CD 445 Final Exam | Questions with 100% Correct Answers, Spring 2025

CD 445 Final Exam | Questions with 100% Correct Answers, Spring 2025 Two most common causes of hearing loss high intensity noise exposure and age related hearing loss (presbycusis) Outer Ear Disorders can be easily spotted during... Otoscopy Collapsing Ear Canals are most commonly seen in what should be used during testing infants and the elderly - inserts to help open the ear, supra aural headphones do not show appropriate hearing Mircotia A broad term used for more pronounced malformations of the ear Atresia Absence of an outer ear and canal with small remnants of tissue Anotia Complete absence of an outer ear What is the typical hearing loss for people with microtia conductive or mixed Otitis Externa what can it lead to Inflammation of the outer ear, meaning the ear canal is infected - pose a health problem rather than a concern for loss of hearing Stenosis a narrowing or restriction of the ear canal from abnormal infection/inflammation What are the two types of Bony Abnormalities Osteoma and Exostosis Osteoma Greek words : bone and tumor - growths projecting into the ear canal on a stalk -usually found in ONE ear Exostosis Greek words : out and bone - hard growths towards the TM - typically found in BOTH ears How is Exostosis often formed exposure of ear canal to cold water - "surfers ears" Eustachian Tube Dysfunction in children and adults kids - very small diameter and an especially small opening at the end near the middle ear - also oriented horizontally rather than a vertical direction like most adults, causing fluid to remain still and build up. adults - Pressure equalization is crucial for allowing fluid to move out of the middle ear. - Those with inflammation of the eustachian tube might find difficulty during elevation changes Patulous Eustachian Tube - eustachian tube has difficulty closing - whooshing sounds, typically produced by the air Tympanic Membrane Perforations Perforations are typically associated with trauma, middle ear disease, or surgical procedures - Cotton swabs and pens are common causes - also a sharp blow to the outer ear - common in military combat Spontaneous Rupture: of TM Can occur in patients with excessive inflammation and a significant increase in pressure in the middle ear space. Otitis Media types and meaning ear, inflammation, and middle - "ear infection" broad spectrum of diseases - Acute Otitis Medi - Purulent Otitis Media - Recurrent Acute Otitis Media - Otitis Media w/ Effusion What type of hearing loss occurs for patients with otitis media Patients can lose about 25-30dB. Typically, a conductive loss unless an already sensorineural loss is present. How does Otitis media develop 1. Ongoing eustachian tube dysfunction usually leads to negative air pressure in the middle ear space. Oxygen in the middle ear space 2. bacteria is already in the middle ear space, making it the leading cause of infection. Acute Otitis Media Caused by either a viral or less often, bacterial infection in the middle ear space. occurs rapidly in children - fever, pain, irritability, disruption of sleep reddish, white, or yellow tympanic membrane that often bulges outward. Purulent Otitis Media pus could also be seen behind the membrane wall - Drainage of pus into the external canal indicates that there is a perforation in the eardrum. Recurrent Otitis Media This is just referring to a child who has experienced it multiple times Otitis Media with Effusion OR Serous Otitis Media effusion meaning an accumulation of fluid, Serum referring to a watery substance - no pain or fever - dull retracted TM or visible air bubbles How to treat otitis media anti biotics, PE tubes, ear drops Cholesteatoma A growth of skin or cyst in the middle ear space. - can lead to permanent hearing loss and even dizziness, paralysis, or life threatening infections of the skull Otosclerosis A progressive bone disease that typically results in fixation and stiffening of the ossicular chain. shows a conductive HL What is the progression of otosclerosis look like - bones get spongy, then dense. starts at the stapes footplate Management of Otosclerosis 1. monitor hearing status 2. hearing aids 3. stapedectomy Ossicular Chain Disarticulation Disarticulation is a break or interruption somewhere in ossicular chain Sensory vs neural hearing loss sensory - inner ear disorder neural - brainstem, nerve Prenatal causes of HL cochlea is still developing, inheritance, infections of mom or baby Perinatal causes of HL Refers to the period of time near a child's birth - inadequate blood or oxygen supply to the auditory system, low birth weight Postnatal Nonsyndromic vs syndromic Nonsyndromic - Do not have a pattern of abnormalities involving other senses/systems in the body syndromic - other medical factors causing HL Meningitis The meninges are a thin membrane that surrounds and protects the brain and spinal cord - bacteria get in and can cause sensorineural HL - use vaccines to treat it Cytomegalovirus (CMV): CMV is contracted from an infected mother to the fetus - one of the most common causes of childhood HL Autoimmune inner ear disease (AIED) In this disease, antibodies or immune cells damage inner ear structures, particularly tissues containing endolymph - anti-inflammatory drugs such as steroids treat it Ototoxic Medications may cause auditory dysfunction and produce hearing loss Aminoglycoside Antibiotics treat infections in newborns - affect outer hair cell function Loop Diuretics Diuretics help to remove excessive fluid in patients, BUT can interfere with the function of OHC Meniere's disease/Endolymphatic Hydrops issue and symptoms a buildup of fluid in the cochlea 1. fluctuating hearing loss 2. episodic vertigo 3. tinnitus 4. fullness or pressure Meniere's disease/Endolymphatic Hydrops interventions minimize vertigo and improve hearing - meds to reduce vestibular function surgery to cut into vestibular nerve Superior Canal Dehiscence Syndrome Hearing loss and vertigo, bothered by own voice Dehiscence An abnormal thinning or even absence of bone that covers the superior semicircular canal in the vestibular system Sudden Sensorineural Hearing Loss (SSHL) causes theory 1. Likely explanation is a viral infection that affects the cochlear function. 2. A vascular cause that disrupts the blood flow to the cochlea Sudden Sensorineural Hearing Loss (SSHL) intervention Anit-inflammatory drugs, antiviral, antioxidants Noise Induced Hearing Loss/ exposure to loud noises Cochlear dysfunction and damage is possible whenever noise levels exceed 85Db Temporary Threshold Shift (TTS) A decrease in hearing sensitivity occurs for a period of 16-48 hours -tinnitus may occur -muffled speech Permanent Threshold Shift (PTS) High frequency sensorineural hearing loss Presbycusis age-related hearing loss. - affects more than 1/2 population Presbycusis potential causes 1. loss of hair cells in high frequency 2. loss of stria vasularis tissue 3. loss of neurons in the spiral ganglion 4. conductive, no changes in cochlea/nerve Usher's Syndrome HL and balance issues inherited mutations in genes no cure Usher's Syndrome type 1 hearing loss and balance issues are present at birth - later might develop vision issues Usher's Syndrome type 2 moderate tosevere hearing loss at birth - can develop worse vision issues