Week 11 - Conductive Hearing Loss Flashcards
Causes of Conductive Hearing Loss
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)
Otosclerosis characteristics
Disrupts movement of the middle ear bones Progressive No spontaneous resolution Significant hearing loss More common in women Familial link
Treatment of otosclerosis
Stapedectomy
Hearing aids
Cochlear implant
Otitis media
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
Visual Examination for Otits Media
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
Otoscopy of otits media
Bulging and retracted
Visible fluid level or bubbles
White/yellow/red
Decreased mobility
Types/Progression of OM
Acute OM Otitis media with effusion Chronic suppurative otits media (CSOM) Tympanosclerosis Chronic OM
Complications of Otits Media
Extracranial complications: *Mastoiditis *Cholesteatoma Intracranial complications *Meningitis *Brain abscess *Lateral sinus thrombosis
Behavioural signs of hearing loss due to OME
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
Mastioiditis
Potentially life threatening
Initial treatment may include hospitalisation
Infection in mastoid - swelling behind ear, pushes ear forward
Chronic Suppurative Otitis Media
Perforated tympanic membrane with persistent drainage from middle ear
Cholesteatoma
Facial palsy arising from cholesteatoma - facial nerve travels through middle ear
Treatment of OM
GP assessment
Antibiotics - most benefit in children under 2 with bilateral infection, AOM and discharge
Treatment of OME
Surgical management if doesn’t resolve after active monitoring
Risk Factors - endogenous
(internal cause/origin)
- age
- anatomical features
- ethnic group
- prematurity
- allergy
Risk Factors - Exogenous
(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
Protective Factors
- breast feeding
- swimming pools
- nutrition
- day care attendance (in non-indigenous children)
- hygiene
Otitis Media and Literacy
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
Effects of OME on Phonological Repertoire
Vowels may be restricted/distorted; voiceless sounds are difficult to perceive/discriminate and articulate
Effects of OME on Phonotactics
Reduction of blends
Weak syllable deletion
Final sound deletion Underspecified syllables in multisyllabic words
Effects of OME on Speech Processing
Impacts on vocab size, leading to slow retrieval
Increasing syntactic complexity is associated with difficulties with input and output
OME Effects on Speech
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
