Flashcards in Hearing Loss Deck (55):
1
tumor that blocks ES
Nasopharyngeal tumor
2
Tx bell's palsy *extra
steroid
3
DISEASES: external - pinna, canal
OE, Exostosis/Osteoma, Cerumen Impaction
4
DISEASES: middle - TM, Ossicles, ES
OM, Cholesteatoma, Otosclerosis, ETD
5
DISEASES: inner - cochlea, semicircular canals, auditory nerve
Meniere's, BPPV, Aucoustic Neuroma, Sensorineural HL
6
labyrinth - location, function
Inner Ear
Hearing, Balance
Transmit to CN 8
7
what provide brain w/ info about Head Movement and Motion?
saccule
utricle
8
Conductive hearing loss:
Weber lateralizes to...
affected side
9
Sensorineural Hearing Loss:
Weber lateralizes to...
unaffected side
10
Rinne: AC>BC
normal
Sensorineural hearing loss
11
Rinne: BC>AC
Conductive Hearing loss
12
tinnitus risk factors
noise exposure
old
male
smoker
cardio disease
13
Intermittent tinnitus workup/Tx
NONE
14
pulsatile tinnitus
rhythmic with pulse
15
Tinnitus causes
idiopathic
acoustic trauma (acute/chronic)
Neuro damage
vascular
TM perf
purulent/serous OM
ETD
16
Tinnitus Dx
Refer ENT
subjective (most) vs. objective
Pulsatile? MRA/carotid doppler
imaging/neuro-otologic tests
17
Acute Tinnitus Tx
oral steroid taper
18
Chronic Tinnitus Tx
Lipoflavinoids
Niacin / B complex
White noise
Hearing aid
19
Tinnitus prevention
minimize noise exposure (<85dB)
20
which are first sounds to go in elderly hearing loss?
low decibel, extreme high + low frequencies
21
what frequency is cochlea near oval window?
high
22
Presbycusis : characteristics
sensorineural hearing loss
old age
symmetrical + high frequency
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Presbycusis : risk factors
half adults over 75
genetic
noise exposure
DM/ atherosclerosis
24
Presbycusis : presentation
bilateral worsening over time
difficulty w/ social situations
can't localize
tinnitus
isolation
25
Presbycusis : Dx
Dx of exclusion
audiogram - symmetrical, high frequency loss
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Presbycusis : Tx
Hearing Aid
Prevention (noise)
27
Acoustic trauma : damage frequency + decibel
high frequency, >85 dB
28
Acoustic Trauma : Presentation
hearing loss
tinnitus
Hx of noise exposure
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Acoustic Trauma: Dx
PE normal
Audiometry = 4K noise notch
bilat/unilat
30
Acoustic Trauma: Tx
hearing aid
possible steroid
Prevention *noise
31
Where does Acoustic Neuroma/Vestibular Schwannoma grow?
CN 8 - Schwann cells
32
Acoustic Neuroma/Vestibular Schwannoma
: S/S
UNILATERAL hearing loss + tinnitus
Headaches/dizziness
Facial weakness/numbness
Possibly silent until large
continuous vertigo
33
Acoustic Neuroma/Vestibular Schwannoma
: risk factors
Neurofibromatosis Type II (cafe au lait/bilat)
Ionized radiation
34
What should you order if UNILATERAL Sensorineural hearing loss?
MRI
35
Acoustic Neuroma/Vestibular Schwannoma
: Dx
Audiogram: unilateral loss
**MRI - Cerebellopontine Angle w/ gadolinium contrast
Auditory Brainstem Response
36
Acoustic Neuroma/Vestibular Schwannoma
: Tx
Refer ENT/neurosurgery/radiation
Image/audio monitor every 6 mos.
37
Causes of conductive hearing loss
Cerumen impaction
OM/OE
TM perf
Otosclerosis
Mastoiditis
Cholesteatoma
Foreign Body
Exostoses/Osteomas
38
Cerumen impaction : Presentation
Hearing Loss
Ear discomfort
Dizziness/tinnitis if impacted against TM
39
Cerumen impaction: Tx
Dissolve (H2O2, OTC)
Irrigation, removal
Refer ENT if fail or no audio return
40
Exostoses: cause
Cold water swimming as child
41
Exostoses (multiple) : Tx
Monitor
If obstruct, refer ENT
42
Osteomas (single - tympanic bone) - Tx
Monitor
Refer ENT if obstruction
43
Otosclerosis: risk factors
Genetic
White female
Young adult to middle age
44
Otosclerosis: what is
Spongy bone growth at stapes-oval window junction
Worsens over time
Possible tinnitus
45
Otosclerosis: Dx
TM moves normal
Conductive hearing loss (Carthart notch 2K)
DX: Temporal bone CT/exploratory surgery
46
Otosclerosis : Tx
Refer ENT : exploration, stapedectomy, ossicular chain reconstruction
*hearing amp/monitor
47
Cholesteatoma is
Middle ear cyst w/ keratin
Destroys middle ear, labyrinth, mastoid air cells, facial nerve, *middle cranial fossa of brain
48
Cholesteatoma: associated w/
ETD, TM perf, Congenital
49
Cholesteatoma : presentation
CHRONIC DRAINING EAR (brown/yellow/odor)
PAINLESS
Conductive H.L.
Dizziness
TM pearl
DX: CT temporal bone, otoscope granular tissue
50
Cholesteatoma: Tx
Surgical excision
51
ETD : cause
*Hairs can't remove
*Bad ES contraction
*Narrow ES
*Adenoid blocks ES
*Swollen nose blocked
*Adult - NP tumor (unilat OM)
52
ETD: associated w/
OM
Barotrauma
Maybe cholesteatoma
53
ETD : presentation
Follow URI/allergic rhinitis
Ear pain/pressure
Stuffy - valsalva useless
Hearing loss/ tinnitus
54
ETD : physical exam
Retracted TM
Tympanogram flat
55