Deafness

Question 1

______ is defined as impairment of hearing,

regardless of its severity

Answer 1

Deafness

Question 2

Fifty per cent of people
over ______ years have deafness severe enough to be
helped by a hearing aid.

Answer 2

80

Question 3

The threshold of normal hearing is from ________ about the loudness of a soft whisper

Answer 3

0 to
20 decibels (dB),

Question 4

Degrees of hearing impairment with vocal
equivalent: 2, 3
— mild = \_\_\_\_\_\_\_
— moderate = \_\_\_\_\_\_\_\_\_
— severe = \_\_\_\_\_\_\_
— profound = loss of over 90 dB (shout

Answer 4

loss of 20–40 dB (soft-spoken voice)

loss of 40–60 dB (normal-spoken voice)

loss of 70–90 dB (loud spoken voice)

Question 5

________ is caused by an
abnormality in the pathway conducting sound waves from the outer ear to the inner ear, as far as the
footplate of the stapes

Answer 5

Conductive hearing loss

Question 6

__________is a defect
central to the oval window involving the cochlea
(sensor), cochlear nerve (neural) or, more rarely,
central neural pathways

Answer 6

Sensorineural hearing loss (SNHL)

Question 7

The commonest acquired causes of deafness
are 
1
2
3

Answer 7

impacted cerumen (wax), serous otitis media
and otitis externa

Question 8

People with mild hearing loss notice only subtle
differences and may have trouble hearing certain
high-frequency sounds, such as______

Answer 8

‘s’, ‘f’ or ‘th

Question 9

Hair-rubbing method to assess hearing loss

If this sound
cannot be heard, a________ loss is likely
(usually about 40 dB or greater).

Answer 9

moderate hearing

Question 10

Audiometric assessment includes the following:

1
2
3
4

Answer 10

• pure tone audiometry
• impedance tympanometry
• electric response audiometry
• oto-acoustic emission testing

Question 11

_______is a graph of frequency expressed
in hertz versus loudness expressed in decibels. The
tone is presented either through the ear canal (a test
of the conduction and the cochlear function of the ear)
or through the bone (a test of cochlear function

Answer 11

Pure tone audiometry

Question 12

_______ measures the mobility of the tympanic
membrane, the dynamics of the ossicular chain and
the middle-ear air cushion

Answer 12

Tympanometry

Question 13

How is tympanometry done?

Answer 13

The test consists of a sound
applied at the external auditory meatus, otherwise
sealed by the soft probe tip.

Question 14

Deafness may be associated with what syndromes?

Answer 14

Deafness may be associated with Down syndrome

and Waardenburg syndrome.

Question 15

________,
which is dominantly inherited, is diagnosed in a
patient with a white forelock of hair and different
coloured eyes

Answer 15

Waardenburg syndrome

Question 16

_____ and ______ are common causes of

temporary conductive deafness

Answer 16

Purulent otitis media

and secretory otitis media

Question 17

Permanent deafness in the first few years of life
may be due to 
1
2
3

Answer 17

virus infections, such as mumps or
meningitis, ototoxic antibiotics and several other
causes.

Question 18

The aim of screening should be to recognise every
deaf child by the age of 8 months to 1 year—before
______

Answer 18

the vital time for learning speech is wasted

Question 19

When are the optimal times to perform hearing screening

Answer 19

• 8 to 9 months (or earlier)

