Hearing loss
Hearing Loss
Presented by Nader Aldajani, an Otologist at KFMC.
Presentations
Definition
Deafness is the loss of auditory function.
Conductive Hearing Loss (CHL) Involves external and middle ear diseases up to the footplate of the stapes.
- Air decreased-bone normal, there is an air-bone gap
Sensorineural Hearing Loss (SNHL)
Involves diseases ahead of the footplate of the stapes up to the auditory cortex. - Both air & bone decreased-there is NO air-bone gap.
Causes of SNHL
- Congenital
- Acquired: Infections of labyrinth, trauma, noise-induced hearing loss, ototoxic drugs, presbycusis, Ménière’s disease, acoustic neuroma, sudden hearing loss, systemic disorders.
Mixed Hearing Loss (MHL)
- Both air & bone decreased-there is an air-bone gap.
Degree of hearing loss
- 10 – 25 dB HL: Normal range
- 26 – 40 dB HL: Mild hearing loss
- 41 – 55 dB HL: Moderate
- 56 – 70 dB HL: Moderately Severe
- 71 – 90 dB HL: Severe
- Greater than 90 dB HL: Profound
Approach
Steps
- History taking
- Complete ENT examination
- Tuning fork tests
- Audiology: PTA, Speech audiometry, Tympanometry, OAE, ABR
- Radiological investigations: CT and MRI
- Labs
Audiogram
- Hearing threshold
- Type of hearing loss
- Degree of hearing loss
- Configuration of hearing loss
Management
General Management
- Depends on the cause
- Ear wash
- Antibiotics for otitis externa and media
- Antifungal drops for otomycosis
- Hearing aid
- Surgery: Reconstruction of EAC, Myringotomy & VT, Tympanoplasty, Ossiculoplasty, Stapedectomy, Cochlear implant
Treatment
Hearing Aids
ototoxicity, meineir disease, failure of treatmentZ
Cochlear Implant
profound bilateral hearing lossz
Indication and Contraindication
Indications
- Bilateral severe-to-profound sensorineural hearing loss with PTA of 90 dB or greater in better ear
- -No appreciable benefit with hearing aids
contraindication
- If there is absent cochlea
- If there is absent vestibulocochlear nerve