sensorineural h/l d efination hearing loss when the cause is cochlea or auditory nerve
TRANSCRIPT
Diagnosis: History/audiological tests
Disability is more with S/N deafness than
conductive deafness WHY. (recruitment and reduce discrimination
Causes:Infections: Viral(Mumps and Measles.Ramsy hunt syndrome.
Bacterial: Supporative Labyrinthitis.(Serous c/f). Syphilis congenital and acquired,progressive hearing loss with very loud Tinitus.VDRL
Presbycusis:degenerative changes in cochlea at basal turn first and neural.
difficulty in understanding speech even loud(loss of high frequency..consonants), in background noise,Recruitment..distortion.poor discrimination and lack of concentration.
Acoustic neuroma:
Incidence:common 80% of all CP angle tumor.10% of brain tumor.
Origin Scwan cells of vestibular nerve with in IAM. Growth very slow 1-2 mm/yr..
Clinical features:
Age/Sex 40-60 yrs.. male and females
2/Unilateral SNHL +Tinnitus due to pressure on 8th nerve in the canal
3/ Vth Nerve Corneal Reflex
VII Th. nerve Sensory fibers first loss of taste and reduced lacrimation.
IX and X nerve dysphagia and hoarseness Its should be very large tumor ,rare to reach to that size before diagnosis.
Treatment: depend on size of tumor.
Intracanalicular and small 1.5 cm-and in some case Medium can be left alone and observed by yearly MRI , Large needs SURGERY.
Investigation and Management Of SNHL.
History: detailed.
Clinical examination, Otoscope
Cranial nerve :5th Corneal reflex,7th,..
MRI
Blood investigation
1/ CP and ESR 2/ Random Glucose.3/ Lipid profile.4/ Immune complexes.5/Thyroid function test.6/ VDRL.
Sudden SNHL: It has been defined for research purposes and has been accepted by most authorities as 30 dB or more sensorineural hearing loss over at least three contiguous audiometric frequencies occurring within 3 days or less.
Etiology 1/ Vascular 2/ Trauma,head injury, 3/barotrauma 4/ perilymph fistula5/ Viral 6/ immune complexes
Treatment: 1/ admit to hospital
2/ investigations
3/ steroid 40-60mg prednisolone, intrtympanic injections
4/inhalation Carbogen.
Question, Define Meniers disease
1/ describe etiology
2/ symptoms
3/ investigation
4/ treatment of Meniers disease.