* school entry

Question 20

The average age at which

these deaf children were diagnosed was _____

Answer 20

26 months

Question 21

Hearing milestones

_______ Should notice sudden constant sounds
(e.g. car motor, vacuum cleaner) by pausing and listening.

_______ Should respond to loud noise (e.g. will stop
crying when hands are clapped).

_______Should turn head to look for source of
sound, such as mother speaking behind
the child

Answer 21

1 month

3 months

4 months

Question 22

Hearing milestones

______ Should turn instantly to voices or even to
quiet noises made across the room.

_______ Should listen out for familiar everyday
sounds.

_______Should show some response to familiar
words and commands, including his or
her name.

Answer 22

7 months

10 months

12 months

Question 23

_________is essential to exclude middleear

effusions

Answer 23

Pneumatic otoscopy

Question 24

_________ is unreliable in children
under 4 years of age, so special techniques such as
tympanometry are required

Answer 24

Pure tone audiometry

Question 25

All children with SNHL (even those with profound deafness), as well as children with conductive losses not correctable by surgery, benefit from ________

Answer 25

amplification

Question 26

T or F, There appears to be a genetic predisposition | to presbyacusis

Answer 26

T

Question 27

``` Features of Presbycusis 1 2 3 4 ```

Answer 27

* loss of high-frequency sounds * usually associated with tinnitus * intolerance to very loud sounds * difficulty picking up high-frequency consonants

Question 28

________ is a disease of the bone surrounding the inner ear and is the most common cause of conductive hearing loss in the adult with a normal tympanic membrane.

Answer 28

Otosclerosis

Question 29

Pathology of otosclerosis

Answer 29

The normal middle ear bone is replaced | by vascular, spongy bone that becomes sclerotic

Question 30

Otosclerosis affects the ______ of the stapes may progress rapidly during _____ begins in_______ frequencies, then progresses

Answer 30

footplate pregnancy lower

Question 31

Otosclerosis • impedance audiometry shows characteristic features of ___ and ______ • may be associated with ____

Answer 31

conductive loss with a mild sensorineural loss Ménière syndrome

Question 32

A ______ is a sac of keratinising squamous epithelium that arises from a perforation involving the periphery of the TM

Answer 32

cholesteatoma

Question 33

Cx of cholesteatoma

Answer 33

destroy adjacent structures, including the TM, ossicular chain and cochlear.

Question 34

______ occurs in about 5% of the normal population but is more prevalent in older people especially with the use of hearing aids

Answer 34

Ear wax impaction

Question 35

The average wax production is ______mg/week. Most ear wax clears spontaneously without treatment.

Answer 35

2.81

Question 36

Examples of cerumenolytic drops

Answer 36

``` — carbamide peroxide (Ear Clear) — docusate sodium (Waxsol) — hydrogen peroxide — sodium bicarbonate — oil based (e.g. olive oil, almond oil) ```

Question 37

Sounds exceeding _____ are potentially injurious | to the cochlea, especially with prolonged exposures.

Answer 37

85 dB

Question 38

__________ is defined as a sound perceived by the | ear that arises from an internal source

Answer 38

Tinnitus

Question 39

When pathology in the inner ear is the cause, the tinnitus is _______

Answer 39

non-pulsating, continuous and may have variable | frequencies and intensity.

Question 40

_______ are most useful in conductive deafness. This is due to the relative lack of distortion, making amplification simple

Answer 40

Hearing aids

Question 41

Modern aids selectively amplify ________ and ‘cut out’ excessive volume peaks that would cause discomfort

Answer 41

higher frequencies

Question 42

The _________is used in adults and children with severe hearing loss unresponsive to powerful hearing aids

Answer 42

cochlear implant or ‘bionic ear’

Question 43

T or F Near normal speech and hearing may be achieved in children with congenital or acquired deafness with early implantation

Answer 43

T

Question 44

Cochlear implants The device is most suitable for children over_______s and adults with severe deafness.

Answer 44

2 year

Question 45

Red flags for priority referral

Answer 45

* Asymmetrical sensorineural hearing loss * Cranial nerve defects * Ear canal or middle-ear mass * Deep ear pain * Discharging ear

Question 46

Suspect deafness in an infant with 1 2 3

Answer 46

delayed development and in children with speech defects or behavioural problems

Question 47

Sounds tend to be softer in a ______ | loss and distorted with ____

Answer 47

conductive hearing sensorineural loss