Hearing Loss

Question 1

What are the types of hearing loss?

Answer 1

Conductive =due to obstruction/damage to outer/middle ear

Sensorineural = cochlea/neural pathway abnormalities

Question 2

What are common causes of conductive hearing loss?

Answer 2

• Impacted wax
• OM/OE
• Tympanic membrane perofation
• Ostoclerosis
• Cholesteatoma

Question 3

Rinne’s tes was postive means what?

Answer 3

Normal. Air should be louder than bone - if can’t hear once when testing air then confu

Question 4

What is the normal hearing range on audiometry?

Adults and children

Answer 4

20-25dB in adults

15dB in children

Question 5

What is presbyacousis?

Answer 5

• Age related sensorineural hearing loss

* Audiometry show bilateral high frequency hearing loss

Question 6

What is ostoscleorsis?

Answer 6

• Autosomal dominant so strone FHx
• Onset 20-40years
• Ossicles harden and ticken

Question 7

Unilateral sensorineural hearing loss is what until proven otherwise?

Answer 7

Acoustic neuroma

Question 8

Explain the steps in Rinne’s test and the results meaning:

Answer 8

1. Place tuning fork firmly on the mastoid process
2. Confirm the patient can hear the sound of the tuning fork and then ask them to tell you when they can no longer hear it.
3. When the patient can no longer hear the sound, move the tuning fork in front of the external auditory meatus to test air conduction
4. Ask the patient if they can now hear the sound again. If they can hear the sound, it suggests air conduction is better than bone conduction, which is what would be expected in a healthy individual (this is often confusingly referred to as a “Rinne’s positive” result).

Question 9

Explain the steps in Webber’s test:

What do the results mean

Answer 9

1. Tap tuning fork and place in the midline of the forehead
2. Ask the patient “Where do you hear the sound?”

Results:
Normal: sound is heard equally in both ears.

Sensorineural deafness: sound is heard louder on the side of the intact ear.

Conductive deafness: sound is heard louder on the side of the affected ear.

Question 10

What results of rinnes test would be expected in sensorineural and conductive deafness?

Answer 10

Sensorineural deafness: air conduction > bone conduction (Rinne’s positive) – due to both air and bone conduction being reduced equally

Conductive deafness: bone conduction > air conduction (Rinne’s negative)