Chapter 16: Ears

Conductive Hearing Loss

Hearing loss affecting the external/middle ear, caused by a mechanical dysfunction such as impacted cerumen, foreign bodies, perforated TM, middle ear fluid, or otosclerosis

Sensorineural Hearing Loss

Hearing loss affecting the inner ear/CN VIII, caused by nerve/receptor dysfunction such as presbycusis, ototoxic drugs, or noise exposure

1-3-6 Intervention Timeline

Timeline for infant hearing interventions: screening must be completed by 1 month, diagnostic evaluation must be completed by 3 months, and intervention must begin by 6 months

Presbycusis

Gradual nerve degeneration in the inner ear or auditory nerve due to age, begins with high frequency tone loss

Eustachian Tube

Tiny tube connecting middle ear with nasopharynx to allow passage of air, opens with swallowing and yawning

Organ of Corti

Receptor hair cells, sensory organ of hearing

Otosclerosis

Gradual bone formation that causes footplate of stapes to become fixed in oval window which impedes sound transmission, occurs in adults 20-40 years old

Otitis Media

Middle ear infection caused by obstruction of eustachian tube or passage of nasopharyngeal secretions into middle ear

Otoacoustic Emissions Test

Newborn hearing screening in which a soft probe is placed in the ear canal to measure the echo when clicks/tones are played

Auditory Brainstem Response

Newborn hearing screening in which clicks/tones are played through soft earphones while electrodes measure how the auditory nerve and brainstem carry sound

Otitis Externa

Infection of outer ear with painful movement of pinna/tragus, redness, and swelling of pinna and canal, scanty purulent discharge, scaling, fever, and enlarged, tender lymph nodes (swimmer’s ear)

Chrondrodermatitis Nodularis Helicis

Painful nodules on rim of helix as a result of repetitive mechanical pressure or environmental trauma, are usually small, indurated, dull, red, poorly defined, and painful

Battle Sign

Ecchymotic discoloration just posterior to the pinna and over mastoid process caused by trauma to side of head

Sebaceous Cyst

Nodule filled with sebaceous material

Tophi

Small, whitish yellow, hard, nontender nodules in or near the helix and antihelix

Exostosis

Small, bony, hard, rounded nodules of hypertrophic bone covered with normal epithelium, usually does not obstruct the view of eardrum, common in cold water swimmers

Cholesteatoma

Overgrowth of epidermal tissue in the middle ear or temporal bone, has pearly, white, cheesy appearance, causes otorrhea, otoglia, unilateral conductive hearing loss, and tinnitus

Hemotypanum

Blood in middle ear

Bullous Myringitis

Small vesicles containing blood on eardrum, usually due to mycoplasma pneumonia or viral infections

Yellow Eardrum

Serum or pus behind eardrum, usually due to otitis media with effusion or chronic otitis media

Prominent Eardrum Landmarks

Retraction of eardrum, usually due to vacuum in middle ear from obstructed eustachian tube

Air Bubbles in Eardrum

Serous fluid behind drum, usually due to otitis media with effusion

Distorted Eardrum Light Reflex

Bulging of eardrum, usually due to acute otitis media

Bright Red Eardrum

Infection in middle ear, usually acute otitis media

Blue/Red Eardrum

Blood behind eardrum, usually due to trauma or skull fractures

Diminished Eardrum Landmarks

Thickened drum, usually due to chronic otitis media

Weber Test

Using a tuning fork on the top of the head to test bone conduction hearing

Rinne Test

Using a tuning fork on the temporal bone to test bone conduction hearing