deafness for undergraduates
Post on 10-Apr-2017
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Deafness
By Moustafa M. Dawoud
Assistant lecturer of ORLMFM 2015
Deafness
Definition:Diminution of hearing??
Drop of hearing threshold by 20dB or more.Mild >> 20-40 dB
Moderate>> 40-60 dB
Severe>> 60-80 dB
Profound>> more than 80 dB
Deafness
Types
Conductive Sensorineural
Mixed Functional
Deafness
Conductive deafness
•WaxEAC•Perforation either pathological
or traumaticTM•Otitis media.…
•Otosclerosis•Eustachian tube
ME
Ear wax
TM Perforation
Stapes removed
Deafness
SENSORINEURAL HEARING LOSS
SNHL
The defect is either Cochlear>> failure to convert sound waves
into electrical impulses.
Retrocochlear>> defect in transfer of impulses along the 8th nerve.
SNHL
Cochlear SNHL
1 -Congenital:Usher , Pendred $>>>Heridetary
Rubella & Drugs>>> Prenatal
Delivery trauma>>> Natal
Kernictrus & Neonatal infection>>> postnatal
Cochlear SNHL
2_ Traumatic:- Fracture skull base,- Acoustic trauma >>>acute or chronic exposure- Stapedectomy.
- 3- Inflammatory:- Infective: viral(MMR) , Syphilis.- Toxic: drugs , uremia , thyrotoxicosis.
Cochlear SNHL
4 -Vascular.>> spasm or embolus in internal auditory artery.
5 -Miscellaneous:-presbycausis.
-Meniere’s-Pure cochlear otosclerosis
-PLF
Retrocochlear SNHL
1 -Vestibulococchlear nerve affection:Acoustic neuroma, congenital cholesteatoma, Meningitis, vascular loop.
2 -Central lesions : e.g, MS, Brain tumors.
Comparison
SNHL CHL Character
High LOW Voice
Poor Good Speech discrimination
High frequenciesHears men better
Hears worse in noise
Low frequencies-Hears women
better-Hears better in
noise
Frequencies affected
Assessment
Subjective: Infants>> distraction method
2-5 years>> play-conditioned audiometryAbove 5 years & Adults>> PTA , Speech audiometry.Objective :ABR EChoGOAE
PTA
CHL Mixed Hearing loss
Synopsis
1 -Commonest cause of CD= ear wax.2 -CD in children= think of SOM first!
3 -Bil CD with intact TM= think otosclerosis!4 -Elderly , gradual hearing loss???
Presbyacusis.5 -Severe HL in children (MMM)
6 -unilateral SNHL, adult, very poor speech discrimination??? Think acoustic neuroma
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