Audiology, Exam II
Terms
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- Extoses, Osteomas
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-Pinna, EAC
-benign bony tumors
-if big, cause HL
TX-surgical removal - Granulomas
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EAC
-result from trauma/infection
-don't usually cause HL - Malignancies
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Pinna, EAC
-appear with AIDS (Kaposi Sarcoma in EAC) - Prolapsed Canals
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EAC
-EAC collapse when pinna pressed
-cartilage in EAC broken down
-most daily functions not affected
-cannot test with circumaural phones - Bullous Myringitis
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EAC, TM
-blood blisters deep in EAC/on TM
-caused by viral infection
-very painful
TX-pain killers, goes away on own - TM Perforation
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TM
-hole caused by infections, foreign bodies, or P build up in Mid.Ear
-barotrauma, or blast outside TM
-HL depends on size of hole
TX-myringoplasty (patch), keep ear dry - Malformed Auricles
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Pinna
-no HL by itself
-may suggest malformations elswere in Aud. System if congenital
-microtia=small, anotia=not there, malformed=weird
-more in males, more on right side - Atresia
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EAC
-EAC closed
-hefty HL
-Congenital or from otitis Externa, or burns
TX-surgically make EAC, BC hearing aid - Stenosis
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EAC
-very narrow EAC
-cerumen impacts easily, causeing HL
-seen with Down Syndrome - Foreign bodies/Cerumen impacts
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EAC
Wax: ear feels blocked, may cough (vegus nerve), prob. w/hearing aids, can cause HL
FB: may be pulled out with tweezers - Otitis Externa
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EAC
"Swimmers Ear"
-skin inflamation caused by bacteria, fungus, pH imbalance (water washed out cerumen)
-swelling, white secretion, feel buring/blockage/pain
TX-drops to restore pH, antibiotics - Malignant Otitis Externa
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EAC, Temporal Bone
-rare, O.E. spreads to temporal bone
-seen in elderly diabetics
-can be life threatening - Tympanosclerosis
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TM
-Thickening/Scarring TM
-white patches on TM
-result of perforation/infection healed
-usally no HL - Acute Otitis Media
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Mid Ear
infected, neg P in MidEar, TM retracted, fluid buildup
->otalgia, TM red, feer, TM may perforate
->TX: antibiotics and painkillers - Serous Otitis Media
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M. Ear
OM w/ Effusions
-chronic inflamation, no infection
-thick, gelatenous "glue ear"
-cond. HL
TX: optional - Suppurative Otitis Media
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M.ear
-infected fluid
-otalgia, cond. HL, TM red/bulging, otorrhea
-Comp: enzymes eat ossicles, mastoiditis, meningitis, cholesteotoma, S/L delay
TX: antiboitics, PE tubes/myringotommy, tympanoplasty - Cholesteotoma
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M.ear
-benign tumor
-seem w/chronicOM w/TM perforation
-made of dead skin cells/fat
-chronic neg. m.ear P draws cell thru perforation
-otorrea, otalgia, HL depending on location (may eat ossicles), brain abscess or meningitis
TX: modified radical mastoidectomy (remove tumor and part of EAC wall)
-Cond. HL may remain after surgery - Eustachain Tube Dysfunction
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-M.ear
-usually result of Upper resp. infection
Patulous E. T.:
->ET always open, annoying to hear on speech/breathing, no TX - Disarticulation
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M. ear, ossicles
-break in ossicular chain (ossicles may be eaten by cholesteotoma or OM)
-MAX cond. HL
TX: surgery or heal naturally - Heredity, Inner Ear
- 55% of congenital cases, may be progressive, may be part of syndrome
- Rh Incompatibilty, Inner Ear
- mom makes antibodies against fetus, problems with 2nd+ pregs., Rhonogram shot given after 1st baby to prevent, may cause Erythroblastosis (lots of disorders occur)
- Medications/Drugs, Featal Alchohol Syndrome, Inner ear
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Prenatal, cross placenta
-thalidomide, other Rx drugs
-some OTC drugs and illegal drugs make problems
FAS: many problems, HL is just one - Maternal Infections, Inner ear
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-Rhubella
-CMV
-Toxoplasmosis (parasite in cat poop/raw meat)
-Genital Herpes (perinatal)
-Syphillis (perinatal) - Perinatal Complications, Inn.Ear
