Evaluation of the Patient with Hearing Loss Flashcards Preview

Neuro 2 > Evaluation of the Patient with Hearing Loss > Flashcards

Flashcards in Evaluation of the Patient with Hearing Loss Deck (25)
Loading flashcards...
1
Q

What to look at in hearing loss?

A

Ext ear, auditory canal, tymp membrane…if no abnormalities, begin to shift to middle or inner ear

2
Q

Most common ossicular problem

A

Stapes fixation (otoscelorisis)

Lateral chain fixations less common (malleus or incus()

3
Q

Tuning forks and differences

A

Higher freq, less precise

4
Q

Otoscelrosis

A

Also otosongiosis

Lesions of spongy bone of toci capsule

More in women and whites…early progression rapid but later slowerq

Only 12% produce CHL by involving stapes

5
Q

Audiogram and otosclerosis

A

Dip at 2000

6
Q

Tx of conductive hearing loss

A

Hearing aids

Surgical correction

7
Q

Labyrinthtis
Herpes zoster oticus
Measles
Mumps

A

Could result from OM or meningitis…sudden loss

SNHL and vertigo could have facial paralysis

Usually bilateral and in children

Nearly unilateral and sudden

8
Q

CMV and syphilis

A

Progressive in children and sudden in adults…HIV

Neurosyphilis more common…may present like meniere’s

9
Q

RMSF and lyme dz

A

Rapid progressive…serologic titers

Causes CN 7 paralysis

10
Q

Trauma and SNHL

A

Temporal bone fractures (typically HF SNHL)…if corsses labyrinth, then total SNHL

Blut concussion could also be HF

11
Q

Noise induced SNHL

A

Temporary threshold shift - disappears in 24-48 hrs

Permanent threshold shift - does not get better

12
Q

Chronic noise exposure ajudioogram

A

Dip at 4000

Normally bilateral

13
Q

MS

A

Periventricular white matter plaques and SNHL

14
Q

Benign Intracranial hypertension

A

Could have headache with blurred vision and pulsatile tinnitus but also SHNL and vertigo

Look for papilledema and confirm with LP

15
Q

Cogan’s syndrome

A

Interstital keratisi, SNHL, vertigo

Ts with steroids

16
Q

Polyarteritis nodosa

A

Necrotizing vasculitis of small and medium sized arteries

17
Q

Relapsing polychondritis

A

Arthitis and eye findings present

18
Q

Wegner’s granulomatosis

A

Usually conductive because of middle ear involvement

19
Q

Primary AI ear dz

A

Bilateral

Usually associated with vertigo

Reponds to steroids and cytotoxic drugs (hgih dose steroids nad intratympancic dexamethasone)

68kD protein antibody

20
Q

Presbycusis

A

Dip around 2000 but never recovers

Typically worse in HF and in men..accelerates with age

21
Q

Sudden SNHL

A

30dB or more SNHL occuring in at least 3 fequencies within 3 days or less

Unilateral

Vertigo or imbalance

22
Q

Prognositc factors of SNHL

A
Severity of loss
Vertigo
Poor speech
Over 40 or children
Slope of audiogram 

Most recovery in first 2 weeks

23
Q

Tx of SNHL

A

Hearing aids

Cochlear impalantation

24
Q

Cochlear implant prognositc

A
Post lingual onset
Duration of loss
Residual hearing 
Increased intelligence 
HEaring environment of recipiejent
25
Q

CI candidacy

A

Infant - 12 months with profound SNHL…cannot progoress with normal hearing aids

Over 24 months…PTA should equal or exceed 70 dB with best fitting HA in place

Open set sentence recognition is 60% or 40% or less with best aided condition