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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

23

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

26

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

29

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

ETD : Tx

Nasal Decongest - *Sudafed, *Afrin
Nasal steroid - *Flonase, *Nasonex
SEVERE - oral steroid, myringotomy/tube