The document discusses various causes of hearing loss including conductive hearing loss like glue ear and malignant otitis externa. It also discusses sensorineural hearing loss such as presbycusis, Meniere's disease, and acoustic neuroma. Tests for investigating different types of hearing loss are mentioned.
The document discusses various causes of hearing loss including conductive hearing loss like glue ear and malignant otitis externa. It also discusses sensorineural hearing loss such as presbycusis, Meniere's disease, and acoustic neuroma. Tests for investigating different types of hearing loss are mentioned.
The document discusses various causes of hearing loss including conductive hearing loss like glue ear and malignant otitis externa. It also discusses sensorineural hearing loss such as presbycusis, Meniere's disease, and acoustic neuroma. Tests for investigating different types of hearing loss are mentioned.
The document discusses various causes of hearing loss including conductive hearing loss like glue ear and malignant otitis externa. It also discusses sensorineural hearing loss such as presbycusis, Meniere's disease, and acoustic neuroma. Tests for investigating different types of hearing loss are mentioned.
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ENT
Most common cause of conductive hearing loss in childhood is: GLUE EAR/ OTTITIS MEDIA WITH EFFUSION. Bluish grey retracted or bulging tympanic membrane, ear pain is rare, parental smoking is a R/F, audiogram show conductive hearing loss, reassure and review after 3 months, surgery grommet insertion, hearing aids
ACUTE OTTITIS MEDIA: usually preceding viral URTI, red, erythematous or cloudy bulging tympanic membrane, absence of cone reflex or light reflex not visible rapid onset of ear pain, fever, bacterial [s.oneumonia] or viral [conservative treatment, PCM, analgesics] , Amoxicillin 5 days course. erythro or clarithromycin.
Malignant otitis externa: in diabetes or immunocompromised patients, severe ear pain,
headaches, conductive hearing loss, foul smelling discharge, cranial nerve involvement [7,1 CN], IV antibiotics. Acute otitis externa: itch first then ear pain, discharge, bacterial, hearing diminished, topical gentamycin + hydrocortisone, oral flucloxacillin if infection spreading.
Lipoma: soft, mobile, round and painless mass within dermal layer of the skin. Epidermoid cyst: firm, round nodules of various sizes with a central punctum, cutaneous cyst results from proliferation of epidermal cells within a circumscribed pace of dermis. Cystic hygroma: transilluminates. Branchial cleft cyst: do not transilluminate
Conductive hearing loss Sensorineural hearing loss
Glue ear/OTTITIS MEDIA WITH EFFUSION Labyrinthitis viral
[childhood], chronic otitis media Malignant otitis externa Presbycusis [age-related] progressive bilateral high frequency hearing loss Cholesteatoma [progressive deafness] Meniere’s d/s low frequency hearing loss Otosclerosis [progressive] flamingo tinge TM Vestibular schwannoma high frequency due to hyperemia hearing loss [acoustic neuroma] MRI Noise induced hearing loss high frequency hearing los Stensens duct drains the parotid gland. Whartons duct drains the submandibular glands. Stones are common in submandibular glands.
Parotid gland: most tumors; submandibular gland: most stones
Viral sinusitis: no fever and clear nasal discharge. Bacterial sinusitis: fever present and nasal discharge can be colored
Allergic rhinitis: for mild to moderate cases oral or intra-nasal antihistamines can be used; for moderate to severe cases intranasal corticosteroids can be used. Topical decongestants should not be used for more than a week as they may cause rebound congestion [rhinitis medicamentosa] on withdrawal, also tachyphylaxis.
Nasal polyps: if small and bilateral not causing severe nasal obstruction managed with saline nasal douche and intranasal steroids. If unilateral, large polyps causing obstruction or bleeding present refer to ENT or nasal endoscopy.
Abscess will usually present with fever and general malaise.
Pure tone audiometry or MRI: to investigate Sensorineural type of hearing loss
Otoscopy for examination of external auditory canal, tympanic membrane, and the middle ear.
CT scan FOR HEAD INJURIES AND CSF RHINORRHEA
Auditory brainstem response (ABR) is a test that can help to identify
neural or brainstem abnormalities in the auditory pathway, such as an acoustic neuroma. However, it is not the first-line test for a simple sensorineural hearing loss and would not typically be used unless there was a concern for a central cause of the patient's hearing loss.
Pure-tone audiometry is the initial test of choice for assessing
sensorineural hearing loss. It is a subjective test that measures the softest sound an individual can hear at various frequencies. This test provides an audiogram, which is a graphical representation of the auditory threshold as a function of frequency. The test can distinguish between conductive and sensorineural hearing loss and can quantify the degree of hearing loss. This test is preferred over other options because it directly assesses the patient's perception of sound across a range of frequencies and can differentiate between types of hearing loss. Tympanometry is typically used to assess the function of the middle ear, looking for evidence of fluid, wax, or perforation of the tympanic membrane that might be causing conductive hearing loss, which does not fit with this patient's presentation.
Otoacoustic emissions (OAE) are sounds produced by the inner ear
that can be measured with a sensitive microphone placed in the ear canal. This test can provide objective evidence of damage to the cochlea, particularly to the outer hair cells, but does not directly assess a patient's hearing.
