Hearing Loss

Question 1

What are the causes of conductive hearing loss?

Answer 1

Wax

Otosclerosis - bilateral

Otitis media

Glue ear

Infection

Question 2

How should conductive hearing loss be treated?

Answer 2

Remove wax with warm water/olive oil

Treat infection

Question 3

What are the causes of sensorineural hearing loss?

Answer 3

Environmental noise toxicity

Presbycusis

Congenital

Gentamicin

Mumps

Acoustic neuroma - unilateral

Multiple sclerosis

Stroke

Vasculitis

Question 4

How is sensorineural hearing loss managed?

Answer 4

Hearing aid

Cochlear implant

Question 5

Explain the rinne and webers test

Answer 5

Question 6

What is otosclerosis?

Answer 6

Autosomal dominant, replacement of normal bone by vascular spongy bone. Onset is usually at 20-40 years - features include:

• conductive deafness
• tinnitus
• tympanic membrane - 10% of patients may have a ‘flamingo tinge’, caused by hyperaemia
• positive family history

Question 7

What is presbycusis?

Answer 7

Presbycusis describes age-related sensorineural hearing loss. Patients may describe difficulty following conversations

Audiometry shows bilateral high-frequency hearing loss

Question 8

Which drugs can cause ototoxicity?

Answer 8

Aminoglycosides - gentamicin

Aspirin

Loop diuretic - furosemide

Many cytotoxic agents

Question 9

What is acoustic neuroma?

Answer 9

Also called vestibular schwannoma

Features can be predicted by the affected cranial nerves

cranial nerve VIII: hearing loss, vertigo, tinnitus

cranial nerve V: absent corneal reflex

cranial nerve VII: facial palsy

Bilateral acoustic neuromas are seen in neurofibromatosis type 2

Question 11

What is exostosis?

Answer 11

Exostosis is caused by repeated exposure to cold water and wind which causes a benign bony growth in the external auditory canal, this is a form of conductive hearing loss.