Hearing loss

Question 1

what type of hearing loss do patients on cisplatin for laryngeal cancer have

Answer 1

• High frequency loss

- outer hair cells affected

Question 2

High frequency sounds are detected where?

Answer 2

in the base!

low frequency - apex

Question 3

semicircular canals are responsible for what type of movement?

Answer 3

rotational

Question 4

Otolithic organs responsible for

Answer 4

linear movement

Question 5

what type of test is the weber?

Answer 5

Screening test

Question 6

10 decibels is

Answer 6

a doubling of sound

Question 7

Normal persons dB hearing

Answer 7

At 20 or better at all frequencies

Question 8

If the bone conduction and air conduction lines overlap and are reduced (below 20) then

Answer 8

Have sensorineural hearing loss

if a gap >=15 dBls = air conduction

Question 9

Cerumen should always be present where?

Answer 9

More proximally, not close to the ear drum

Question 10

Common external ear organisms

Answer 10

Pseudomonas Aer
E. coli
S. aureus

Question 11

treatment of otitis externa

Answer 11

4 drops ciprodex (CIPRO and Dex) BID x7 days

Question 12

who is at risk for malignant OE

Answer 12

Immunocompromised, elderly, Diabetic

Question 13

3 key features of malignant OE

Answer 13

• granulation tissue floor
• Nocturnal pain
• pseudomonas

Question 14

What is a cholesteatoma

Answer 14

squamous epithelium of middle ear, not a tumor, due to retracted drum

Question 15

How does a cholesteatoma present?

Answer 15

draining ear
foul smelling discharge
conductive loss
wax in epitypanic area

Question 16

Fixation of the stapes to the oval window - disease?

Answer 16

Otosclerosis - progressive conductive hearing loss

Question 17

what is the carhart notch

Answer 17

Bone line dips down at 2kHz

air conduction line comes up at 2 kHz

Question 18

4 kHz notch suggestive of

Answer 18

Noise induced hearing loss

Sensorineural!

Question 19

Gradual decline in hearing loss - worse at higher Hz - Presbycusis

Answer 19

age related
Sensorineural HL
bilateral

Question 20

Drugs that can cause ototoxicity (3 classes)

Answer 20

Aminoglycosides - gentamycin, strepto
Salicylates - loop diuretics, antimalarials
Cisplatin

Question 21

2 mechanisms of ototoxicity

Answer 21

lose the outer hair cells

and High Hz sound

Question 22

Most imp treatment for SNHL that is sudden onset

Answer 22

oral steroids 72 hr

Question 23

Hearing aids can treat both

Answer 23

conductive and SNHL

Question 24

Criteria to diagnose meniere’s disease

Answer 24

1) 2 episodes of rot vertigo last 20 minutes
2) Audiometric confirm SNHL
3) Tinnitus/pressure

Question 25

Treatment of meniere's

Answer 25

``` Benzo antihistamine anticholin antiemetic rest volume replete ```

Question 26

ways to prevent acute episodes of meniere's

Answer 26

Diuretics vestibular suppressant betahistidine - vasosdilator

Question 27

treating malingnant OE

Answer 27

- IV anti pseudomonal Abx | surgical debirdement

Question 28

retraction of which pars is associated with a cholesteotoma

Answer 28

pars flaccida

Question 29

middle ear disease that progresses during pregnancy

Answer 29

Otosclerosis

Question 30

carhart's notch suggests

Answer 30

otosclerosis | conductive loss

Question 31

central perforation that does not involve the annulus

Answer 31

usually due to infection

Question 32

what infections can cause inner ear disease - hearing loss

Answer 32

TORCH | meningitis

Question 33

progressive bilateral SNHL high frequency

Answer 33

presbycusis

Question 34

what can cause sudden onset SNHL

Answer 34

viral vasculature autoimmune

Question 35

vestibular neuronitis lasts

Answer 35

days to weeks

Question 36

BPPV lasts

Answer 36

one minute or less

Question 37

causes of BPPV

Answer 37

idiopathic trauma vestibular neuritis degenerative

Question 38

``` Dix hall pike maneuver BPPV latency: duration: Nystagmus response ```

Answer 38

2-10 seconds 15-60 seconds reverses upon sitting fatiguable

Question 39

acute (1-5 days) extreme vertigo with nausea, disabling | nystagmus towards affected side

Answer 39

vestibular neuritis - self-limited

Question 40

treatment for vestibular neuritis

Answer 40

anti-inflammatory