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OTO > HL > Flashcards

HL Flashcards

1
Q

Two types of hearing loss?

A

Conductive and Sensoineural

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2
Q

Conductive HL is a dysfx of?

A

Middle/external ear

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3
Q

Sensoineural HL is a dysfx of?

A

Deterioration of cochlea

Lesions on CN VIII

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4
Q

What tests help differ Conductive and Sensoineural HL?

A

Weber and Rinne tuning fork tests

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5
Q

What does Weber test evaluate?

A

Lateralization

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6
Q

Weber test w/ sound lateralizing as louder on affected side has?

A

CHL

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7
Q

Weber test w/ sound lateralizing as louder in better/NL ear has?

A

SNHL

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8
Q

CHL - weber test result

A

sound will lateralize and be perceived as louder on the affected side

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9
Q

SNHL - weber test result

A

sound will be perceived as louder in the better or NL hearing ear

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10
Q

CHL in the right ear will have a Weber test of?

A

Heard better in Right ear

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11
Q

SNHL in the right ear will have a weber test of?

A

Heard better in Left ear

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12
Q

What does Rinne test evaluate?

A

Air vs Bone conduction

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13
Q

NL Rinne test is?

A

AC > BC

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14
Q

CHL Rinne test result?

A

Sound is heard through bone longer than air

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15
Q

SNHL Rinne test result?

A

Sound hear longer through air than bone

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16
Q

What are the 4 main causes of CHL? (all impairment of passage)

A

(MCC of CHL) -Obstruction (i.e. cerumen impaction)

  • Mass loading (i.e. middle ear effusion)
  • Stiffness effect (i.e. otosclerosis)
  • Discontinuity (i.e. ossicular disruption)
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17
Q

CHL TXT?

A

Medical: treat infections, impaction
Surgical: tympanoplasty or prosthesis

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18
Q

Transient CHL is usually due to?

A

Cerumen impaction or ETD due to URI

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19
Q

Persistent CHL is usually due to?

A

Chronic ear infection
Trauma
Otosclerosis

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20
Q

Differences between sensory/neural HL?

A

Sensory HL - cochlea deterioration

Neural HL - involves lesions of CN 8

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21
Q

SNHL causes

A

Noise/physical trauma
Presbycusis
Ototoxicity
Autoimmune HL

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22
Q

Unilateral or asymmetric SNHL suggests?

A

Lesion Proximal to cochlea (acoustic neuroma)

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23
Q

Are cochlea diseases reversible?

A

No

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24
Q

MC cause of SNHL?

A

Presbycusis - age related

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25
Q

Presbycusis Affects what range of hearing?

A

High freq and symmetric

  • Bird chirping
  • Telephone ringing
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26
Q

Is Presbycusis unilateral?

A

No - bilateral

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27
Q

MC complaint of Presbycusis

A

Loss of speech discrimination

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28
Q

2nd MC cause of SNHL

A

Noise trauma

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29
Q

Noise trauma def

A

> 85dB injury to cochlea

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30
Q

Noise trauma HL begins w/ what freq?

A 
High freq (esp. 4000 Hz)
- progresses to speech
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31
Q

Otoxicity affects what inner ear system?

A

Auditory and vestibular

32
Q

MC Otoxic Rx?

A

aminoglycosides
loop diuretics
antineoplastic agents

33
Q

Otoxic therapeutic doses may cause what

A

Irreversible HL

34
Q

Reduce otoxicity risks by?

A

Serial audiometry
Monitor Rx levels
Substitute non-otoxic Rx

35
Q

(top) ototoxic Rx?

A

Ear drops

  • neomycin
  • gentamicin
36
Q

What must be avoided w/ topical ototoxic Rx?

A

Avoid placing in ear w/ TM perf

37
Q

Sudden sensory HL is?

A

Unilateral HL in >20yo

38
Q

TXT of Sudden sensory HL?

A

Prompt (po) CCS/audiogram
Intratympanic admin
Not effective >6w

39
Q

Autoimmune HL is ass/w what D/O?

A

SLE
granulomatosis
Polyangiitis
Cogan syndrome

40
Q

Cogan syndrome triad?

A

HL
keratitis
Aortitis

41
Q

What labs may be elevated w/ Autoimmune HL?

A

Ana
Rheum factor
ESR

42
Q

TXT of Autoimmune HL

A

1st-L - (po) CCS prednisone

2nd-L - (po) cytotoxics methotrexate

43
Q

SNHL Txt -

A 
Not correctable 
Hearing aids (cochlear implant)
44
Q

Tinnitus essentials of Dx

A

ABNL ear or head noises

45
Q

Persistent Tinnitus often indicates?

