HEARING LOSS Flashcards
What are the causes of conductive hearing loss?
External ear:
Congenital atresia (microtia)
Wax
Foreign body
Otitis externa
Tympanic membrane and middle ear:
Tympanic perforation
Otitis media
Eustachian tube blocking (nasopharyngeal tumour, allergic rhinitis)
Fixation of ossicles (fusion of ear bones)
Otosclerosis
What are the causes of sensorineural hearing loss?
Congenital causes:
Premature birth
Neonatal jaundice
Intrauterine infection
Traumatic or noise induced
Toxic - gentamicin, loop diuretics, aspirin, cytotoxics
Autoimmune hearing loss (AIED)
Cerebellopontine angle tumours - Vestibular schwannoma
Sudden onset hearing loss - herpes simplex
Menieres disease
Presbycusis (age related hearing loss)
What are the causes of acute onset hearing loss?
Otitis externa
Otitis media with effusion (glue ear)
Toxic causes
Traumatic causes
Infective causes
Vestibular schwannomas
What are the causes of more insidious onset hearing loss?
Presbycusis (age related hearing loss)
Noise induced hearing loss
Tumours
What are the causes of fluctuating hearing loss?
Middle ear effusions
Ménière’s disease
Is more copious ear discharge more associated with external ear infections or middle ear infections?
Middle ear infections
What conditions might ear discharge indicate?
Otitis externa or media
Perforated tympanic membrane
Cholesteatoma
What factors of birth and pregnancy can lead to congenital deafness?
Prematurity
Low birth weight
Neonatal jaundice
Rubella infection
What is the autosomal dominant inherited form of conductive hearing loss?
Otosclerosis
What are the medications that can cause hearing loss?
Loop diuretics
Gentamicin
Aspirin
Anti-neoplastic agents
Quinines
What are the two types of hearing loss?
Conductive hearing loss
Sensorineural hearing loss
What does Rinne’s test look for?
Conductive hearing loss
What are the two possible results from Rinne’s test?
Positive - normal - the tuning fork is still heard next to the ear when it is no longer heard when placed on the mastoid.
Negative - abnormal - the tuning fork is heard best when placed on the mastoid process.
What does Weber’s test look for?
Hearing loss - both conductive and sensorineural
It must be used in conjunction with Rinne’s test to work out which it is.
On examination of a patient with hearing loss, they have a negative result in the left ear during Rinne’s test and when Weber’s test is performed the sound lateralizes to the left. What is the likely nature of the hearing loss?
Conductive loss in the left