Deafness in adults Flashcards
What are dangerous causes of deafness in adults?
acoustic neuroma
cholesteatoma
effusion from nasopharyngeal cancer
What are the most common causes of hearing loss?
ear wax
OM
OE
What is the inheritance pattern of otosclerosis?
autosomal dominant w incomplete penetrance
what is otosclerosis?
vascular spongy bone replaces normal lamellar bone of otic capsule origin particularly around the oval window which fixes the stapes footplate, restricts ossicular movement
What are the sx of otosclerosis?
conductive deafness
tinnitus
mild transient vertigo
Schwartz sign - pink tinge to TM
When does onset usually occur with otosclerosis?
20-40 years
What is the treatment of otosclerosis?
- fenestration - old method
- Hearing aid
- Surgery to replace adherent stapes - stapedectomy
- fluoride - inhibit sclerotic progression
- cochlear implant if severe
What is presbycusis?
age related hearing loss (high frequency sounds) from accumulated environmental noise toxicity
What causes eventual deafness in presbycusis?
sensory hair cells and neutrons in the cochlea atopy over time
When is hearing most affected in presbycusis?
in the presence of background noise
How does presbycusis present?
History of: speech becoming difficult to understand need for increased volume TV difficulty using telephone worsening of sx in noisy environments
What investigations are done in presbycusis
- otoscopy - rule out otosclerosis, cholesteatoma + conductive hearing loss (foreign body, impacted wax)
- Tympanometry - normal middle ear function w hearing loss
- audiometry - bilateral sensorineural pattern hearing loss
- bloods - inflammatory markers and abs normal
What does unilateral sensorineural deafness indicate?
acoustic neuroma
