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Otolaryngology > Hearing loss > Flashcards

Hearing loss Flashcards

1
Q

What are the 3 types of hearing loss?

A
  • Conductive
  • Sensorineural
  • Mixed
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2
Q

What is meant by conductive hearing loss?

A

Hearing loss arising due to a pathology of sound conduction through the tympanic membrane or ossicles

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3
Q

What is meant by sensorineural hearing loss?

A

Hearing loss arising due to a pathology of sound detection in the nerves or middle ear components

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4
Q

What are some causes of conductive hearing loss?

A
  • Otitis externa
  • Acute otitis media
  • Chronic otitis media
    • Otitis media with effusion (Glue ear)
    • Cholesteatoma
    • Perforation
  • Otosclerosis
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5
Q

What is shown?

A

Tympanic membrane perforation

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6
Q

What are some causes of tympanic membrane perforation?

A
  • Acute otitis media (Younger)
  • Trauma (E.g. Barotrauma, insertion of objects into the ear)
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7
Q

How will tympanic membrane perforation present?

A

Sudden severe pain sometimes followed by bleeding from the ear, hearing loss, and tinnitus

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8
Q

What investigations are required in tympanic membrane perforation?

A

Otoscopy
Audiometry

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9
Q

How is tympanic membrane perforation managed?

A

Usually heals spontaneously

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10
Q

When is surgical repair of tympanic membrane perforation indicated?

A

If the patient is symptomatic with recurrent discharge

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11
Q

What is otosclerosis?

A

Hereditary disorder in which new bony deposits occur within the stapes footplate and the cochlear, resulting in gradual onset hearing loss

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12
Q

Who is most at risk of otosclerosis?

A
  • Family history
  • Women (Linked to high oestrogen)
  • Pregnant women (High oestrogen)
  • 2nd - 3rd decade
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13
Q

How will otosclerosis present?

A

Gradual onset hearing loss

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14
Q

How will otosclerosis present on audiometry?

A

Conductive or mixed hearing loss
A classic feature is Carhart’s notch at 2KHz

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15
Q

How is otosclerosis managed?

A
  • Hearing aids
  • Stapedectomy
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16
Q

What are some causes of sensorineural hearing loss?

A
  • Presbycusis
  • Noise-induced hearing loss
  • Drug-induced hearing loss
  • Vestibular schwannoma
  • Meniere’s disease
  • Skull fracture
17
Q

What is presbycusis?

A

Degenerative disorder of the cochear resulting in hearing loss

18
Q

What causes presbycusis?

A
  • Loss of outer hair cells - environmental noise toxicity over time is a major factor
  • Loss of ganglion cells
  • Strial atrophy
19
Q

How does presbycusis present?

A

Gradual onset hearing loss

20
Q

What will audiometry show in presbycusis?

A
  • Higher frequencies affected most
  • Usually sensorineural hearing loss
21
Q

What condition is shown?

A

Presbycusis

22
Q

How is presbycusis managed?

A
  • High-frequency-specific hearing aid
  • Usualy high frequency
  • Highly variable onset
23
Q

How does noise-induced hearing loss occur?

A

Cochlear damage can occur, for example, from shooting without ear protectors or from industrial noise

24
Q

Describe the legal implication of noise-induced hearing loss in the workplace?

A

Employers have legal responsibility regarding protection at work

25
Q

How can noise-induced hearing loss be prevented?

A

Ear protection

26
Q

What will noise-induced hearing loss show on audiometry?

A
  • Sensorineural hearing loss
  • Characteristically has a dip at 4 kHz
  • Classic dip at 4kHz in hearing
  • Preventable with protection
27
Q

What condition is shown?

A

Noise-induced hearing loss

28
Q

What are some drugs that can cause sensorineural hearing loss?

A
  • Gentamicin (+Other aminoglycosides)
  • Chemotherapeutic drugs (E.g. cisplatin, vincristine)
  • Aspirin and NSAIDs (In overdose)
29
Q

What is a vestibular schwannoma (Acoustic neuroma)?

A

Rare, benign tumour of the CN VIII nerve sheath that arises in internal auditory meatus

30
Q

What are some possible associations with vestibular schwannoma?

A

Loud noise exposure
Neurofibromatosis type 2

31
Q

Where do vestibular schwannomas occur?

A

Vestibular portion of CN VIII
Within the temporal bone
95% unilateral

32
Q

Describe the gross appearance of vestibular schwannoma

A

Circumscribed tan/white/yellow mass

33
Q

Describe the histology of vestibular schwannoma?

A

Encapsulated, two growth patterns (Antoni A and Antoni B)

34
Q

How does a vestibular schwannoma present?

A
  • Progressive sensorineural unilateral hearing loss and tinnitus
  • Imbalance in larger tumours
  • Facial numbness can occur due to compression of the trigeminal nerve as the tumour enlarges
35
Q

What investigation is required in vestibular schwannoma?

36
Q

How is vestibular schwannoma managed?

A
  • Monitoring with MRI
  • Surgical excision
37
Q

What are some possible ENT symptoms of skull fracture?

A
  • Hearing loss
  • Facial pasly
  • CSF leak

Otolaryngology (23 decks)

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