Hearing Loss

Question 1

What drugs cause hearing loss

Answer 1

Loop diuretic
Aminoglycosides
Chemotherapy drugs, e.g. cisplatin

Question 2

1. What is the purpose of the Rinne’s test?
2. Explain Weber’s test

Answer 2

1. To test for conductive hearing loss

You have conductive hearing loss in the right ear if BC>AC in the right ear. This is Rinnes negative
If one or both ears are Rinne’s positive i.e. AC>BC, this does not tell you if the ear/ears are normal or if there is sensorineural hearing loss.

Therefore you MUST then perform Weber’s next to confirm if there is sensorineural hearing loss.

2. Weber’s test:

If right ear has conductive hearing loss, and left ear is normal, sound will lateralise to the conductive loss ear.

If R ear - conductive loss and L ear - sensorineural loss, sound will lateralise to right side.

Therefore in Weber’s…

Sensorineural hearing loss: Sound localises to the normal/better ear

Conductive hearing loss: Sound localises to the worse ear

Question 3

1. What is presbycusis?
2. Symptoms of it?
3. Risk factors?

Answer 3

1. Age related sensorineural hearing loss
2. Gradual onset symmetrical hearing loss initially of HIGH PITCHED NOISES, e.g. speech, tinnitus
3. Age, smoking, diabetes, hypertension
   Loud noise exposure
   Ototoxic medications
   Male
   Family history

Question 4

Management of idiopathic sensorineural hearing loss?

Answer 4

Immediate referral to ENT within 24 hours of presentation
Oral/intra tympanic steroids

Question 5

Contradindications to ear irrigation?

Answer 5

Perforation of tympanic membrane
Otitis externa

Question 6

Management options for ear wax removal?

Answer 6

1st line: Olive oil/sodium bicarbonate 5% drops
2nd line: Ear irrigation
3rd line: Microsuction