Ear Disorders 382 Exam 2

Microtia

Microtia

pinna abnormally small

Anotia

pinna entirely absent

basal cell carcinoma

cancer of the skin, on skin tissue on pinna

atresia

lack of canalization; may be due to congenital effect such as trencher Collins syndrome or trauma

• cannot be treated with hearing aids

• CHL directly related to the area and amount of occlusion

• suspect that TM and Middle ear are also effected

Stenosis

narrowing of the EAC; can cause easy clogging from ear wax but wont typically cause CHL by itself

Collapsing Auditory Canal

can see a CHL in hearing test if using supra aural headphones, need to use inserts

• 4% of caseload

• more common in elderly population

foreign bodies in EAC

• if pushed too far will cause swelling and surgical removal might be required

• may or may not cause CHL

External Otitis (Swimmer’s ear)

infection in the skin of the EAC

• bacterial infection or otomycosis

• depending on swelling and infectious debris may have mild CHL

• if pain too much might not be able to do hearing test

Osteoma

growth in the outer ear that is a bony tumor

Extoses (surfers ear)

outward projections; happens if spend a lot of time in cold water

Cerumen Build Up

too much ear wax occludes EAC may cause CHL - can be indicated by type B tympanogram with a small volume

Perforation of TM

• causes: rapid pressure change, direct trauma, excessive pressure build up

• showed by type B tympanogram with large volume

Tympanosclerosis

TM thickened or scarred in response to infection

Calcium Plaques on TM

calcium plaques may form on it, affects vibration of the TM

• HL may or may not happen

eustachian tube dysfunction

• negative middle ear pressure

• can result from swelling from infection or blockage at the opening

• slight conductive CHL and type C tympanogram

Otitis media

infection of the mucus lining of middle ear chamber

• 70% children get it by age 2 in US

• seen by flat bilateral CHL, great WRS, type B tympanogram, reduced static compliance; absent OAEs (acoustic reflexes)

types of Otitis media (can progress into each other)

serous OM: accumulation of fluids that can usualy be drained

Superlative OM: pus that fills middle ear cavity

Mucoid OM: thick mucous secretions

Cholesteatoma

a growth in the middle ear that occurs when skin is introduced to middle ear cavity

• most likely to cause a max CHL

• if gets into inner ear can cause SNHL

Facial Palsy

damage to facial nerve causing paralysis to one side of the face

can occur after chronic otitis media

often resolves spontaneously

typically no CHL

patulous eustachian tube

ET is chronically open

• autophony

• no CHL

otosclerosis

ossicles change and become spongy

• not seen until invades middle ear cavity and causes CHL

• can be identified in audiometry by Carhart’s notch

  • BC thresholds reduced at 2000 Hz

otospongiosis

spongy bone growth over the footplate of the stapes

• if moves to cochlea, will 1st see a HL in low frequencies

Sudden Idiopathic SNHL

unilateral (usualy) HL that develops instantly or over a few days

• decrease of at least 30 dB over at least 3 octaves within 72 hrs

• medical emergency

manières disease

over secretion or not enough absorption of endolymph

• sudden attacks of vertigo, “roaring” tinnitus, vomiting, unilateral HL, aural fullness

Autoimmune Inner Ear Disease

chronic inflammatory condition that results in bilateral, fluctuating, and progressive sensory hearing loss

Presbycusis

normal hearing loss due to age

• phonemic regression, difficulty in speech recognition

Noise-Induced HL

hearing loss due to noise exposure

• Temporary Threshold shift: after a loud event, normal hearing comes back

• Permanent threshold shift: irreversible HL

• outer hair cells die

Ototoxic HL

HL due to exposure to drugs or chemicals that are toxic to the inner ear

• some antibiotics

• antimalarial

• chemotherapeutic drugs

• repeated long-term use of diuretics, nicotine, alcohol, and asprin