Inner Ear Disorders

Question 1

Rubella Virus (German measles)

Answer 1

Greatest effect on auditory system during the 1st and 2nd trimester (teratogen)
Can lead to
- congenital HL
- congenital cataracts
- Cardiovascular problems
- possible intellectual disability

Question 2

Paramyxovirus (mumps)

Answer 2

Affects salivary glands, primarily the parotid gland
Can lead to
- acquired permanent SNHL, typically unilateral

Question 3

Cytomegalovirus

Answer 3

A part of the herpes family
Very common viral disease that mimics the common cold
Once affected, you will always carry the virus. It is only teratogen if the mom has an active flare-up during pregnancy.
Can lead to
- progressive profound permanent SNHL with final stage being reached around 3-5 yrs old
- CI candidacy
- Cardiovascular problems
- Neurological and motor deficits
- Blindness
- Intellectual disability

Question 4

Acquired Immunodeficiency Syndrome (AIDS)

Answer 4

Caused by HIV
Attacks the nervous system, lymph glands, and immune system
Can lead to
- OME with or without CHL; SNHL (during later disease stages)
- Otalgia
- Vertigo
- Tinnitus
- Aural fullness
- Reduced OAEs (OHCs affected)
- Delayed ABR interwave latencies (central effects)
Can also be symptoms secondary to
- Ototoxic effects of the AIDS Tx
- Recurrent/chronic OME and other opportunistic infections that attack the ear due to the suppressed immune system

Question 5

Pediatric AIDS (PAIDS)

Answer 5

Can be transmitted through the placenta and be congenital.
Can lead to
- Greater incidence of otitis media with poorer prognosis in children with AIDS due to the compromised immune system
- Higher rate of recurrence of infection
- Higher failure rate of response to treatment
- Edema of the brain tissue
- encephalopathy/encephalitis

Question 6

Meningitis

Answer 6

Inflammation of the meninges surrounding the CNS (brain and spinal cord)
Symptoms include fever, neck rigidity, headache, nausea
If it goes untreated, it can lead to
- SNHL
- permanent abnormal cochlear bone formation
- Vertigo and balance problems
- blindness
- paralysis

Question 7

Perilymphatic Fistula

Answer 7

An abnormal connection in either or both the oval and round window to the ME space and fluid (perilymph) filled spaced.
Symptoms include
- Episodic vertigo without hearing loss
- Hearing loss without vertigo
- Symptoms maybe virtually indistinguishable from Meniere’s disease, i.e., tinnitus, SNHL, vertigo, aural fullness
- Miscellaneous symptoms with disequilibrium but not episodic vertigo

Question 8

Presbycusis

Answer 8

Sensorineural hearing loss associated with aging. A vascular, metabolic, and neural disorder.
Common manifestations include
- sloping high frequency SNHL (>1kHz)
- may progress to a flat configuration
- Difficulties with speech perception especially in noise
- Struggle with consonants
- Upward spread of masking
- Recruitment

Question 9

Noise-Induced Hearing Loss (NIHL)

Answer 9

Hearing loss that is caused by both the dose (level) and duration of noise exposure.
High frequency and narrow-band sounds are more harmful.
Common manifestations include:
- profound SNHL RARELY
- low freqs rarely worse than 40 dB
- high freqs are rarely worse than 75 dB
- asymmetries can occur in those who shoot guns
- symmetry related to occupational or recreational noise exposure

Question 10

Acoustic Trauma

Answer 10

A distinct form of NIHL that results in sudden permanent hearing loss. Caused by impulse noise (i.e. bombs, firearms, industrial blasts) or blast injuries from high pressure waves caused by explosions.
Very loud sounds >140 can cause TM ruptures and fracture of the ossicular chain
Manifestations include:
- noise notch at 3k and 6k
- variety of configurations with flat being the most common
- Type Ad tymps
- absent ARTs