AUD 643 EXAM 2 100% SOLVED
What is presbycusis? - ANSWER age related hearing loss
-partially a genetic component
-may be caused by oxidative damage, free radicals, and other auditory damage
(ototoxicity, poor diet, smoking, noise, etc.)
how to reduce risk of presbycusis? - ANSWER -avoid hazardous noise
-have a healthy diet (?) (avoid cardiovascular disease and increase antioxidants)
-have a healthy body (take care of heart, kidneys, lungs, etc)
healthy blood pressure - ANSWER 120/80 mmHg or lower
where is the damage from presbycusis? - ANSWER -organ of corti (loss of OHC sensory
cells) (first to go)
-nerve fibers (loss of synapses and spiral ganglion neurons) (aka age-induced cochlear
synaptopathy)
-stria vascularis (loss of cells)
-a combo of these
what hearing loss is expected from presbycusis? - ANSWER -progressive, bilateral
SNHL
-tinnitus (bilateral if have a bilateral HL)
assessment/management of presbycusis - ANSWER -basic CHE: word rec scores may
be associated with central involvement of memory, attention, processing
-rule out any other medical causes of the hearing loss and obtain a thorough case
history
-placebo supplements may have an effect
-prescribe HAs, CIs, ALDs, aural rehab, support groups
why are there medications to help fix tinnitus or hearing loss? - ANSWER -the FDA
checks for harm, but not efficacy, so it's legal.
What is Superior Semicircular Canal Dehiscence? - ANSWER -first described in 1998
-an abnormal opening or thinning of the bone of the superior semicircular canal
,-incidence is unknown but one study says 0.4-0.5% of cadaver temporal bones
Causes of SSCD - ANSWER -possibly congenital, but symptoms appear later in life
-bone might be thinning due to age
-possibly caused by barometric or head trauma. (likely to cause a fistula (hole in
cochlea))
What is happening in the inner ear with SSCD? - ANSWER -waves in cochlea cause
abnormal movement of perilymph in SSC
-causes loss of acoustic energy and then vestibular symptoms appear
-results in worsened AC thresholds and improved BC thresholds, and vertigo
-there is a conductive component in cochlea
Symptoms of SSCD - ANSWER -vertigo during loud noises (called Tullio phenomenon),
with air pressure changes, or when straining muscles
**SHORT DURATION OF VESTIBULAR SYMPTOMS!
-increased sensitivity to own voice, heartbeat, eye movements, skeletal movements, etc
-can have any type of audiogram from this!
Assessment/management of SSCD - ANSWER -CHE: test bone below 0dB to justify
air-bone gap! also test bone at 250Hz as well
-VEMPs test: abnormally reduced thresholds
-ARTs: may or may not be absent
-vestibular testing: can demonstrate nystagmus in response to sound/pressure changes
-CT scan can show dehiscence
-if persistent HL, then HAs
-vestibular physical therapy
-avoidance (can be isolating)
-surgery: patching dehiscence (can come off)
-surgery: SSC plugging (recovery is very dizzy 6-8 weeks, but it works)
perilymphatic fistula - ANSWER -"leak" typically in round windows but possibly by the
oval window
-symptoms can overlap with Menieres, but this is normally associated with an
, implosive/explosive event.
-can happen with children as well!
likely causes of perilymphatic fistula - ANSWER -iatrogenic (illness)
-idiopathic (unknown cause)
-head trauma
signs of PF - ANSWER -Hennenbert's Sign: pressure induced nystagmus in ipsi direction
-Tullio phenomenon: loud sound induced dizziness and nystagmus
-elevated SP/AP ration
-barotrauma
Assessment/Management of PF - ANSWER -highly compliant tymps
-usually results in mixed hearing loss
-ARTs and Tymps may induce dizziness and could be absent if conductive components
are found
-repair any head trauma
-repair window leak (HL recovery varies)
Sudden Idiopathic Sensorineural Hearing Loss - ANSWER -hearing loss of at least 30dB
at 3 consecutive frequencies within 72 hours. Usually it's more than 30 dB
-it's a medical emergency!
-differs from Meniere's, in which only low frequency loss is occurring.
