Hearing loss

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Revision as of 12:01, 23 November 2023 by Nikolas (talk | contribs) (Created page with "* Conductive hearing loss ** Impaired conduction of sound through outer ear, tympanic membrane or middle ear ** Children and young adults ** Etiology *** Tympanic membrane perforation *** Otitis media with effusion *** Barotrauma *** Otosclerosis ** Diagnosis *** Pure tone audiometry **** Auditory threshold increased for air conduction **** Auditory threshold normal for bone conduction *** Speech audiometry **** Increasing loudness eventually leads to 100% speech compreh...")
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  • Conductive hearing loss
    • Impaired conduction of sound through outer ear, tympanic membrane or middle ear
    • Children and young adults
    • Etiology
      • Tympanic membrane perforation
      • Otitis media with effusion
      • Barotrauma
      • Otosclerosis
    • Diagnosis
      • Pure tone audiometry
        • Auditory threshold increased for air conduction
        • Auditory threshold normal for bone conduction
      • Speech audiometry
        • Increasing loudness eventually leads to 100% speech comprehension
      • Rinne test
        • Unable to hear tuning fork after moving it from mastoid to outer ear
  • Sensorineural hearing loss
    • Lesion of cochlea, vestibulocochlear nerve or central auditory pathways
    • Adults and elderly
    • Etiology
      • Congenital
      • Acquired
        • Presbycusis (aging) (most common cause)
          • Especially high frequencies
        • Ototoxicity
        • Meniere disease
        • Acoustic neuroma
        • Noise-induced hearing loss
        • Trauma
        • Otitis interna
        • Diabetic otopathy
    • Diagnosis
      • Pure tone audiometry
        • Auditory threshold increased for both air and bone conduction
      • Speech audiometry
        • Increasing loudness never leads to 100% speech comprehension
  • Combined hearing loss
    • Diagnosis
      • Pure tone
        • Auditory threshold is increased for both air and bone conduction, but it is increased more for air conduction
  • Tuning fork tests
    • Distinguish conductive and SNHL
    • Weber test
      • Tests for lateralization (sound is louder in one ear)
      • Base of tuning fork on the middle of forehead – bone conduction to cochlea
      • Interpretation
        • Lateralization to one ear = contralateral sensorineural HL or ipsilateral conductive HL
        • No lateralization = normal hearing or bilateral HL
    • Rinne test
      • Tests for air conduction and bone conduction
      • Base of tuning fork on the mastoid process
        • -> which side is louder?
        • -> when the patient no longer hears the tone, move front of the fork to the outer ear and ask if the patient still hears it
          • Air conduction is greater than bone, so patient should still hear the fork
      • Interpretation
        • Sound is louder with air than bone conduction (positive Rinne) = no conductive HL in examined ear
        • Sound is louder with bone than with air conduction (negative Rinne) = conductive HL in examined ear‎