ENT Lecture: Hearing Loss and Ear Disorders

Conductive Loss

Abnormality of canal or TM may be seen on physical exam; hearing may seem to improve in a noisy environment; Pt has soft voice.

Sensorineural Loss

Abnormality of canal or TM usually not seen on exam; hearing worsens in noisy environment; Pt voice loud; problem w inner ear/cochlear nerve; complaints of others 'mumbling'.

Gross Hearing

Responses to questions.

Weber Test

Place vibrating tuning fork on pt head and ask which side they hear it; sound lateralizes to impaired ear with conductive hearing loss; sound lateralizes to good ear with sensorineural hearing loss; heard midline, equally in both ears = normal.

Rinne Test

For comparison of air conduction and bone conduction; place tuning fork on base of the mastoid bone; if pt can hear noise longer through air than bone = normal.

Otorrhea

Fluid from ear.

Otalgia

Ear pain.

Vertigo

Illusion of movement (surroundings spin); Vestibular system disorder.

Dizziness

Imprecise term for a wide variety of complaints; light-headed, unsteady, faint.

Otitis media

Middle Ear, tympanic cavity; sense of fullness in ear; intense earache.

Otitis externa

External ear and ear canal; Inflammation of ear canals skin.

Bullous myringitis

Infectious myringitis; SS: painful blisters on tympanum, ear drainage, temp. hearing loss; Treatment: ABX, sometimes lancing.

Meniere disease

Chronic vertigo tinnitus, fluctuating hearing loss, N/V, pressure or pain in ear; no cure, several tx to help with symptoms.

Mastoiditis

Acute otitis media spreads from the ear to the mastoid bone; bone fills with infected materials and may deteriorate.

Nasal ala

'Wing' outside support to the nostril.

Nares

Nostrils or nasal opening.

Vestibule

Area just inside the nostril that leads into the nasal cavity.

Columella

'Small column' between nostrils, inside support to nostril.

Turbinates

Bony structure inside the bone, covered by mucosa.

Kieselbach's Plexus

Vascular network formed by 5 arteries that supply the septum.

Transillumination of sinuses

Tilt pt head back and shine light through the sinuses.

Allergic rhinitis

Immune system reaction to environmental trigger; often with itchy eyes, ears, and/or nose; pale or boggy turbinates.

Acute Rhinosinusitis

Facial pain, cheek pain, radiating frontal or teeth; postnasal discharge, blocked nose, persistent coughing.