presbycusis + otosclerosis

Question 1

what is presbycusis?

Answer 1

-age related sensorineural hearing loss

Question 2

how does presbycusis present?

Answer 2

• age related sensorineural hearing loss
• tends to affect higher pitches first
• gradual hearing loss
• symmetrical

-may have associated tinnitus

Question 3

what are risk factors for presbycusis?

Answer 3

• increase in age
• male gender
• family history
• loud noise exposure
• diabetes
• hypertension
• ototoxic medication
• smoking

Question 4

what investigations are done for presbycusis?

Answer 4

• audiometry

- will show normal/near normal hearing at lower frequencies and sensorineural hearing loss at higher frequencies

Question 5

what is management of presbycusis?

Answer 5

• cannot be reversed
• hearing aids to amplify sounds
• if hearing aids don’t work then cochlear implants may be used

Question 6

what is otosclerosis?

Answer 6

-a condition where there is remodelling of the small bones in the middle ear leading to conductive hearing loss

Question 7

who is otosclerosis more common in?

Answer 7

• women
• there is a connection with increase in oestrogen so tends to progress more rapidly during pregnancy
• can be inherited in an autosomal dominant pattern

<40 years

Question 8

how does otosclerosis present?

Answer 8

• gradual conductive hearing loss
• tinnitus
• tends to affect lower pitch sounds

Question 9

how does otosclerosis present on Webers test?

Answer 9

• if otosclerosis is bilateral then Webers test will be normal meaning that when the tunic fork is applied to the centre of the forehead they will hear the sound equally in both ears
• if otosclerosis is unilateral or affects one ear more than the other the sound will be louder in the more affected ear

Question 10

how will otosclerosis present on Rinne’s test?

Answer 10

• it will show conductive hearing loss
• the sound will be easily hear when the tuning fork is applied to the mastoid process (bone conduction)
• when the patient stops being able to hear the sound during bone conduction and the fork is removed from the mastoid process and held close to the ear canal, they will still not hear the sound ( air conduction is worse than bone conduction)

Question 11

what investigations are done for otosclerosis?

Answer 11

Audiometry:
-ottosclerosis will show conductive hearing loss especially of lower frequencies

Tympanometry:
-will show generally reduced admittance (absorption) of sound

CT:
-can detect bony changes associated with ossicles however this is not required

Question 12

what is the management for otosclerosis?

Answer 12

Conservative:
-hearing aids

Surgical:
-stapedectomy