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94 Cards in this Set
- Front
- Back
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what does it mean to have a ENDOGENOUS disorder?
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within the system
comes from GENETICS can be CONGENTIAL (from birth) |
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what does it mean to have a EXOGENOUS disorder?
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outside the system
- inflammatory disease - toxicity - accident - injury or damage |
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What is the MAJORITY of hearing loss caused by?
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mutations in the DNA
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what is a GENE?
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the unit of heredity in living organisms that is encoded in a sequence of nucleotide bases that occupy part of a LONG strand of DNA
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what is a CHROMOSOME?
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structure containing many genes. It is a packet of DNA in the cells in the form of two double helical DNA molecules.
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How many chromosomes does an offspring inherit?
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23 from each parent (22 + 1 sex)
total = 46 total X from mom, X/Y from dad |
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How many bp of DNA do the 46 chromosomes contain?
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3 billion bp of DNA
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how many mutations can cause hearing loss?
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mutations in more then 100 genes
combo- 400 types of hearing loss/deafness |
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what does AUTOSOMAL DOMINANCE mean?
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some family members in each generation are affected and others ARE NOT.
one NORMAL and one ABNORMAL copy ND x NN = 50% chance deaf |
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What does AUTOSOMAL RECESSIVE mean?
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hearing loss with TWO copies of the ABNORMAL gene
1 normal + 1 abnormal = carriers |
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what does X - LINKED RECESSIVE mean?
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if all the family members with loss are MALE & none of the affected fathers have affected sons
-- X LINKED> ** All daughters of affected fathers will be CARRIERS b/c they inherit fathers X. |
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What are the %s for patterns of inheritance?
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GENETIC 50%
NON GENETIC 25% IDIOPATHIC 25% |
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What kind of hearing loss is MAJORITY?
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autosomal recessive
75-85% |
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What is the % of autosomal dominant hearing loss?
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25%
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What is the % of Sex linked hearing loss?
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2-3%
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Where is EARWAX produced?
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ceruminous and sebaceous glands lining the ear canal
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what is the purpose of EAR WAX?
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trap sand/dust and objects from entering EAR DRUM
- migrates out of canal with skin |
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Why do hearing aid users tend to have a blockage of ear wax?
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the wax cant leak out so it gets trapped and builds up
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what blockage of ear canal by EARWAX causes CONDUCTIVE hearing loss?
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only a COMPLETE blockage causes CONDUCTIVE loss
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What is SURFER's EAR?
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DIFFUSE EXOSTOSIS
= bony growth of ear canal from COLD WATER!! - STENOSIS = narrowing of ear canal -- INFECTIONS |
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what kind of hearing loss can be caused by SURFERS EAR?
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only complete blockage can cause CONDUCTIVE hearing loss
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How do you TREAT / PREVENT SURFERS EAR?
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earplugs while surfing
trt- may involve SURGERY ** TAKES A LONG TIME TO DVP |
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what is SWIMMERS ear?
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OTITIS EXTERNA
dermatitis = skin infection ** bacterial / fungal infection of ear canal ** SHORT TIME TO DVP |
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How do you TREAT / PREVENT SWIMMER's EAR?
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treat = ear drops, antifungal
prevent= earplugs, dry out ear canal |
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what is ATRESIA?
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congenital abnormality
**NO EAR CANAL |
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what is MICROTIA?
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congenital abnormality
**SMALL, ABNORMAL PINNA |
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what is ANOTIA?
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congenital Abnormality
**NO PINNA |
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What should you do first with atresia, microtia and anotia?
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Check INNER EAR hearing before treatment!!
- bone conduction or ABR |
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what is the TREATMENT for ANOTIA?
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prosthetic pinna
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what is the TREATMENT for MICROTIA?
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ranges in severity
- facial plastic / ear surgery at 4-5 yo -repair for THIS before atresia! |
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what also occurs with ATRESIA?
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some degree of microtia
malform ossicles ** Conductive loss as well |
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what is the treatment for ATRESIA?
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reconstructive surgery at 4yo
drill thru bony plate skin grafts in canal, no cerumen ** more susceptible to infections, very fragile |
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what are some alternative treatments for atresia microtia and anotia?
