Hearing Loss

Question 1

What is the difference between sensorineural and conductive hearing loss?

Answer 1

sensorineural involves the inner ear, cochlea, or auditory nerve

Conductive = any cause that limits external sound into the inner ear.

Question 2

Outer ear causes of hearing loss?

• congenital
• infecction
• trauma
• tumor
• systemic dz
• cerumen

Answer 2

Congenital:
-Microtia; absence of malformation of auricle

Infection: otitis externa

Trauma: penetrating trauma to EAC

Tumor: MC tumor of EAC is squamous cell carcinoma, benign growths such as exostosis and osteoma

systemic dz: DM or other immunocompromised state

cerumen: Q tips

Question 3

Middle ear causes of hearing loss

• congenital
• ET dysfunction
• infection
• tumors
• otosclerosis
• trauma

Answer 3

congenital: malformation or fixation of ossicles

ET: viral upper resp tract infection or sinusitis and allergies

Infection: otitis media

Tumor: cholesteatoma

Otosclerosis: bony overgrowth of the footplate of the stapes.

Trauma: TM perforation or barotrauma

Question 4

Inner ear causes of hearing loss

• congenital
• presbycusis
• infection
• meniere dz
• trauma
• tumor ototoxic substances

Answer 4

congenital: nonhereditary= insult to developing cochlea, viral infection CMV, hepatitis, rubella, toxoplasmosis, HIV, and syphilis
hereditary: autosomal recessive (Mondini)

Presybycusis: MC cause of hearing loss WORLDWIDE!!!

Infection: MC in adults is viral cochleitis, MC in children is meningitis

Meniere dz

Trauma: skull fx

Tumors: acoustic neuroma

Ototoxic substance: abx = aminoglycosides, erythromycin, tetracycline. & chemo = cisplatin

Question 5

Sx of hearing loss?

Answer 5

• unilateral/bilateral hearing deficit
• difficulty understanding speech, conversations, TV/Radio
• social withdrawl

Question 6

Conductive Hearing Loss tx:

• congenital
• infection
• trauma
• otosclerosis

Answer 6

Congenital: surgery if possible, bone conduction hearing aid

Infection: abx

Trauma: surgery

Otosclerosis: surgery to replace immobile stapes with mobile prosthesis or hearing aid

Question 7

Sensorineural hearing loss Tx:

• trauma
• viral
• menieres
• tumors
• irreversable

Answer 7

Trauma: corticosteroids

Viral: corticosteroids

Menieres dz: low Na diet, diuretics, corticosteroids

Tumors: surgery or radiation

Irreversible: hearing aids, cochlear implants