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ENT > Hearing Loss > Flashcards

Hearing Loss Flashcards

1
Q

.Describe the 6 steps from sound entering the ear to when it reaches the brain.

A
  1. The auricle catches incoming sound waves and funnels them into the external auditory canal
  2. Sound waves vibrate the TM, causing motion of the ossicles resulting in the piston-like action of the stapes
  3. Piston motion pushes inner ear fluid around in the cochlea
  4. Frequency-specific movement sets up fluid waves in the cochlea which sets motion of the Organ of Corti
  5. Organ of Corti movement bends the stereocilia, depolarizing the action of auditory message traveling through hair cells via the auditory nerve to the brain
  6. The brain organizes the information
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2
Q

Classification of hearing loss: 3 types

A
  1. Sensorineural
  2. Conductive
  3. Mixed
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3
Q

Describe the following types of hearing loss:

  1. Sensorineural
  2. Conductive
  3. Mixed
A
  1. Involving the inner ear, cochlea, or auditory nerve
  2. Any cause that limits external sound into the inner ear
  3. Combo of sensorineural and conductive
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4
Q

What are the outer ear causes of earing loss? 5

A
  1. Congenital
  2. Infection
  3. Trauma
  4. Tumor (malignant)
  5. Benign growths
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5
Q

Describe the disease processes that are most associated with the following causes of hearing loss:

  1. Congenital
  2. Infection
  3. Trauma
  4. Tumor (malignant)
  5. Benign growths
A
  1. Microtia: absence or malformation of auricle
  2. Otitis externa: inflammation of the EAC, or debri
  3. Penetrating trauma to EAC
  4. Most common malignant tumor of EAC is squamous cell carcinoma
  5. Most common are exostosis and osteoma
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6
Q

What is this?

A

exostosis

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7
Q

Systemic diseases associated with outer ear hearing loss?

3

A
  1. DM
  2. Immunocomprimised states
  3. Cerumen impaction (using Qtips)
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8
Q

Middle ear causes of hearing loss?

7

A
  1. Congenital
  2. Eustachian tube dysfunction
  3. Infection
  4. Tumors
  5. Otosclerosis
  6. Tympanic membrane perforation
  7. Barotrauma
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9
Q

What is this a picture of?

A

CHOLESTEATOMA

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10
Q

Describe the following disease processes that are associated with the following causes of middle ear hearing loss:

  1. Congenital
  2. Eustachian tube dysfunction
  3. Infection
  4. Tumors
  5. Otosclerosis
A
  1. Malformation or fixation of the ossicles
  2. Viral upper resp. tract infection or sinusitis, and allergies
  3. Otitis media
  4. Cholesteatoma
  5. Bony overgrowth of the footplate of the stapes.
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11
Q

Inner ear hearing loss causes?

7

A
  1. Congenital (non-hereditary and hereditary)
  2. Presbycusis
  3. Infection
  4. Meniere disease
  5. Trauma
  6. Tumors
  7. Ototoxic substances
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12
Q

What is the nonhereditary congenital inner ear hearing loss due to?

2

A
  1. Insult to developing cochlea
  2. Viral infections: CMV, hepatitis, rubella, toxoplasmosis, HIV and syphilis
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13
Q
  1. What is the hereditary congenital inner ear hearing loss due to?
  2. What is the most common type?
A
  1. 90% autosomal recessive (sensorineural)
  2. Most common is Mondini
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14
Q

What is the most common cause of hearing loss world wide?

A

Presbycusis

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15
Q
  1. What is the most common cause of inner hearing loss due to infection in adults?
  2. Children?
  3. Whats the most common tumor cause of sensorineural hearing loss?
  4. What kind of trauma would cause inner ear hearing loss?
A
  1. Most common in adults is viral cochleitis
  2. Most common in young children is meningitis
  3. Most common tumor cause sensorineural hearing loss is acoustic neuroma
  4. skull fracture
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16
Q

What is this an MRI of?

A
17
Q

What are the antibiotics that cause ototoxicity? 3

What is the chemo drug that mostly causes otoxicity? 1

A

Antibiotics

  1. Aminoglycosides
  2. Erythromycin
  3. Tetracycline

Chemo

  1. cisplatin
18
Q

Hearing loss symptoms may include?

3

A
  1. Unilateral/bilateral hearing deficit
  2. Difficulty understanding speech, conversations, TV/Radio
  3. Social withdrawal
19
Q

What is an abnormal Rinne test?

A

Abnormal results occur when sound is at least equally loud or louder when the fork is placed on bone as compared to when held near the ear (BC>AC)

Normal test is when the vibrating fork placed near the ear is louder than when placed on the mastoid (AC>BC)

20
Q

In patients complaining of unilateral decrease in hearing, Weber test suggest sensorineural if what?

A

sound lateralizes to the “good” side, conductive is suspected if sound lateralizes to “bad” side

21
Q

Abnormal Rinne test when what BC>AC is consistent with conductive, particularly if Weber test also shows what?

A

lateralizes to that side

22
Q

When Weber lateralizes to ear which Rinne is normal, Rinne test in opposite ear should be performed. A normal Rinne test in contralateral ear suggests what?

A

sensorineural in this contralateral ear (Weber lateralized to the normal ear)

23
Q

Describe the four combinations of of the Weber and Rinne tests that could occur and what they mean?

A

see picture

24
Q

What does a nonmobile TM on pneumoscopy suggest? 2

A
  1. Fluid or mass in middle ear cavity
  2. Stiff or sclerotic TM
25
Q

What does hypermobile TM indicate?

A

Ossicular chain disruption

26
Q

What decibal levels are:

  1. Faint?
  2. Moderate?
  3. Loud?
  4. Very loud?
  5. Extremely loud?
  6. Painful acoustic trauma?
A

See picture

27
Q

Name the following treatment for the types of hearing loss: Conductive

  1. Congential? 2
  2. Infections?
  3. Trauma?
  4. Otosclerosis? 2
A

Conductive

  1. Congenital
    - Surgery if possible
    - Bone conduction hearing aid
  2. Infections
    - Antibiotics
  3. Trauma
    - Surgery if possible
  4. Otosclerosis
    - Surgery to replace immobile stapes with mobile prosthesis
    - Hearing aid
28
Q

What is the treatment for the following sensorineural hearing losses:

  1. Trauma?
  2. Viral origin?
  3. Menieres disease? 3
  4. Tumors?
  5. Irreversible? 2
A
  1. Trauma (Acoustic trauma)
    - Corticosteroids
  2. Viral origin
    - Corticosteroids
  3. Menieres disease
    - Low-sodium diet
    - Diruetics
    - Corticosteroids
  4. Tumors
    - Surgery or radiation
  5. Irreversable
    - Hearing aids
    - Cochlear implant
29
Q

Describe how a cochlear implant works:

5 steps

A

See picture

ENT (8 decks)

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