Hearing Loss Flashcards
types of hearing loss
conductive sensorineural mixed central
pathology behind conductive hearing loss
something stopping sound waves from reaching inner ear
pathology behind sensorineural hearing loss
problem with cochlear/ auditory nerve
pathology behind central hearing loss
problem within brain e.g. stroke
important tests for hearing loss
Rinne + Weber Test Pure tone audiometry (PTA)
what tuning fork is used in Rinne + Webers test
512 Hz
how is Rinne’s test performed
place tuning fork on patients mastoid process and ask them to say when they can no longer hear it move tuning fork outside of auditory canal and ask if they can still hear it
In a Rinne’s test, if patient can no longer hear the sound when moved from mastoid process to in front of the ear what type of hearing loss do they have?
conductive hearing loss - bone conduction is greater than air conduction
In a Rinne’s test, if patient can hear sound when moved from mastoid process to in front of the ear what type of hearing loss do they have?
NONE- normal result
how is Webbers test performed
place tuning fork in middle of patients forehead ask which side the sound is heard loudest
in Webbers test, patient hears sound loudest in the unaffected ear - what type of hearing loss do they have?
unilateral sensorineural hearing loss
in Webbers test, patient hears sound loudest in the affected ear - what type of hearing loss do they have?
unilateral conductive hearing loss
Webbers test result indicating - conductive hearing loss - sensorineural hearing loss
conductive = sound loudest in affected side sensorineural = sound loudest in unaffected side
causes of conductive hearing loss
unilateral: - glue ear - cholesteatoma - otitis media / otitis externa bilateral: - otosclerosis
what is otosclerosis? what age does it present?
gradual onset bilateral conductive hearing loss + tinnitus - fixation of stapes - onset 20-40 years
inheritance of otosclerosis
autosomal dominant
what can exacerbate otosclerosis
pregnancy
what is typically seen on an audiogram of otosclerosis
Carharts Notch - drop in bone conduction at 2000 Hz
tx of otosclerosis
conservative: hearing aids surgical: replacement of stapes with stapedectomy or stapedotomy
causes of sensorineural hearing loss
unilateral: - Meniere’s Disease - Acoustic Neuroma bilateral: - Presbycusis - Noise induced - Drugs - Congenital
what drugs can cause sensorineural hearing loss
gentamicin furosemide aspirin
congenital causes of sensorineural hearing loss
CMV Rubella Alport syndrome (sensorineural hearing loss + glomerulonephritis)
what is presbycusis
age related bilateral sensorineural hearing loss
treatment of presbycusis
hearing aids
presentation of Meniere’s disease
recurrent episodes of vertigo, tinnitus, sensorineural hearing loss fullness/pressure in ears
drug given during attack of Meniere’s
buccal / IM prochlorperazine
drug used to prevent attacks of Meniere’s
betahistine
what is a cholesteatoma
non-cancerous growth of keratinised squamous epithelium that causes local destruction
symptoms of cholesteatoma
foul smelling ear discharge conductive hearing loss vertigo / facial nerve palsy if invasion has occurred
tx of cholesteatoma
surgical removal
what is an acoustic neuroma
tumour of vestibulochochlear (CN VIII) nerve sheath
symptoms of an acoustic neuroma
unilateral sensorineural hearing loss vertigo tinnitus
what reflex is lost in an acoustic neuroma
corneal reflex
imaging for suspected acoustic neuroma
MRI cerebellopontine angle
bilateral acoustic neuromas are seen in which genetic condition
NF 2
on an audiogram, what level of hearing is normal?
>20 dB

on an audiogram what do these symbols mean:
- X
- O
- Triangle
- [
- ]
- red line, blue line
X = air conduction left ear
O = air conduction right ear
Triangle = bone conduction
[ = bone conduction right ear
] = bone conduction left ear
red = right ear
blue = left ear
what type of hearing loss does this audiogram show

conductive hearing loss
- gap between air + bone conduction
- air conduction reduced
- bone conduction normal
what type of hearing loss does this audiogram show

sensorineural hearing loss
what type of hearing loss does this audiogram show

mixed hearing loss
- gap between bone + air – conductive
- bone below normal levels – sensorineural
== mixed hearing loss
what does this audiogram show

otosclerosis
- Carharts notch at 2000 Hz