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-anoxia (usually CP also results, high F SNHL)
-prematurity
-infection (group B Strept common)
-hypterbillirubinemia (jaundice, liver problem, CNS damage)
-newborn infection (many treated with Ototoxic drugs) - Noise Exposure, inner ear
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TTS: temporary shift, related to F exposed to, plateaus (shifts only so far)
PTS: permanent, lots of TTS over time, hair cells die, light skin/eyes/hair more likely
--> 'Noise notch' at 2/*3/4/*6 kHz
-audiogram slopes down - Presbycusis
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inn. ear
-caused by oldness
-hard to distinguish from NIHL
-some genetic basis, related to cardiovascular problems
-audiogram constant slope down
-speech understanding problems
-bilateral, progressive - Systemic Viral/Bacterial infections, Inn.Ear
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-meningitis (bilateral severe-profound HL)
-measles
-mumps (usually unilateral)
-chicken pox
-syphillis
-Herpes Zoster (shingles)(affects facial nerve) - Labrynthitis
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inn. ear
-HL w/ or w/o vertigo
-somtimes hearing returns to normal, sometimes not
-infection of cochlea - Ototoxic Drugs
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inn ear
-more risk with high doses, preexisting HL, kidney problems, old people, concurrent noise exposure, hypretension, fever
-aminoglycoside (end in -mycin), loop diuretics, chemotherepy=common causes
-tinnitus is first symptom
-HL may be delayed, may be temp. or perm. - Meniere's Disease
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Inn ear
-aka endolymphatic hydrops
-too much endolymph in cochlea
-P builds on HCs in coch
symp: sudden HL in one ear, severe vertigo, roaring tinnitus, fullness
-lasts hours or weeks (per attack
TX: avoid salt/caffine, take diuretics, antiverts (combat vertigo), endolymphatic sac decompression, meniette device, sever VIII nerve - Vascular disorders
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Inn ear
-sudden SNHL unilateral
-may have vertigo and tinnitus
TX: IV vasidoalators to open vessles and restore hearing - Sudden Idiopathic HL
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inn ear
-no idea what caused it
-other disorders ruled out
-25-50% will return to normal - Head Trauma
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inn ear
-fracture to temporal bone, membranous labrynth damaged
no TX - Perilyphatic Fistula
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inn ear
-inn ear fluid leaks to mid. ear
-caused by heat trauma, barotrauma, congenital, blowing nose
symp: fluxuation SNHL, progressive, vertigo, worse at night
TX: may fix itself, surgery can fix vertigo but not HL - Autoimmune Inner Ear Disease
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-progressive, fluxuating SNHL
-bilateral (may be to different degrees tho)
-1/2 have vertigo
-age 40-50 onset. more in women
TX: steroids (improves hearing, but can't stay on for life) - Acoustic Neuroma
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ANS
-slow growing, usually benign tumors on 8 nerve
Small: high F HL, tinnitus, speech percept. probs, feel full
BIG: taste affected, headache, pain/numb in face, otalgia, vertigo
TX: surgical removal (8 nerve may be severed in process, permanent HL) - Neurofibromatosis (NF2)
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ANS
-tumors on peripheral nerves
-bilateral acoustic neuromas
-if malignant, must be removed (probably remain deaf)
-inherited disorder - Multiple Sclerosis
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ANS
-myelin breaks down
-may or may not cause HL
-episodic-HL may go away - Vascular Neuritis
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ANS
-inflamation of vestibular part of 8 nerve
-one sudden, severe vertigo episode (3-4 days)
-no HL
-may feel unsteady for up to 6mos - Auditory Dysynchrony/Neuropathy
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ANS
-normal OAEs, not normal ABRs
-PTTh may be almost normal->profound HL
-usually bilateral, may not symmetric
-very poor speech understanding
TX: visual communication techniques, coch. implants - Brain Stem disorders
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ANS
-lower BS: PTTh may be affected, ipsilateral
-higher BS: normal PTTh, contralateral or bilateral symps, poor speech perception
-tumors or MS can affect BS - Auditory Cortex disorders
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ANS
-normal PTTh, poor speech perception, contralateral symps.
-tumors
-MS
-Stroke (aphasia affecting receptive language
-head trauma
-APD-umbrella term, symp. probs: aud. sequencing, aud. memory, aud. discrimination, aud. closure (po_rn), localization