hearing disorders 1.0
TRANSCRIPT
HEARING DISORDERS
HEARING LOSS
CONDUCTIVE HL Occurs when auditory stimuli are not
adequately transmitted through canal, TM, middle ear or ossicle chain to inner ear Ear obstruction Infection Otosclerosis Trauma to TM
SENSORINEURAL HL Sound waves conducted to inner ear but
abnormalities to cochlear apparatus/auditory nerve decrease/distort the transfer of info to the brain Presbycusis Meniere’s dss. Congenital HL Noise-induced HL Benign to malignant tumors Central auditory dysfxn
Diagnostics PE History Tuning fork test Audioscopy Audiogram
Management Restore HL
Antibiotics, acyclovir, oral corticosteroids X ototoxic drugs Surgery
Assist hearing Hearing aids
Manage tinnitus Rehab
Lip reading, sign language
INFECTION OF THE EAR
OTITIS EXTERNA Damaged by dryness, moisture or treatment Leads to edema Itching, redness, tenderness, narrowing of ear
canal, pain in pinna/canal Watery/purulent discharge & intermittent HL Tx
Antibiotics X trauma Swimmer’s: dilute alcohol, acetic acid, Burrow’s
solution
OTITIS MEDIA Acute suppurative sudden onset, short duration
Chronic repeated infxn w/ drainage & perforation
ACUTE OM Pressure of fluid in middle ear in combi w/ s/sx
of acute/systemic infxn Follows URTI present for several days Cause:
Bacteria, virus s/sx
Otalgia Fever HL
Dx PE Otoscopic exam = pneumatic otoscopy Tympanometry Tympanogram Acoustic reflectometry Tympanocentesis
Tx Myringotomy
ROM 3 new AOM episodes w/in 6mos
or 4 episodes in 1yr that occurs w/ URTI
OM w/ EFFUSION TM is intact & fluid accumulation in
middle ear w/o s/sx of infection 3wks to 3mos Sx via dx:
TM clear yellow/bluish fluid or air-filled level or bubbles or both
Mgt Promote healing
Ear irrigation Antibiotics
Suppurative: systemic, topical antiB, analgesics
Chronic: myringotomy
TRAUMA
BAROTRAUMA Injury from inability to equalize barometric
stress/middle ear imposed by air travel/underwater diving
From persons travelling w/ URTI Mgt
Autoinflation Intranasal (phenylephrine HCl) & systemic
decongestants Myringotomy
TM TRAUMA MGT to infection Myringoplasty Tympanoplasty
MENIERE’S DISEASE
Disorder of inner ear due to distention of endolymphatic compartment (excess endolymph) of inner ear (vestibular/semicircular canals)
Triad of sx Rotary vertigo Unilateral HL Tinnitus
Lesion in the EL sac
EL filtration & excretion
Increase endolymph prod.
Malfxn & blockage
Decrease absorption of endolymph
Increase vol. of EL sac
Decrease perilymph prod.
Cause Idiopathic
Dx Audiogram Electronystamography Admin. Of hyperosmolar substances
Management Suppressant drugs Diuretics Histamine analogs Low Na diet Steroid hormone Prednisone Gentamicin therapy Surgery
EL shunt Vestibular nerve section