound travelling from the environment to the inner ear
What is sensorineural hearing loss
Problem with the sensory system or vestibulocochlear nerve in the inner ear
Associated symptoms to enquire about
Tinnitus, vertigo, pain, discharge, neurological problems
What do Weber’s and Rhinnes test do
Differentiate between conductive and sensorineural hearing loss
What will Weber’s test find
In sensorineural hearing loss is present then the sound will be louder in the normal ear. In conductive hearing loss the sound will be louder in the affected ear
What will Rhinne’s test find
Normal result is when air conduction is hear better than bone conduction.
Abnormal result is when bone conduction is better and indicates conductive hearing loss
Causes of sensorineural hearing loss
Sudden hearing loss (<72 hours)
Presbycusis (age)
Noise exposure
Menieres disease
Labyrinthitis
Acoustic neuroma
Neurological conditions - MS, stroke, tumours
Infections - meningitis
Medications
Common medication causes of sensorineural hearing loss
Loop diuretics
Aminoglycoside Abx
Chemotherapy drugs
Causes of conductive hearing loss
Ear wax
Infection
Fluid in middle ear
Eustachian tube dysfunction
Perforated tympanic membrane
Otosclerosis
Cholesteatoma
Exostoses
Tumours
What is sudden sensorineural hearing loss (SSNHL)
Sudden loss of hearing over less than 72 hours,unexplained by other causes
Causes of SSNHL
90% idiopathic
Infection, Menieres, ototoxic medication, MS, migraine, stroke, acoustic neuroma, Cogan’s syndrome
Investigations into SSNHL
Audiometry - loss of at least 30 decibels in three consecutive frequencies.
Management of SSNHL
Immediate referral to ENT for assessment within 24 hours.
Treat underlying cause
Management of idiopathic SSNHL
May be treated with steroids under the guidance of the ENT, can be oral or intra-tympanic
