case presentation-OTOLOGY

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OTOLOGYOTOLOGYGTA 206/2GTA 206/2

CASE PRESENTATIONCASE PRESENTATION

Name : Khadijah binti Kamarudin

Course : AudiologyMatric No : 106014

I/C No : 900322115358



Name : MAS

Age : 4 years old

D.O.B : 28th

August 2007Sex : Male

Race : Malay

Registration No : B 344138Date of clerking : 18th March 2011

PATIENT DETAILS..PATIENT DETAILS..



Child came for hearing assessment as

referred by ORL doctor due to anotia with

atresia in the left ear and GoldenharSyndrome.

According to mother, child responded to

sound at home.

PRESENT SITUATION..PRESENT SITUATION..



Antenatal

� No problem noted during antenatal

Birth

� Fullterm pregnancy

� Patient was born via EMLSCS due to maternal PEand DM on diet control.

� Big baby-birth weight 4.42kg

� No other complications

Postnatal

� Admitted 3 days in ward due to GoldenharSyndrome.

Birth Medical HistoryBirth Medical History

PATIENTS HISTORY..PATIENTS HISTORY..



Physical

Have normal physicaldevelopment

Speech

During age of 2 years,

mother noted childsspeech progress is at 1word stage limitedvocab

4 yrs old, increase

vocabulary andincompletepronouncation (pelat).

Good understanding(simple instruction)

Developmental HistoryDevelopmental History

Hearing

Showed good response to

sound at home

Able to response correctly

toward simple instruction

But, at the moment hesusing gestures to indicate his

need

Able to imitate speech

soundSocial

Able to develop social play

skill with others



Youngest out of 6 siblings

Both parents are consanguineous marriage

Family history of birth defect cousin

His father have mild facial dysmorphism

His mother having diabetes - history of big babies

about 3 times (3rd, 4th, and 5th )

While his older brother have colour blind

Family HistoryFamily History



Tympanometry and OAE cant be done on left ear due tocomplete atresia.

For right ear, OAE - clear EAC and intact TM,tympanometry - persistent type B suggest of abnormalmiddle ear function.

DPOAE refer on the right ear

ABR (click stimulus) - wave V detected down to 40dBnHLfor R ear, suggest of conductive HL. Wave V detecteddown to 65dBnHL for L ear.

Play audiometry mild to moderate for R ear andmoderate to severe for L ear

Speech vocab increase, receptive-good and expressive-talk a lot but pelat.

ASSESSMENT DONE..ASSESSMENT DONE..



Discussion with parents regarding childs

condition.

Parents were advised to monitor childs speech

& hearing development at home. Child referred to ENT clinic for ENT

management.

M ANAGEM ENT..M ANAGEM ENT..



Right ear mild HL, suggestive of conductive

problem

Left ear suggestive hearing level at moderate

HL, due to anotia

IM PRESSION..IM PRESSION..



Repeat Tympanometry test to monitor middle

ear status.

KIV for hearing aid.

RECOMMENDATION..



Anotia is the complete absence of theauricle (external ear, also called the

pinna) and auditory canal.

This occurs when the tissues that form

the auricle fail to develop during thefirst few weeks of pregnancy - 80% of

the cases of anotia are unilateral

Atresia- absent of opening of the

external auditory meatus and causesignificant conductive hearing loss

which can be as great as 60dB.

DISCUSSION DISCUSSION ....





Jerry L. Northern & Marion P. Downs. (2001).

Hearing in Children. Sydney : Lippincott Williams

& Wilkins.

http://www.in.gov/isdh/files/anotia.pdf http://www.faces-cranio.org/Disord/Golden.htm

REFERENCES..REFERENCES..



THANK YOU..THANK YOU..

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case presentation-OTOLOGY