Week 11 - Conductive Hearing Loss

Question 1

Causes of Conductive Hearing Loss

Answer 1

Infection of the EAM (swimmers ear) 
Wax/cerumen
Foreign bodies
Benign tumours 
Dislocation 
Otosclerosis
Otitis media
Structural, congenital issues; 
* Microtia (incomplete pinna) 
* Anotia (absence of external ear) 
* Atresia (absence or closure of EAM)

Question 2

Otosclerosis characteristics

Answer 2

Disrupts movement of the middle ear bones
Progressive 
No spontaneous resolution
Significant hearing loss
More common in women
Familial link

Question 3

Treatment of otosclerosis

Answer 3

Stapedectomy
Hearing aids
Cochlear implant

Question 4

Otitis media

Answer 4

Inflammmation of the middle ear cavity with/without fluid, or with/without intact tympanic membrane
May be asymptomatic
Diagnose via external visual examination, otoscopy and tympanometry

Question 5

Visual Examination for Otits Media

Answer 5

Redness of external auditory canal
Ear pain
Pulling on ears (younger children) 
Irritability, fever, lack of/loss of appetite, vomiting, lethargy 
No external pain/fever

Question 6

Otoscopy of otits media

Answer 6

Bulging and retracted
Visible fluid level or bubbles
White/yellow/red
Decreased mobility

Question 7

Types/Progression of OM

Answer 7

Acute OM 
Otitis media with effusion 
Chronic suppurative otits media (CSOM) 
Tympanosclerosis
Chronic OM

Question 8

Complications of Otits Media

Answer 8

Extracranial complications:
*Mastoiditis
*Cholesteatoma
Intracranial complications
*Meningitis
*Brain abscess
*Lateral sinus thrombosis

Question 9

Behavioural signs of hearing loss due to OME

Answer 9

Not following directions
Asking you to repeat what you siad
Seems to be ignoring you
Doesn’t pay attention to sounds or speech most children would be interested in
Sometimes speech can be more unclear than typical

Question 10

Mastioiditis

Answer 10

Potentially life threatening
Initial treatment may include hospitalisation
Infection in mastoid - swelling behind ear, pushes ear forward

Question 11

Chronic Suppurative Otitis Media

Answer 11

Perforated tympanic membrane with persistent drainage from middle ear

Question 12

Cholesteatoma

Answer 12

Facial palsy arising from cholesteatoma - facial nerve travels through middle ear

Question 13

Treatment of OM

Answer 13

GP assessment

Antibiotics - most benefit in children under 2 with bilateral infection, AOM and discharge

Question 14

Treatment of OME

Answer 14

Surgical management if doesn’t resolve after active monitoring

Question 15

Risk Factors - endogenous

Answer 15

(internal cause/origin)

• age
• anatomical features
• ethnic group
• prematurity
• allergy

Question 16

Risk Factors - Exogenous

Answer 16

(external cause)

• crowded conditions
• smoke exposure
• seasons
• crowding at home (strongest predictor of nasopharyngeal carriage of otopathogens in aboriginal children)
• exposure to tobacco smoke
• exposure to fire smoke

Question 17

Protective Factors

Answer 17

• breast feeding
• swimming pools
• nutrition
• day care attendance (in non-indigenous children)
• hygiene

Question 18

Otitis Media and Literacy

Answer 18

OM and subsequent HL in early school years - impaired development of PA skills
HL impact on social and educational well-being
OM and subsequent HL possible risk factors for language development and learning

Question 19

Effects of OME on Phonological Repertoire

Answer 19

Vowels may be restricted/distorted; voiceless sounds are difficult to perceive/discriminate and articulate

Question 20

Effects of OME on Phonotactics

Answer 20

Reduction of blends
Weak syllable deletion
Final sound deletion Underspecified syllables in multisyllabic words

Question 21

Effects of OME on Speech Processing

Answer 21

Impacts on vocab size, leading to slow retrieval

Increasing syntactic complexity is associated with difficulties with input and output

Question 22

OME Effects on Speech

Answer 22

0-6 months: lower rates of canonical syllable production
18 months: smaller expressive vocabs
12-18 months: hearing levels associated with subclinical or clinical speech disorder at 3
9 years: significantly lower scores for articulation and sound discrimination