Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations...
-
Upload
thomas-strickland -
Category
Documents
-
view
214 -
download
2
Transcript of Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations...
![Page 1: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/1.jpg)
Hearing loss
Overview
![Page 2: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/2.jpg)
Not “deafness”
• Deaf is a total lack of hearing
• Deafness has connotations of discrimination
• Word “deaf” frightens people
![Page 3: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/3.jpg)
Hearing loss (HL) - classification
• Conductive - any interruption of passage
of acoustic energy between
pinna and oval window
(CHL)
• Sensorineural
![Page 4: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/4.jpg)
Hearing loss (HL) - classification
• Conductive
• Sensorineural - any damage to the organ
of Corti or VIII nerve
pathway or auditory cortex
(SNHL)
![Page 5: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/5.jpg)
Hearing loss (HL) - classification
• Can be “mixed”
conductive & sensorineural
![Page 6: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/6.jpg)
Testing
• Multitude of testing possibilities
- clinical (in room with patient)
- audiological (by audiologist or
audiometrician)
![Page 7: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/7.jpg)
Testing
• Clinical
- tuning forks
simple, quick and
accurate means of differentiating
between CHL & SNHL and
between true HL and malingering
![Page 8: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/8.jpg)
Tuning forks
• T fork large so that rate of decay is not rapid
• 512 Hz (or 256 Hz)
• Broad base - applied to bone
• If frequency too low – felt more than heard
• If frequency too high – dissipates too fast
![Page 9: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/9.jpg)
Rinne
• Tests air conduction – much more efficient than BC
• + Rinne
• - Rinne
• false - Rinne
![Page 10: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/10.jpg)
Tuning fork - Rinne
![Page 11: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/11.jpg)
Weber
• Assymetrical conductive loss
• Very sensitive in compliant patient
• If CHL unilateral as little as 5 dB detected
![Page 12: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/12.jpg)
Tuning fork - Weber
![Page 13: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/13.jpg)
Testing
• Clinical
- free-field speech testing
Simple, rapid, accurate to within 3 dB of true threshold of speech
reception threshold
![Page 14: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/14.jpg)
Normal audiogram
![Page 15: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/15.jpg)
![Page 16: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/16.jpg)
Conductive HL
• Congenital – many syndromes affecting the
development of ext. ear from
1st branchial cleft and 1st & 2nd
branchial arches
(eg Treacher-Collins, Pierre-Robin,
Crouzon’s, Apert’s)
![Page 17: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/17.jpg)
Conductive loss
![Page 18: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/18.jpg)
Congenital CHL classification• Hereditary - EA or ME
- present at birth (syndromes)- appearing in childhood (osteogenesis imperfecta)
• Predisposing disorders- cystic fibrosis, cleft palate, Down syndrome
• Miscellaneous - congenital cholesteatoma- fibrous dysplasia
![Page 19: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/19.jpg)
Congenital CHL
• Minor aplasia - EAC narrow
- pinna normal or minor deformity
- ossicular fixation
![Page 20: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/20.jpg)
Congenital CHL
• Major aplasia - microtia
- EAC atresia
- ossicular fixation
![Page 21: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/21.jpg)
Congenital CHL
• Major aplasia / atresia - EAC atretic
- tympanic cavity small
- cochlear abnormal
![Page 22: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/22.jpg)
Congenital CHL - management
• Congenital loss may be suspected at birth (eg family history or syndromal)
• Refer to Paediatric ENT or Audiologist for:
- investigation
- appropriate surgery
- appropriate rehabilitation
![Page 23: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/23.jpg)
Conductive HL
• Acquired - OME/ effusions
- foreign body / wax
- perforation
- ossicular damage
- otitis externa / furuncle
- fracture
- EAC neoplasm- benign
- malignant
- atresia and stenosis
![Page 24: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/24.jpg)
Acquired CHL - management
• From history and examination,
diagnose and treat appropriately
![Page 25: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/25.jpg)
Sensorineural HL
• Congenital – many syndromes involve the
VIII nerve to varying degrees
(eg Pendred’s, Usher’s Waardenbur’s)
![Page 26: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/26.jpg)
Congenital SNHL classification
• Hereditary - HL present at birth - HL alone - syndrome + HL
- HL appears in childhood - HL alone - syndrome + HL
• Secondary to intrauterine event- Infections (rubella, CMV, syphilis)- Ototoxic drugs (aminoglycosides,
diuretics, cytotoxics,salicylates, quinine,anticonvulsants)
![Page 27: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/27.jpg)
Congenital SNHL classification
• Secondary to intrauterine event
- Metabolic disorders (diabetes mellitus)
- Perinatal disorders (hypoxia,
hyperbilirubinaemia,
premature delivery,
low birth weight)
![Page 28: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/28.jpg)
Congenital SHL
• Variable - uni- or bilateral
- mild
- moderate
- severe
- profound
![Page 29: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/29.jpg)
Congenital SHL - management
• Prevent
• Depends on cause
• Depends on extent
• Depends whether uni- or bilateral
![Page 30: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/30.jpg)
Congenital SHL - management
• Hearing amplification - if appropriate
• Alternative means of communication
- lip reading
- sign language
• Cochlear implant - if appropriate
![Page 31: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/31.jpg)
Congenital SHL - management
• Family support and advice
![Page 32: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/32.jpg)
Sensorineural HL
• Acquired - trauma - sharp / blunt
- acoustic – blast / noise
- barotrauma – window rupture
- surgery
- infective labyrinthitis
- syphilis
- Meniere’s
- presbycusis
- ototoxicity
- CVA
![Page 33: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/33.jpg)
Acquired SHL - management
• Prevent
• Depends on cause
• Depends on extent
• Depends whether uni- or bilateral
![Page 34: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/34.jpg)
Acquired SHL - management
• Hearing amplification - if appropriate
• Alternative means of communication
- lip reading
- sign language
• Cochlear implant - if appropriate
![Page 35: Hearing loss Overview. Not “deafness” Deaf is a total lack of hearing Deafness has connotations of discrimination Word “deaf” frightens people.](https://reader035.fdocuments.us/reader035/viewer/2022070412/5697bf821a28abf838c859f2/html5/thumbnails/35.jpg)
Acquired SHL - management
• Family support and advice