A

SNHL

46
Q

Intermittent Tinnitus often is?

A

Normal

47
Q

Dx Tinnitus

  • non-pulsatile
  • unilateral
  • pusaltile
A
  • non-pulsatile - audiogram R/O HL
  • unilateral w/ HL no cause (noise trauma) MRI
  • pusaltile - Magnetic resonance angiography and venography
48
Q

Pusatile Tinnitus is described as?

A

ABNL - Listening to own heartbeat

49
Q

Pusatile Tinnitus May be due to

A 
CHL or
Serious 
- glomus tumor
- venous sinus stenosis
- carotid occlusion
- AV malform
- aneurysm
50
Q

Staccato tinnitus is?

A

Rapid series Clicking/popping lasting seconds to mins w/ fluttering feeling in ear

51
Q

Staccato tinnitus is due to?

A

Middle ear spasm

Palatal myoclonus - (rhythmic involuntary movement of soft palate.)

52
Q

Tinnitus TXT

A 
Avoidance - noise, Rx
Habituation techniques
-masking/retraining therapy
Antidepressants 
-nortriptyline
53
Q

Hyperacusis is

A

Excessive sensitivity to sound w/ normal hearing.

54
Q

Hyperacusis Causes?

A

Ear disease
Noise trauma
Migraine susceptible
Psych

55
Q

TXT of Hyperacusis?

A

Earplugs in noisy environments

56
Q

Eval HL points

A 
Type HL
Degree/severity of HL
Config (audiogram)
Anatomy
Etiology
57
Q

Unilateral serous effusions in adult req?

A

Prompt fiberoptic exam of nasopharynx for neoplasms

58
Q

CN V and VII dysfx May indicate?

A

Tumors involving cerebropontine angle

59
Q

Every patient w/ HL (except due to impaction/OM) should be referred where?

A

Audiologic exam

60
Q

Augiograms are measured between?

A

250-8000 Hx (pure tones) by dB

61
Q

Pure tone testing - Notes

A

Soundproof booth
the higher the threshold > poorer the hearing
Tests each ear and both types (CHL)AC/BC(SNHL)

62
Q

What are ABNL thresholds for audiogram?

A

> 20dB

63
Q

Typmanometry is used for?

A

Eval TM and middle ear

64
Q

Tympanogram is measured via

A

Pressure -x axis
Compliance -y axis
> Graph

65
Q

According to the shape of the graph where are the different types?

A

Type A - NL
Type AS - shallow (Ossicular fixation)
Type AD - deep (Ossicular Disarticulation)

Type B - Poorly mobile TM (Fluid/Perf)

Type C - Retracted TM or ETD (ETD)

66
Q

If there is HL but a normal Tympanogram then?

A

HL is SNHL

67
Q

A Type A - NL tympanogram peak pressure falls where?

A

Near 0 decapascals

68
Q

A Type AS - shallow tympanogram peak pressure is located where?

A

Near 0 decapascals BUT w/ very shallow peak indicating decreased compliance.

69
Q

Type AS - shallow tympanogram is ass/w?

A

Ossicular fixation
Otosclerosis
TM scarring
ETD is NL

70
Q

Type AD - Deep tympanogram peak complaince curve is and a pressure curve?

A

> 2.0mL - compliance

NEAR 0 decapascals - pressure

71
Q

Type AD - deep tympanogram essentially indicates?

A

Ossicular disarticulation
OR
Ossicular chain discontinuity
ETD is NL

72
Q

Type B - (flat) poorly mobile tympanogram peaks are?

A

Absent/poorly defined peaks w/ a markedly negative middle ear pressure greater than -200daPa
- little or no TM mobility

73
Q

Type B - (flat) poorly mobile tympanogram indicates?

A

Fluid in middle ear or a TM perf

74
Q

Type B - (flat) poorly mobile tympanogram max compliance is?

A

Below NL range

75
Q

Type C - retracted TM or ETD tympanogram peak is?

A

clearly defined peak but falls Negative 150daPA or less on pressure scale indicating NEG middle ear pressure.

76
Q

Type C - retracted TM or ETD tympanogram compliance peak will be?

A

Normal

77
Q

Type C - retracted TM or ETD tympanogram Dx?

A

ETD w/ very mild CHL or WNL

OTO (7 decks)

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