-comprises only 1% of all SNHL; 4000 new cases each year
Is SSNHL typically unilateral or bilateral? - ANSWER unilateral
etiology of SSNHL - ANSWER -viral
-autoimmune
-labyrinthe membrane rupture
-vascular
-neurologic
-sometimes we know the cause, and other times we do not
symptoms of SSNHL - ANSWER -rapid onset, unilateral SNHL, often severe and
What is presbycusis? - ANSWER age related hearing loss
-partially a genetic component
-may be caused by oxidative damage, free radicals, and other auditory damage
(ototoxicity, poor diet, smoking, noise, etc.)
how to reduce risk of presbycusis? - ANSWER -avoid hazardous noise
-have a healthy diet (?) (avoid cardiovascular disease and increase antioxidants)
-have a healthy body (take care of heart, kidneys, lungs, etc)
healthy blood pressure - ANSWER 120/80 mmHg or lower
where is the damage from presbycusis? - ANSWER -organ of corti (loss of OHC sensory
cells) (first to go)
-nerve fibers (loss of synapses and spiral ganglion neurons) (aka age-induced cochlear
synaptopathy)
-stria vascularis (loss of cells)
-a combo of these
what hearing loss is expected from presbycusis? - ANSWER -progressive, bilateral
SNHL
-tinnitus (bilateral if have a bilateral HL)
assessment/management of presbycusis - ANSWER -basic CHE: word rec scores may
be associated with central involvement of memory, attention, processing
-rule out any other medical causes of the hearing loss and obtain a thorough case
history
-placebo supplements may have an effect
-prescribe HAs, CIs, ALDs, aural rehab, support groups
why are there medications to help fix tinnitus or hearing loss? - ANSWER -the FDA
checks for harm, but not efficacy, so it's legal.
What is Superior Semicircular Canal Dehiscence? - ANSWER -first described in 1998
-an abnormal opening or thinning of the bone of the superior semicircular canal
,-incidence is unknown but one study says 0.4-0.5% of cadaver temporal bones
Causes of SSCD - ANSWER -possibly congenital, but symptoms appear later in life
-bone might be thinning due to age
-possibly caused by barometric or head trauma. (likely to cause a fistula (hole in
cochlea))
What is happening in the inner ear with SSCD? - ANSWER -waves in cochlea cause
abnormal movement of perilymph in SSC
-causes loss of acoustic energy and then vestibular symptoms appear
-results in worsened AC thresholds and improved BC thresholds, and vertigo
-there is a conductive component in cochlea
Symptoms of SSCD - ANSWER -vertigo during loud noises (called Tullio phenomenon),
with air pressure changes, or when straining muscles
**SHORT DURATION OF VESTIBULAR SYMPTOMS!
-increased sensitivity to own voice, heartbeat, eye movements, skeletal movements, etc
-can have any type of audiogram from this!
Assessment/management of SSCD - ANSWER -CHE: test bone below 0dB to justify
air-bone gap! also test bone at 250Hz as well
-VEMPs test: abnormally reduced thresholds
-ARTs: may or may not be absent
-vestibular testing: can demonstrate nystagmus in response to sound/pressure changes
-CT scan can show dehiscence
-if persistent HL, then HAs
-vestibular physical therapy
-avoidance (can be isolating)
-surgery: patching dehiscence (can come off)
-surgery: SSC plugging (recovery is very dizzy 6-8 weeks, but it works)
perilymphatic fistula - ANSWER -"leak" typically in round windows but possibly by the
oval window
-symptoms can overlap with Menieres, but this is normally associated with an
, implosive/explosive event.
-can happen with children as well!
likely causes of perilymphatic fistula - ANSWER -iatrogenic (illness)
-idiopathic (unknown cause)
-head trauma
signs of PF - ANSWER -Hennenbert's Sign: pressure induced nystagmus in ipsi direction
-Tullio phenomenon: loud sound induced dizziness and nystagmus
-elevated SP/AP ration
-barotrauma
Assessment/Management of PF - ANSWER -highly compliant tymps
-usually results in mixed hearing loss
-ARTs and Tymps may induce dizziness and could be absent if conductive components
are found
-repair any head trauma
-repair window leak (HL recovery varies)
Sudden Idiopathic Sensorineural Hearing Loss - ANSWER -hearing loss of at least 30dB
at 3 consecutive frequencies within 72 hours. Usually it's more than 30 dB
-it's a medical emergency!
-differs from Meniere's, in which only low frequency loss is occurring.
-comprises only 1% of all SNHL; 4000 new cases each year
Is SSNHL typically unilateral or bilateral? - ANSWER unilateral
etiology of SSNHL - ANSWER -viral
-autoimmune
-labyrinthe membrane rupture
-vascular
-neurologic
-sometimes we know the cause, and other times we do not
symptoms of SSNHL - ANSWER -rapid onset, unilateral SNHL, often severe and
