Lecture 21: Ear disease and hearing loss Flashcards
Why are kids more likely to get middle ear infections and effusions of the middle ear?
Their eustachain tube is at about 10˚ where as adults have tubes at closer to 45˚ and a bit longer as well.
Types of hearing loss?
Conductive (outer and middle ear)
Sensorineural (inner ear)
Mixed (both)
Central disorders -(auditory processing)
Hearing loss categories?
- normal
- mild
- moderate
- severe
- profound
History?
age, severity, duration
Onset, consistency, precipitating factors
family history -(tinnitus, vertigo, fullness, headaches)
Investigations?
Audiogram done in adults always
otoacoustic emissions - idea of inner ear function in children
ABR- auditory brainstem response
CT/MRI
Examination?
Clinical test of hearing (whisper test)
Webber and rinne test?
Both use a 512Hz tuning fork
Rinne’s compares air conduction with bone conduction with the fork either next to the pinna or hard against the skull.
Webber’s test holds the fork on the top of the head as looks to see if it is heard in the middle or louder on one side. Louder in bad ear if conduction and good ear if sensorineural.
Conductive hearing loss - differential diagnosis?
Middle ear
- Inflammatory (otitis media w. effusion, chronic otitis media)
- Metabolic (otosclerosis, arthritis)
- Congenital
- tumour (glomus)
- trauma
Ear canal
- Congeital (microtia/atresia, stenosis)
- Aquired (exostoses = bone formation, stenosis)
otitis media with effusion? Treatment?
Common in children 1-4 years
Eustchian tube dysfunction
infection/inflammation - effusion
negative pressure
TREATED with GROMITS to allow air into middle ear
Mastoiditis?
Puss build up in the mastoid area behind the ear as a result of otitis media and is a medical emergency
Sensorineural hearing loss differential diagnosis?
Congenital
Hereditary
Heredity with delayed onset
Aquired
Aquired
Noise induced
Temporal bone trauma
Ototoxicity (eg aminoglycoside, gentamicin, cisplatin)
Infection (syphillis, post meningitis, viral)
Vestibular schwannoma (or other tumours)