hearing loss Flashcards
what are two types of hearing loss ?
conductive hearing loss
sensorineural hearing loss
what are the causes of conductive hearing loss ?
wax
foreign body
accute otitis media
otitis media with effusion
cholesteatoma
otosclerrosis
what are the causes of sensorineural hearing loss ?
congenital causes:
pendred syndrome ( goitre plus hearing loss)
long QT syndrome
Bjornstad syndrome ( abnormal hair)
End-organ:
advanced aging
occupational acoustic trauma
meniere’s disease
ototoxic drugs
nerve lesions:
acoustic neuroma
cranial trauma
inflammatory lesions:
labrynthitis
sarcoidosis
Tuberculous meningitis
neurosyphilis
Carcinomatous meningitis
brainstem lesions:
Multiple Sclerosis
Infarction
what is the treatment for wax causing hearing loss ?
suction and earwash
what is the difference between traumatic and mucosal chronic perforation ?
traumatic - irregular, thin edges, minimal blood, history of trauma, normal middle ear mucosa
mucosal chronic - oval/circular in shape, thick fibrotic edges, with or without discharge
what is the management for perforation that occured due to trauma ?
nothing healing should occur on its own
what is the management for perforation that occured due to chronic mucosal ?
Myringoplasty
what type of curve shows up in tympanometry in cases of acute otitis media with effusion ?
flat type B curve
what are the signs of cholesteatoma ?
retraction pocket
keratin debris
adjacent bony erosions
granulations
TM will be intact if it is a congenital cholesteatoma
purulent foul discharge
what are the signs of otosclerosis ?
the stapes is unable to move - no vibration
schwartz sign - reddish tinge is observed on the tympanic membrane
on pure tone audiogram - carhart notch - depression in the bone conduction specifically at 2kHz
what is presbycussis ?
SNHL that happens due to old age
what is the presentation of presbycusis ?
bilateral gradual onset
may be associated with tinnitus
normal ear examination
what is the presentation of NIHL ?
history of exposure to loudd noises
often associated with tinnitus
normal otoscopy
what is diagnostic about NIHL on pure tone audiogram ?
characteristic SNHL patter at 4kHz
what is labrynthitis ?
inflammation of thee inner ear due to a virus or bacteria
what is the presentation of labrynthitis?
vertigo
nausea and vomiting
nystagmus
SNHL
what is the presentation of meniere’s disease ?
feeling of aural fullness before thee attack of vertigo
usually rotatory vertigo
fluctuating SNHL
nausea and vomiting
tinnitus
what is the presentation of an acoustic neuroma ?
sudden onset of unilateral hearing loss ( can be bilateral)
very poor speeech discrimination
normal otoscopy
how can an acoustic neuroma be diagnosed ?
through an MRI
where is thee location of an acoustic neuroma ?
cerebellopontine angle
what is the immediate treatment for sudden sensorineural hearing loss ?
steroids
vasodilators
how do hearing aids work ?
through the amplification of surrounding sound
what is the difference between cochlear implants and auditory brainstem implants ?
implants in cochlea
implants in brainstem
what type of patients would need an auditory brainstem implant ?
in patients who need to bypass the auditory nerve such as cases of congenital cochlear nerve aplasia
what is the most common cause of hearing loss ?
ear wax
which drugs are ototoxic ?
gentamicin
furosemide
what is the presentation of sudden sensorineural hearing loss ?
sudden unilateral SNHL
may be associated with vertigo or tinnitus
what is the diagnostic investigation for sudden sensorineural hearing loss ?
pure tone audiogram
what is the other name for acoustic neuroma ?
vestibular schwannoma
