otology Flashcards
what is Cass?
he is a neurologist, psychiatrist, psychologist, surgeon, scientist, teacher, life mentor, husband, gay, also straight, father, and likes purple ties.
pars tensa and pars flaccida
find a fancy picture. in words, lower left is the tensa, upper right in the flaccida
cholesteotoma
skin infection in the parse flacida
epidemiology of hearing impairment
16% of adults 20-69yrs
2/1000 infants
by age 75, 40%
4th most prevalent major chronic disability
effects of hearing impairment
failure to develop speech, decreased quality of life, depression, anxiety, lower economic success, perceived as having greater disabilities
audiogram components
pure tone audiogram, 250hz-8000hz contained in normal speech, hearing level on db scale to determine intensity require for person to hear a given frequency.
bone conduction
sound transmitted through bone
air conduction
sound transmitted through air
word recognition score
ability of patient to hear and process speech. so important, pay attention to this score.
down sloping
look it up
rising
look it up
flat loss
look it up
unilateral loss
hearing loss in one ear, ie meningioma, schwanoma, neuroma
types of hearing loss
conductive, sensory, neural
conductive hearing loss
collapsed ear drum, will result in change between bone and air conduction - air bone gap. Loss of air conduction, and will be on the exam. dont fuck this up.
common causes: otitis media - ear infection tympanic membrane perforation cholesteatoma otosclerosis congential aural atresia
sensory hearing loss
loss of cilia hair cells - presbycusis (getting old), noise trauma (Metallica concert), ototoxicity (drugs), genetics
Cass dreams of curing this with his magical powers
Neural hearing loss
8th cranial nerve issues, auditory neuropathy, multiple sclerosis (demyelinate the nerve). Think tumors and nerve compression.
asymmetric haring loss is a give away for neural hearing loss. The audiogram will reveal this.
presbycusis
gradual hearing loss associated with age. loss of threshold sensitivity, have speech comprehension issues, also loss of central auditory comprehension.
noise exposure
notch in hearing around 400hz, think trauma. Gun shots, industrial noise, kids with loud headphones. 8hrs at 80db, 4hrs at 90db.
ototoxicity
apoptosis mediated mechanism. aminoglycosides commonly cause this (these are antibiotics).
Asprine appears to help preserve hearing in combo with amiogycosides
most common environamtnal cause of hearing loss at birth
CMV in utero
syndromic group of hearing loss
autosomal recessive, connexin 26 (gap junction), accounts for 50% of these cases.
sensory hearing loss
endolyphatic hydrops, its an infammatory something from somewhere happening in some place.
the endolymph compartment is expanded. causes vertigo, fully ear feeling, loss of hearing, and high car payments.
disorder in inner ear homeostasis
systemic metabolic disorder, diabetes, hypothyroidism, renal failure, artheriosclerosis.
immune system-related - lupus, cogans, sarccoidoisis.. and more look that up!!!
flocculus
part of cerebellum responsible for eye movement.
treatment of sensorineural hearing impairment
air conduction hearing aids implantable hearing aids cochlear implants assistive listening devices speech and language training