HEARING DISORDERS

HEARING LOSS

CONDUCTIVE HL Occurs when auditory stimuli are not

adequately transmitted through canal, TM, middle ear or ossicle chain to inner ear Ear obstruction Infection Otosclerosis Trauma to TM

SENSORINEURAL HL Sound waves conducted to inner ear but

abnormalities to cochlear apparatus/auditory nerve decrease/distort the transfer of info to the brain Presbycusis Meniere’s dss. Congenital HL Noise-induced HL Benign to malignant tumors Central auditory dysfxn

Diagnostics PE History Tuning fork test Audioscopy Audiogram

Management Restore HL

Antibiotics, acyclovir, oral corticosteroids X ototoxic drugs Surgery

Assist hearing Hearing aids

Manage tinnitus Rehab

Lip reading, sign language

INFECTION OF THE EAR

OTITIS EXTERNA Damaged by dryness, moisture or treatment Leads to edema Itching, redness, tenderness, narrowing of ear

canal, pain in pinna/canal Watery/purulent discharge & intermittent HL Tx

Antibiotics X trauma Swimmer’s: dilute alcohol, acetic acid, Burrow’s

solution

OTITIS MEDIA Acute suppurative sudden onset, short duration

Chronic repeated infxn w/ drainage & perforation

ACUTE OM Pressure of fluid in middle ear in combi w/ s/sx

of acute/systemic infxn Follows URTI present for several days Cause:

Bacteria, virus s/sx

Otalgia Fever HL

Dx PE Otoscopic exam = pneumatic otoscopy Tympanometry Tympanogram Acoustic reflectometry Tympanocentesis

Tx Myringotomy

ROM 3 new AOM episodes w/in 6mos

or 4 episodes in 1yr that occurs w/ URTI

OM w/ EFFUSION TM is intact & fluid accumulation in

middle ear w/o s/sx of infection 3wks to 3mos Sx via dx:

TM clear yellow/bluish fluid or air-filled level or bubbles or both

Mgt Promote healing

Ear irrigation Antibiotics

Suppurative: systemic, topical antiB, analgesics

Chronic: myringotomy

TRAUMA

BAROTRAUMA Injury from inability to equalize barometric

stress/middle ear imposed by air travel/underwater diving

From persons travelling w/ URTI Mgt

Autoinflation Intranasal (phenylephrine HCl) & systemic

decongestants Myringotomy

TM TRAUMA MGT to infection Myringoplasty Tympanoplasty

MENIERE’S DISEASE

Disorder of inner ear due to distention of endolymphatic compartment (excess endolymph) of inner ear (vestibular/semicircular canals)

Triad of sx Rotary vertigo Unilateral HL Tinnitus

Lesion in the EL sac

EL filtration & excretion

Increase endolymph prod.

Malfxn & blockage

Decrease absorption of endolymph

Increase vol. of EL sac

Decrease perilymph prod.

Cause Idiopathic

Dx Audiogram Electronystamography Admin. Of hyperosmolar substances

Management Suppressant drugs Diuretics Histamine analogs Low Na diet Steroid hormone Prednisone Gentamicin therapy Surgery

EL shunt Vestibular nerve section