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Hearing 4

Terms in this set (52)

perforations
tears of the TM can occur because of: excessive pressure build-up of ME space, direct trauma, sudden pressure in the EAM.
tympanosclerosis
thickening or scarring of the TM.
Patulous Eustachian Tube
Persistently patent/open ET
Autophony
Physical disorder
otitis media
An accumulation of fluid in the ME space.
The fluid may be watery (serous) or mucoid (secretory)
The condition may be short-lived (acute) or persistent (chronic)
The fluid may be infectious (supperative or purulent) or non-infectious (non-supperative).
Mastoiditis
- infection of the mastoid air cells of the temporal bone.
Cholesteatoma
a cystic mass in the ME that can result from a chronic ME infection or occur for no reason; can also be congenital. May be removed surgically
Otosclerosis
abnormal growths or deposits on the stapes causing it to become anchored in the oval window. Hinders movement of the footplate and thus affects the fluid movement in the cochlea. Surgical treatment is called a stapedectomy.
Ossicular Discontinuity
the breaking apart of the ossicular chain, typically caused by head trauma. Other causes may be congenital or ME disease. Most common site of discontinuity occurs at the incudostapedial joint. Treatment includes reconstruction surgery, but ossicles may fuse spontaneously.
Temporal Bone Fracture
Bone is extremely dense requiring substantial force to fracture
Blunt
auto accidents, falls, assaults
Penetrating
gunshot wound, stabbings
Compressive
blast injuries, ear strikes
Barotrauma
descent from high altitudes or ascension during diving
Longitudinal
70-80% of temporal bone fractures
Force applied to side of head
Transverse
Force applied to frontal bone
50% result in facial nerve paralysis
Outer and middle ear pathologies
May resolve on their own.
Can generally be treated surgically or pharmaceutically.
May cause a conductive hearing loss.
Inner ear and central auditory pathologies
Usually are not treatable. Considered to be permanent
May result in a sensorineural hearing loss when site of lesion is the inner ear or cranial nerve VIII.
Auditory processing disorder is the typical result of a central auditory lesion.
Anotia or agenesis
absence of the pinna
Microtia or aplasia
deformation of the pinna
Chrondritis
infection of the cartilage of the pinna
Cauliflower ear
disfiguration of the pinna caused by accumulation of blood between the cartilage and its covering.
Otitis externa/swimmer's ear
non-descript outer ear infection caused by bacteria, fungus, virus or a combination
Extosis
bony growths on bony portion of EAM
Cold water
Osteomas
occur more laterally than extosis
Just one rather than two, more in kids
Collapsing ear canal
a narrowing or closure of the EAM produced when unusual pressure compresses the pinna against the side of the head. (older patients)
Impacted cerumen
ear wax becomes impacted when it occludes the canal and gets lodged into place
Stenosis
narrowing of the EAM
Atresia
Complete closure or absence of the EAM.
May involve 1 or both ears.
1 out of 10-20,000 live births.
Males more than female.
Unilateral more than bilateral
Sensorineural Hearing Loss
Permanent hearing loss
Sound distortion
Poor hearing in noise
Accompanying tinnitus
tinnitus
Subjective noise in ear
Can sound like ringing, buzzing, roaring, whistling, etc
caused by outer hair cell damage
Noise Exposure
Loss may be temporary or permanent.
Damages the cochlea.
Long-term exposure to a hazardous noise environment can lead to a noise-induced hearing loss (NIHL).
Short-term exposure to a single blast of intense noise can lead to acoustic trauma.
Temporary threshold shift is caused by short-term exposure to a noisy environment.
Presbycusis
Hearing loss associated with aging changes.
Causation includes environmental and genetic factors.
Age of onset varies.
Gradual bilateral loss of hearing.
Higher frequencies are affected first
Ototoxicity
Reaction within the auditory system to exposure to a toxic substance.
Toxins reach blood supply of the cochlea and vestibular system.
Hair cells are affected.
Can be congenital or acquired.
OAEs used for early detection/changes
Autoimmune Inner Ear Disease
Immune system dysfunction
Antibodies or activated immunologic cells directed at inner ear
Can be primary or secondary disease
Bilateral fluctuating sensorineural hearing loss
Possible tinnitus, vestibular dysfunction
Sudden Idiopathic Sensorineural Hearing Loss
Hearing loss that occurs suddenly and seemingly without reason.