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if one ear is ok, surgery may not be needed
-bone implanted hearing aid BAJA counseling and planning |
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What is the cause of TYMPANIC MEMBRANE perforation?
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trauma- hit, skull fracture, explosion
Q tip hot slag from welding infection- too much fluid |
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what population is affected by Ear Drum Perforation?
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no specific group
pl with reoccurent infections |
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What is a secondary problem of TM perforation?
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Sequelae-- damage
hearing loss HOLE in INNER EAR! |
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What could you also have with Sequelae?
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infection & tinnitus
major concern- water in the ear-- pain, infection, dizziness |
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what is the TREATMENT for sequelae?
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depends on severity
1--- dry out ear-- antibiotics, decongest, ear drops 2- patch, surgery |
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what are 2 ways to REPAIR the tympanic membrane?
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patch- may need reapplying
--structural support for regrowth -improved hearing Tympanoplasty- outpatient surgery, graft onto TM-- GOOD success rate |
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what are some concerns for POST OP after TM repair?
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water in = bad! no swimming
blowing nose dizziness hearing test 4-6 wks |
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what are some other considerations after TM perforation?
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contraindication to surgery- chronic sinus probs & swelling of eustachian tube
-ossicular reconstruction - mastoidectomy- bone gets infected, little sacs in bone |
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What is an OTOSCOPY and what does it look for?
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view of pinna, ear canal and TM
ALWAYS BRACE against skull look for landmarks |
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what are some disorders of the MIDDLE Ear?
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otitis media
tympanostomy tube eustachian tube cholesteatoma otosclerosis |
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what does CONDUCTIVE hearing loss mean?
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something is blocking the sound from getting to the Inner ear!
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what does Sensorineural hearing loss?
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problems with inner ear or nerve
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what is OTITIS MEDIA?
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middle ear infection
-inflammation of lining of ear cavity -with Fluid |
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who usually gets otitis media?
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common in little children
-6-24 mon, 4-6 yo |
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what groups of people have a higher occurrence of OM?
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native american, eskimo
down syndrome cleft palate |
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what are some factors that increase the risk of dvp OM?
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bottle fed infants
exposure to 2nd hand smoke day care settings |
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what are some causes of OM
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eustachian tube dysdunction
upper resp infection bacteria/ virus swelling of adenoids |
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what are the SYMPTOMS of OM?
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hearing loss
fullness in ear tinnitus crackling sounds in the ear chills/fever drainage of fluids |
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what are some OTHER symptoms of OM? not as obv ones
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pulling on or rubbing ears
unusual irritability difficulty sleeping fever |
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what are the 2 types of OM?
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acute & chronic
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what happens with ACUTE OM?
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sudden onset
1 episode lasts less then 21 days with pain and ear ache |
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what happens with CHRONIC OM?
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repeated episodes
greater then 8 weeks duration less severe symptoms may cause perm damage |
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what is OM with EFFUSION?
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effusion = fluid pulled out from tissues, drains into middle ear
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what are the types of FLUID with effusion?
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serous- thin, watery
mucoid- thick, viscous, mucus like purulent - fluid thats infected |
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what are some complications that might devp from OM?
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tympanosclerosis
tymp membrane perforation cholesteatoma mastoiditis ossicle erosion bleeding hearing loss - conductive |
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what is some treatment for OM?
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wait & see
antibiotics anti histamines myringotomy tympanostomy tubes removal of adenoids |
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what are TYMPANOSTOMY TUBES?
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pressure equal/ ventilation tubes
replacement for eustacian tubes inserted in myringotomy incision allows for pressure equil & drainage tubes fall out as ears heal |
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what are some other pressure equalization techniques?
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VALSALVA
pinch nostrils closed and blow air thru noise bad- increase pressure lower bp, increase in pressure |
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what is FRENZEL?
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low pressure Vasalva
nostrils open say K with mouth closed |
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what is TOYNBEE?
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pinch nostrils closed and swallow
musc in back of throat that pull open the eustachian tube |
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what about FLYING?
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yawn chew, swallow to open eustachian tube
may need antihistimines before flying |
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what about DIVING?
