Inner Ear Disorders

Question 1

Prenatal

STORCH Complex

Answer 1

Syphilis - severe-profound bilateral SNHL
Toxoplasmosis - moderate-severe bilat SNHL
Other
Rubella - Profound bilat SNHL “cookie bite”
Cytomegalovirus - Mild-profound bilat SNHL
Herpes Simplex - Moderate-severe unilat or bilateral SNHL

Question 2

Postnatal infections enter cochlea via __________, _________ or __________

Answer 2

Bloodstream, nerve pathway, fluid supply

Question 3

Bacterial Meningitis

Answer 3

Not sure how it enters cochlea
10% severe-profound HL
16% transient conductive

Question 4

Mumps

Answer 4

OAEs CANNOT be normal
Common cause of unilateral SNHL
Mild high Hz to profound

Question 5

Measles

Answer 5

OAEs Normal
If tumour, ABR abnormal
HL in 6-10%
Severe-profound bilateral SNHL

Question 6

Meniere’s Disease

Answer 6

Often unilateral, can be bilateral
Audiogram will loos the same as someone w/ similar level of HL but WORD RECOGNITION low
Symptoms affect membranous inner ear
-fullness, roaring tinnitus, trouble w/ speech recog, turning & whirling sensations, vomiting

Question 7

Ototoxic Drugs

Answer 7

High Hz SNHL (basal end of cochlea)

Aminoglycosides “mycin” drugs

Question 8

Noise Induced

Answer 8

Damages OHC (~50 dB)
Typical “4K notch”
May also see notches at 3 and 6 kHz

Question 9

Presbycusis

Answer 9

Hearing of the elders
>~50 years, hearing deteriorates
Sloping high Hz loss (typically), starts to slope ~1000 Hz

Question 10

Non-organic

Answer 10

Malingerer’s
Audiometric Red Flags (insurance referral, exaggerated effort to hear during case history, inconsistencies b/t pure tone & SRT)
Can do OAW, ABR, Stenger, Reflexes b/c don’t need response