Severity varies; at least 30 dB in 72 hour period is definition
Different than acute onset
Typically unilateral
Recoverable in many cases
Perilymph Fistulas
Leaking of perilymph from either round or oval window
Periods of hearing loss and/or imbalance
Diagnosis difficult; condition cannot often be confirmed
Possible causes: trauma, congenital
Treatment typically rest
Typically unilateral
exploratory diagnosis
Superior Canal Dehiscence
Bony covering of superior semicircular canal is absent, exposing membranous portion.
Fluid leak possible.
Tulio's Phenomenon
Surgical repair possible
Tulio's Phenomenon
noise-induced vertigo;
loud noises cause the patient
to be dizzy
Meniere's Disease
Disorder of the inner ear that appears to be related to a failure of the mechanism regulating the production, circulation and/or absorption of endolymph.
Meniere's Disease symptoms
Unilateral low frequency SN hearing loss
Vertigo
Tinnitus
Ear fullness
Vestibular Meniere's Disease
Vertigo and fullness are the primary symptoms
Cochlear Meniere's Disease
SNHL and tinnitus are present without the vestibular signs.
Thought to be as much as 10X more common than the classic form.
Benign Paroxysmal Positional Vertigo BPPV
Most common cause of episodic vertigo
Otoconia loosen from utricle and settle into a SCC.
Movement causes temporary fluid disturbance causing conflicting signals
Possible causes: head trauma, aging
Treatment: Canalith Repositioning, Epley manuever
Acoustic Neuroma
Benign, slow-growing tumor located on Cranial Nerve VIII.
Vestibular trunk 90% of time
Arises in IAC (internal auditory canal)
As it increases in size, may intrude upon neighboring cranial nerves and brainstem structures.
Signs include:
Hearing loss and/or tinnitus
Vestibular symptoms
Incoordination and staggering gait
Facial nerve problems
Headaches, vomiting
Dysarthria, dysphagia
Most often unilateral.
Treatment includes surgical removal
Auditory Neuropathy Spectrum Disorder
Auditory nerve disorder
Hearing loss - main symptom
Present OAEs
Absent acoustic reflexes
Abnormal ABR
Same rehabilitation may work for some and not others
Missed diagnosis in infant newborn hearing screening depending on assessment used.
Bell's Palsy
Generalized weakness or paralysis; typically unilateral
Sudden, recovers on its own
Can affect sense of taste, tear and saliva production
Cause usually viral in nature; NOT due to stroke
Recovery is possible
Herpes Zoster Oticus (Ramsay Hunt Syndrome)
Inflammatory viral infection, rash (EAM, Pinna, etc.)
Fluctuating unilateral sensorineural hearing loss; relatively sudden.
Otalgia, tinnitus, nausea, facial paralysis, dizziness possible
CN V through XII may be affected.
Recovery is possible
Functional Hearing Loss
Apparent losses that cannot be attributed to an organic etiology or structural change.
In adults, may be related to:
Monitary gain
Emotional stress
Avoidance of specific situations
In children, may be related to:
Attract attention
Shift the concerns of parents or teachers.
Also known as: non-organic, pseudohypoacusis, malingering
Auditory Processing Disorders
Auditory processing is defined as information processing of auditory stimuli.
What we do with what we hear.
Incoming signals, words and sounds, are "processed" as particular words and specific sounds. We assign priority to these signals in order to decide what we listen to and what we let fall into our auditory background.
It is not uncommon for APD to be first identified in children. These children are often suspects for what appears to be a hearing impairment. However, results of the standard audiological evaluation typically suggest normal peripheral hearing.
Central auditory processing disorders (CAPD)
are deficits in this information processing not as a result of impaired peripheral hearing or intellectual impairment
Behavioral Characteristics
APD
Easily distracted by visual and/or auditory stimuli.
Hyperactivity - May be labeled a behavior problem. This child has the inability to ignore incoming, unimportant stimuli and reacts to everything.
Hypoactivity - May be labeled as a "slow learner". In a constant fight to ignore unimportant stimuli, the child becomes tired, lethargic and sometimes bored.
Tend to spend an extreme amount of time alone, possibly because of low self-esteem from constant failure.
Academic Characteristics
APD
Difficulty following verbal instruction.
Spelling skills are poor.
Reading difficulties.
Difficulty attending to class work.
Consistently does not complete assignments.
Poor results on verbal and/or auditory subtests in a psychoeducational test battery.
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