Auditory Disorders

Endogenous

A trait or disorder that arises from the individual’s genes

Exogenous

A trait or disorder that is not attributable to genetic causes

congenital

A trait or disorder that is present at birth but may or may not be of genetic origin

Otitis media

An inflammation of the mucosal lining of the middle ear cavity that may include the accumulation of fluid in the cavity

Presbycusis

Loss of hearing that occurs with advancing age, especially beyond the age of 50 or 60 years

Retrocochlear pathology

A disease or disorder of the auditory system that impacts structures located from the auditory nerve through the auditory cortex (i.e., “beyond the cochlea”)

Exogenous, endogenous

All auditory disorders can be divided into two major classifications:

20%

Autosomal dominant accounts for ______ of genetic deafness.

80%

Autosomal recessive genes account for the remaining ______ of childhood deafness.

2-3%

X-linked accounts for ______ of deafness

conductive

Disorders of the outer or middle ear

Sensorineural

Damage to the nerve endings or to the hair cells in the inner ear

Retrocochlear

Hearing losses resulting from damage to the auditory nerve after it leaves the cochlea

Central auditory impairment

Damage to the nerve pathways within the auditory central nervous system

microtia

Small pinna

Anotia

Absence of pinna

basal cell carcinoma

Most common form of skin cancer, caused by sun exposure

otitis externa

Swimmer’s ear, caused by extreme humidity/moisture, fungal infection

exostoses

Benign, bony growth in the ear canal, often seen in swimmers/divers in cold water, usually left untx

Tympanic membrane perforation

Often caused by trauma - object, pressure change. Sometimes due to ME infection.

Paper patch, myringoplasty (skin graft)

What is the treatment for a tympanic membrane perforation?

Tympanosclerosis

Scarring of the tympanic membrane from tubes, or perforation. Occurs with aging

Cholesteatoma

Accumulation of cellular debris. Can cause erosion of the ossicles or tympanic membrane. Slight to severe hearing loss

Otosclerosis

Bony growth that fixates stapes footplate to oval window

otitis media

Symptoms a bulging, reddened tympanic membrane, pain, and upper respiratory infection. Chronic: large central perforation in the eardrum and discharge of fluid through the perforation.

acute

Sudden onset, new

Chronic

Persistent over several months

serous

Clear fluid

Purulent or suppurative

White, opaque

Mucoid

Thick yellow, bulging eardrum

76% to 95%

______ of all children have at least one episode of otitis media by 6 years of age.

2

The prevalence of the disease peaks during the early years of life and is greatest during the first _____ years

Eustachian tube dysfunction (ETD)

It is commonly believed that otitis media develops because of …

Hearing loss

______ is considered the most common complication of otitis media.

conductive

What type of hearing loss does otitis media usually cause?

50, 25

Loss may range from normal to _____ dB HL loss. Usually flat, usually mild (____ dB HL).

antimicrobial agents

A common means of treating acute otitis media is the routine administration of _______.

myringotomy

A common surgical approach to the management of both supportive and nonsupportive otitis media is a _______.

Tonsillectomy, adenoidectomy

________and_______ surgeries are also considered as a management approach to otitis media.

Tympanoplasty

More radical surgical approach for otitis media

sensorineural

Hearing loss resulting from cochlear pathology. Includes damage to the sensory receptors (under the hair cells) in the Organ of Corti

Retrocochlear pathology

A problem further up the ascending neural pathways

syphilis, toxoplasmosis, rubella, cytomegalovirus (CMV), herpes simplex virus (HSV)

List the (S)TORCH complex

meningitis, mumps, measles

List postnatal infections

meninigitis

Postnatal infection likely via blood supply to ear, S-P SNHL in 10%, 16% CHL

mumps

Postnatal infection that causes unilateral hearing loss (one ear), usually sudden

measles

Postnatal infection, 6-10% of patients affected S-P SNHL bilaterally

causes damage to the auditory system

Ototoxic medication

streptomycin, neomycin, Kanomycin, gentamycin

Antibiotics that are ototoxic

Drugs used for chemotherapy (cisplatin, carboplatin, oxalicisplatin), high doses of aspirin

Other ototoxic meds

tinnitus

Side effect of regular aspirin use

high

Ototoxic meds usually cause ______(high or low) frequency losses

outer hair cells in the basal portion of the cochlea

Noise induced hearing loss causes damage to the…

presbycusis

Hearing loss associated with aging

T

T/F: presbycusis is more common in men than in women

4 K notch

Noise induced hearing loss results in a characteristic …or a loss of hearing at 4000 Hz on the audiogram

Basal region of cochlea damaged, degenerative changes in the brainstem and cortical areas of the ascending auditory pathway

In presbycusis what regions are affected?

retrochochlear pathology

Refers to damage to nerve fibers along the ascending auditory pathways from the internal auditory meatus to the cortex.

tumor

In retrocochlear pathology, most often a _____ is involved, although not always, as in the case of multiple sclerosis or cerebral vascular attack.

vestibular schwanoma

Usually affects one ear only, complaints of tinnitus on one side, difficulty understanding, diagnosed by MRI

100,000

1 in _______ people annually ages 30-60 yo affected by vestibular schwanoma

50

Just over _____% of people with vestibular schwanoma will have dizziness