1. OzarksTechnical Community College HIS 110 Hearing Disorders
Review
2. Disorders of the Outer & Middle Ear Causes a conductive
hearing loss (CHL) On the audiogram, you would find normal bone
conduction thresholds and abnormal air conduction thresholds
Tympanograms (test of middle ear function) will be abnormal 3.
Conductive HL in Right Ear 4. Abnormal Tympanograms Type B=flat
Type C=negative pressure 5. Abnormal Tympanograms TypeAs=stiff,
hypocompliant TypeAD=flaccid, hypercompliant 6. Outer Ear
Pathologies Anotia o absence of the outer ear Microtia o
malformation of the outer ear Wax build-up Otitis Externa o aka
swimmers ear or outer ear infection (bacterial) Atresia o absent or
closed earcanal Stenosis o narrowing of EAC Otomycosis o fungal
infection of EAC Exostoses o bony growth in EAC, common in cold
water swimmers Osteoma o bony tumor in EAC 7. Microtia of Right Ear
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11/194/49689/12720513.cw/index.html 8. Occluding Cerumen
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11/194/49689/12720513.cw/index.html 9. Otitis Externa
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11/194/49689/12720513.cw/index.html 10. Stenosis
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11/194/49689/12720513.cw/index.html 11. Exotoses
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11/194/49689/12720513.cw/index.html 12. Osteomas
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11/194/49689/12720513.cw/index.html 13. Tympanic Membrane
Pathologies Myringitis o inflammation ofTM Tympanosclerosis o
thickening and scarring of theTM Perforation o hole or tear in
theTM o May be caused by fluid pressure due to otitis media,
barotrauma (rapid pressure change due to flying or scuba diving),
or self- inflicted (q-tip use) 14. Bullous Myringitis
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11/194/49689/12720513.cw/index.html 15. Tympanosclerosis
Hawkelibrary.com 16. TM Perforation Hawkelibrary.com 17. Middle Ear
Pathologies Otitis media (OM)=middle ear infection Otitis media
with effusion (fluid) May be acute (sudden onset) or chronic
(long-lasting) Eustachian tube dysfunction malfunction of
Eustachian tube Causes retraction ofTM and popping, crackling,
pressure, pain Patulous Eustachian tube Eustachian tube is stuck
open (patent) Autophony, hearing ones own voice in head, is common
complaint Otosclerosis Bony growth over stapes footplate and
fixation to oval window Ossicular chain discontinuity Loss of
connection between the ossicles; usually due to head injury
Cholesteatoma An erosive tumor composed of skin, protein, and fats
18. Serous Otitis Media
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11/194/49689/12720513.cw/index.html 19. Cholesteatoma
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11/194/49689/12720513.cw/index.html 20. Treatment for Conductive HL
Medical Antibiotic eardrops, oral antibiotics for bacterial
infections Surgical Myringotomy (incision inTM),
pressure-equalization tubes, ossicular repair, stapedectomy
(removal of stapes and prosthesis placement) Amplification CHL is
very easy to fit with a hearing aid(s) Because the sensory cells of
the cochlea are healthy, CHL only requires amplification to power
through the middle ear pathology. Once the sound gets past the
middle ear problem, it is clearly transmitted through the remainder
of the auditory system with ease. 21. Disorders of the Inner Ear
Results in a (primarily) sensorineural hearing loss (SNHL) On the
audiogram, you would find abnormal bone conduction and air
conduction thresholds Tympanograms (test of middle ear function)
will usually be normal 22. Bilateral SNHL 23. Normal Tympanogram
Tests middle ear function = eardrum, ossicles, eustachian tube
Measures changes in the movement of the eardrum TypeA=normal 24.
Inner Ear Pathologies Presbycusis Age-related hearing loss; effects
the high frequencies first Noise-Induced Hearing Loss (NIHL)
Exactly like it sounds; dependent on intensity, duration, and type
of noise exposure, classic noise notch seen from 3 to 6 kHz, with
recovery at 8 kHz Menieres disease Overacummulation of endolymph in
the cochlea; characterized by attacks of vertigo, tinnitus
(roaring), low-frequency SNHL (usually unilateral), nausea/vomiting
Ototoxicity High-frequency SNHL due to damaging effects of certain
drugs (most notably aminoglycoside antibiotics and platinum-based
chemo drugs) Perilymph fistula Hole (fistula) at the oval window,
in which perilymph leaks into middle ear. Fluctuating HL (SNHL or
Mixed HL) and dizziness common. Superior Semicircular Canal
Dehiscence Hole or thinning of the bony lining of the superior SCC;
symptoms: fullness, autophony, dizziness with/sensitivity to loud
sounds, low- frequency CONDUCTIVE hearing loss with normal
tympanogram 25. Menieres Disease Cochlear Cross-Section *Note the
displacement of the vestibular membrane due to the overabundance of
endolymph in scala media Hawkelibrary.com 26. Ototoxicity Partial
Loss of Outer Hair Cells Complete Loss of Outer Hair Cells One row
of Inner Hair Cells unaffected 3rowsofouterhaircells
Hawkelibrary.com 27. A note about sudden hearing loss Sudden,
idiopathic sensorineural hearing loss is any SNHL that occurs very
suddenly with no identifiable cause Usually unilateral May be
partial or complete loss of hearing Often accompanied by dizziness
and tinnitus Requires IMMEDIATE medical referral Do not assume that
a patient has wax, an infection, or a broken hearing aid if they
call complaining of a sudden inability to hear. If you cant see
themASAP refer them to their primary doctor or an ENT for a
same-day appointment, if possible. Steroid treatment that occurs
within the first week of the hearing loss may result in
improved/recovered hearing. 28. Treatment for SNHL HearingAids
Hearing AssistiveTechnology Cochlear Implants 29. Mixed HL in the
Right Ear Mixed hearing loss (MHL) is a combination of
sensorineural hearing loss with a conductive HL component Commonly
seen in older adults with presbycusis and middle ear disorder May
be seen in cases of perilymph fistula, head injury, barotrauma
Imagefrom:asha.org 30. Treatment for MHL Because MHL is a
combination of CHL and SNHL, the treatment should also take a
combined approach Always refer to ENT for medical treatment FIRST
Finally, amplify the hearing loss that remains
