Lecture 11 Flashcards Preview

AUDI 518: Fundamentals of Audiology > Lecture 11 > Flashcards

Flashcards in Lecture 11 Deck (30)
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1
Q

What is microtia/aural atresia?
Gender more common?
Cochlea affected?
Hearing loss type?

A
Absence of opening in external canal, often accompanied by microtia
Can be uni/bilateral
More common in males
Cochlea usually unaffected
Hearing loss is conductive

Developed in utero; not common; often one accompanied by the other

2
Q

What are the typical audiometric results of microtia?

A

Maximum CHL
Problems related to unilateral HL - localization, speech-in-noise
Can’t conduct - tympanometry, or otoacoustic emissions
Can’t use inserts…

3
Q

What are some aids that can be used for individuals with microtia? (3)

A

BC hearing aid - electrical signal goes to oscillators, will vibrate sounds from the skull; uncomfortable
BC soft band - has microphone and signal processing all in one
Bone-anchored hearing system - is a surgical implant, titanium piece integrated with the bone, sound vibrations transferred to skull

4
Q

What is treacher collins syndrome?

What are some symptoms?

A
Mandibular dysotosis - 
Ossicular defects
Downward sloping palpebral fissures
Receding chin
Dental abnormalities
Middle ear affected
5
Q

What is cleft palate?

A

Abnormal insertion and function of the levator and tensor veli palatini muscle leads to eustachian tube (hard to open/close tube)
Risk for CHL
High arched palate/split

6
Q

What is otitis media with effusion and acute otitis media?

A

With effusion: fluid filled ear with no signs of active infection; sounds don’t travel well.
Negative middle ear pressure - cells effuse into middle ear with fluid; cells start oozing out into vacuum.
Really tight against manubrium
Acute: inflamed, infected

7
Q

What does eustachian tube dysfunction lead to?

A

Poor middle ear aeration, otitis media, fluctuating CHL

8
Q

What age is otitis media most common?

When is it most prevalent?

A

Most common in children <6 ears; rare after 9.
Most common cause of CHL in children

Most prevalent and persistent in winter months (upper respiratory problems)

9
Q
In hearing assessment, what are the results:
Bilateral/unilateral
Degree
Configuration
Type
Speech audiometry
Tympanogram
A

Unilateral - one ear worse than the other
Degree - mild to moderate, (significant impact in class)
Configuration - CHL - flat loss
Type - conductive
Speech - if loud enough will get good recognition; with longstanding HL in the ear, may start to see speech recognition affected
Tympanogram - negative pressure and/or rounded peak, or flat (progresses through these types) - fluid causes loss of peak

10
Q

What are some factors that increase OM prevalence?

A

Allergies
Pacifier use
Lower SES
Eustachian tube dysfunction

11
Q

What does a pressure equalization tube do?

A

Temporary hole in the eardrum to equalize pressured
Will start healing across hole, when pressure comes along sides and pops out tube
Can stay for months - years
Fall out on their own

12
Q

Where are the places that a TM perforation could be?

A

Pars tensa - central: most common and safest; marginal

Pars flaccida - attic: usually associated with cholesteatoma and/or destruction of the ossicles

13
Q

What are acute and chronic TM perforations?

A

Acute: (90%); traumatic cause, usually heals itself, typically smaller perforations
Chronic: (10%); larger perforations (those due to chronic infection), require tympanoplasty

14
Q

What are some causes of TM perforations?

A

Traumatic blow or slap
Sudden explosion
Infection
Skull fracture/head trauma

15
Q

What does the typical audiogram look like for those with TM perforation?

A

Flat or rising mild to moderate CHL

16
Q

What is a cholesteatoma?

What is the result of this?

A

Mass of squamous epithelium cells trapped within temporal bone, middle ear or mastoid
Results of TM retraction pocket which collects shedded cells
Will expand, erode and destroy ME structures and temporal bone

Often left with maximum CHL.

17
Q

What is otosclerosis?
Who/when more common?
What does audiometry show?
How can it be fixed?

A

Fixation of the footplate of the stapes in oval window, unilateral at first, other ear involved later (ossicular chain doesn’t vibrate well)
More common in females, onset in early middle age
Mild to moderate rising (early) to flat (later) CHL
Managed well by surgery or amplification

18
Q

What can a stapedectomy and prosthesis do for otosclerosis?

A

Prosthetic device - metal loop to remove stapes and use this onto incus and oval window (new stapes)
Use fat to cover the membrane of the oval window (risk - possible tearing of oval window)

19
Q

What is sensorineural HL?

A

Can be cochlear (sensory), retrocochlear (neural or central - 8th nerve)

20
Q

What are the examples of causes of genetic cochlear hearing loss?
Syndromal, nonsyndromal, other

A

Syndromal: Down’s syndrome (SNHL, CHL), Usher’s syndrome (sight problems), enlarged vestibular aqueduct syndrome (fluid in vestibular aqueduct)

Nonsyndromal: Connexin 26 (damage/mutation = problem; cilia touch tectorial membrane)

May be congenital or later onset/progressive

21
Q

What are the examples of infectious cochlear hearing loss?

A

Perinatal: TORCH infections (toxoplasmosis, other, rubella, cytomegalovirus, herpes)
Childhood/adulthood: meningitis, mumps

22
Q

What are other neonatal factors of cochlear loss?

A

Low birth weight, ototoxic medicaitons, severe respiratory diseases (asphyxia)

23
Q

What are some causes of cochlear hearing loss in adults?

A

Progressive genetic
Noise induced HL
Age related HL

24
Q

What are some causes of NIHL?
What are the anatomical problems seen?
Where is the most damage seen?

A

Occupational or social
Metabolic exhaustion of OHCs, morphological changes of cilia, rupture of cell membranes, loss of OHC, loss of supporting cells

Cilia fuse and don’t work properly when bombarded with noise

See normal hearing then drop in audiogram - then rise. RF will always be higher (this part of BM most damaged). Most damage in 3000-4000Hz range

25
Q

What are some causes of ARHL?

What frequencies are worse/better?

A

Aging changes to many cochlear and neural structures
Accumulation of lifelong damage - combo of factors
Poor speech discrimination and intolerance of loud sounds
Gradual onset
May be confused with confusion, dementia, depression

Worse in high frequencies
Low frequency responders are stable

26
Q

What are some other causes of cochlear hearing loss? (4)

A

Ototoxicity: chemotherapeutic agents, aminoglycosides
Meniere’s syndrome: vertigo, fluctuating HL, tinnitus
Head injury
Sudden idiopathic HL

27
Q

What are some causes of hearing loss in the retrocochlear region? (4)

A

VIII nerve - vestibular schwannoma
Metabolic (mitochondrial disorder)
Diffuse - auditory neuropathy spectrum disorder
Central - MS, vascular disease, tumors

28
Q

What does a vestibular schwannoma affect?

What does the audiogram look like?

A

Presses on both vestibular and auditory portion of the nerve.

Audiogram: ABR normal, asymmetrical SNHL, mild to moderately severe in LE/RE, normal tympanogram, ART: RE stimulated, good ipsi, elevated contra, no reflexes in LE

29
Q

What is auditory neuropathy spectrum disorder?
Cause?
What happens to signals?

A

Normal OHC function, abnormal responses from VIII and brainstem, in absence of tumor.
Problem of neural transmission
Disorganized arrival of signal to processing centres

30
Q

What is central auditory processing disorder?

A

Impairment of CNS’s ability to decode and use auditory information.
Not a result of higher-order cognitive, language or related disorder