Lecture 13: Ear disease and hearing loss Flashcards
Describe the neural pathway for the cochlea and the mneumonic:
Mneumonic: E Coli
Ear Cochlear nerve Sup Olive Lateral laminiscus Inferior colliculus
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What are the types of hearing loss?
Conductive
Sensorineural
Mixed
Central Disorders
What is the spectrum of hearing loss severity?
Mild
Moderate
Severe
Profound
What can hearing difficulties lead to?
Learning difficulties
Auditory processing difficulties
Speech and language deficits
=
- > Low self esteem and confidence
- > Social isolation
- > Safety
- > Reduced employment opportunities
- > Academic achievement
What can be complications of middle ear disease?
Build up of keratin on the tympanic membrane can lead to lesions in the brain….
What history questions do you ask someone with hearing issues:
Age
Severity
Duration
Onset: I.e rapid/gradual, constant/fluctuating, precipitating factors i.e trauma, drugs noise
Past and family history
Associated symptoms;
- Tinnitus, vertigo, fullness, headaches
What are some methods to investigate hearing loss?
Audiogram Otacoustic emissions ABR CT, MRI END Bloods Genetic testing Cardiac, renal, opthalmic consult
How do you examine the ear?
Clinical test of hearing (whispering) Tuning fork test Otoscopy Neurological exam; Cranial nerves Associated anomalies
What are some causes of conductive hearing loss in the middle ear?
Inflammatory
- Otitis media with effusion
- Chronic otitis media (incl. cholesteatoma)
Metabolic
- Otosclerosis
- Athritis
Congenital
- Ossicles
Tumour
- Glomus
Trauma
What is conductive hearing loss of the ear canal?
Congenital
- Microtia/atresia
Acquired
- Exostoses
- Stenosis
Describe otitis media with effusion:
Common in children
- Eustachian tube dysfunction
- Infection/inflammation
- Negative pressure
- Effusion
Can lead to tympanic membrane perforation
What is mastoiditis?
Complication of otitis media where the mastoid becomes infected and inflammed
Medical emergency
Hearing loss in secondary
What is microtia/atresia?
Normal cochlea
- Maximum conductive hearing loss
What are congenital causes of sensorineural hearing loss?
Hereditary:
- Nonsyndromic; Normal inner ear or inner ear malformation
- Syndromic
Hereditary
- Dominant or recessive
- Syndrome
Acquired:
- Prenatal infections
- Medications
- Birth trauma
What are acquired causes of sensorineural hearing loss?
- Noise induced hearing loss
- Presbyacusis (age related hearing loss)
- Temporal bone trauma
- Menieres disease
- Ototoxicity
- Infection i.e syphillis
- Sudden sensorineural hearing loss
- Vestibular schwannoma
- Metabolic
- Central
