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absence of pinna


closing off of ear canal


narrowing of EAC


small ear/pinna

supernumerary hillocks

ear tags

aural discharge

ear wax, clear fluid-trauma, cloudy fluid, blood, foreign bodies

bony growths

exotoses (multiple growths), osteoma (single growth)

inflammatory conditions

otitis externa, perichondritis (wrestler's ear), furuncle (pimple)

conductive system best assessed

visually, tympanometry

tympanometry measures

tympanic membrane mobility, ME pressure, static compliance (mass, friction, stiffness), patency of PE tubes, ear canal volume

static compliance

mass - ossicles, friction - muscles and ligaments, stiffness - footplate of stapes

anamolies of ME occur with

atresia, cleft palate, microtia; often corrected by surgery

anamolies of ME include

abnormalities, fusion/absence of ossicles

malformations of the inner ear

michel aplasia (inner ear/auditory nerve fail to fully develop), mondini aplasia (incomplete development of inner/middle/outer ear), scheibe aplasia (most common, membranous portion of cochlea-stria vascularis-organ of corti)


hearing loss noted during first 2 weeks of illness, sensorineural loss, associated with upper respiratory infections, diagnose quickly, watch carefully-->cochlear implant possible, ABR/behavioral testing


rare, fatal, undercooked meat, premature birth, CPalsy, blindness, hydrocephaly, appear normal at birth but symptoms appear later on; 2-7/1000 women affected, 30-40% the fetus infected as well

Other.... syphilis

STD, CNS abnormalities, sensorineural hearing loss; by age 2 hearing loss shows


viral, 50% of time hearing loss occurs, may cause heart disease, eye problems; immunizations key

CMV - cytomegalovirus

most common, harmless to most ppl, causes vision problems, seizures, death, dev/cog. delays, transmitted through breast milk; up to 10-40% of children are carriers; no known treatment

Herpes simplex virus

genital herpes/STD, mother's first outbreak during pregnancy, sensorineural loss, 50% mortality rate


drugs that cause damage, but save life (aminoglycosides, chemotherapy drugs, aspirin/quinine, loop diuretics(if with other ototoxicity drugs will cause problem)

presence of OAEs

little or no conductive loss from ME abnormality; normal OHC function; with sensorineural loss = disorder is retrocochlear

absence of OAEs

with conductive loss = does not eliminate possibility of cochlear/retrocochlear loss; with sensorineural loss = confirms cochlear pathology, but doesn't rule out retrocochlear

assessment of neural system

measures of temporal and processing aspect; brain imaging; AEPs

Types of AEPs



patients sleeping, SP(IHCs), AP(distal portion of 8th nerve, IHC-Spiral ganglion), CM(OHCs); 1.5-2ms


2-10ms; 8th nerve; screening


12-60ms; auditory thalamus, primary auditory cortex; awake


75-200ms, awake, auditory cortex


200-600ms, APD, awake, medial temporal lobe

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