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training required
barotrauma can occur in shallow water |
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what is CHOLESTEATOMA?
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skin growth, cystic mass
pouch of skin (onion like) sheds layers of skin that build up - mostly ACQUIRED , few congenital |
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what people get CHOLESTEATOMA?
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acquired at any age
congenital 3-14yo MORE COMMON IN MALES |
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what are the symptoms of CHOLESTEATOMA?
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earache, tinnitus, foul discharge
conduct hearing loss pressure, fullness, dizziness, muscle weakness of left side of face |
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what is PROGRESSIVE CONDUCTIVE hearing loss?
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varying degree
cholesteatoma damages inner ear -> sensorineual hearing loss understanding speech is good tympanometry = type A shallow |
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what is the treatment for CHOLESTEATOMA?
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treat infection first
surgery- remove growth, repair damage may reoccur after trt untreated- infections |
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what is OTOSCLEROSIS?
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buildup of spongy bone within middle ear space
usually in region of stapes footplate can invade cochlea, ossification |
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who gets OTOSCLEROSIS?
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15-45 yo
more common in caucasians MORE COMMON IN WOMEN! may be related to pregnancy |
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what are the complications of OTOSCLEROSIS/
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hearing loss
tinnitus dizziness |
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what are the symptoms of OTOSCLEROSIS
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gradual hearing loss
tinnitus |
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waht are the causes of OTOSCLEROSIS
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unknown
hereditary if 1 parent has it- 25% chance kid will 2 parents = 50% chance |
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what hearing LOSS happens with OTOSCLEROSIS
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gradual, conductive hearing loss
low freq first carhart notch= audiogram spec good understanding speech |
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what is the TREATMENT of OTOSCLEROSIS
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no intervention
hearing aid Stapedectomy / prosthesis -complications with surgery |
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what are the important characteristics of CONDUCTIVE hearing loss?
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unilateral / bi
reversible /treatable hearing aids not always approp affects low freq max hear loss 60 dB abnormal tympanometry good understanding speech |
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what are some examples of SENSORINEURAL hearing loss?
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cochlea
menieres disease ototoxicity sudden sensorineural heaing loss acoustic neuroma audit processing disorder |
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what are the SYMPTOMS of MENIERE'S disease?
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sensorineural hearing loss
tinnitus vertigo, dizziness pressure fullness hearing recovers |
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what happens in MENIERE'S disease?
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inner ear- endolymphatic hydrops
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what are the causes of MENIERE'S disease
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idiopathic
triggers-- stress, dietary factors, food allergy |
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what is the Audiological description of Menieres disease
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sensorineural loss
degree fluctuates over time unilateral in 80% cases -speech understand impaired |
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who gets MENIERES disease?
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40-60 yo
also may have hypercusis |
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what is the TREATMENT for MENIERES disease
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no known cure
dietary/lifestyle changes - stress, diuretics, sodium, caffeine, smoking, food allergy surgery- shunt, labyrinthectomy |
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what is OTOTOXicity?
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hearing damage due to medication
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what are the causes of OTOTOXICITY
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high doses of meds
giving ototoxic meds for life saving purposes |
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what are the symptoms of OTOTOXICITY
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tinnitus
fullness/pressure hearing loss vertigo |
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what happens with OTOTOXICITY?
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cochlea affected - outer hair cells
effects HIGHER freq first bilateral may progress to inner hair cells |
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what are some OTOTOXIC medications?
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salicylates- aspirin, toxic levels, reversible with discontinuation of meds
-Non steroidal anti inflamm drugs advil aleve motrin |
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what are some other OTOTOXIC meds?
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antibiotics
aminoglycosides erythromycin vancomycin and gentamicin loop diuretics chemo quinine |
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what do these ototoxic meds do?
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damage hair cells
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what factors increase risk of OTOTOXIC effects?
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combining ototoxins in treatment
>10 days duration impaired kidney function advanced age pre existing hearing loss |
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what should you do with ototoxic meds?
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benefits of monitoring-- inc awareness, understanding info
if hearing loss is detected- stop meds, reduce dosage, change meds |
