1. Pseudohypacusis
    • Deliberate and potentially deceptive exaggeration of hearing loss
    • Non-organic hearing loss
    • Functional hearing loss
  2. Signs of Pseudohypacusis
    • Exaggerated behavior during interview
    • Unilateral hearing loss with no shadow curve
    • Poor test-retest reliability
    • Poor agreement between SRT and PTA
    • Acoustic reflex thresholds that do not cross check with pure-tone results
    • Positive Stenger
    • Present otoacoustic emissions in the face of a PTA greater than 40 dB HL
  3. What is the Stenger Effect?
    When a sound is presented to both ears, the listener is aware of its presence only in the ear where it is louder.
  4. Loudness Recruitment
    refers to the abnormal perception of loudness that sometimes can occur with a sensorineural hearing loss
  5. Loudness decruitment
    as amp increases the loundness stays steady/ becomes harder to hear (not loud enough)
  6. Tone decay
    ESPECIALLY in retrocochlear pt. / cannot sustain percept of tone and no acoustic reflex
  7. objective and pulsatile tinnitus
    w hearbeat/ vascular/ associated w neoplasm
  8. treatment for tinnitus
    maskers/ no caffeine and nicotine/ meds/ rinnitus retraining therapy/ sugery of 8th nerve/ support group
  9. Vertigo
    sense of dizziness w a spinning or rotating sensation/ vestibular system may be affected
  10. Treatment for vertigo
    meds/ vestibular rehab/ surgery of vestibular portion of 8th nerve
  11. Otologic evaluation
    • Conducted by ENT
    • Gathers history
    • Uses otoscopy
    • May order images (xray, MRI, CT scans)
  12. Otalgia
    Ear pain
  13. Case History includes information about...
    • Ear pain
    • Hearing loss
    • Tinnitus
    • Discharge (otorrhea)
    • Dizziness
  14. Outer ear disorders (terms)
    • microtia - abnormally small pinna
    • agenesis - absent pinna
    • atresia - closure of external aud. meatus
    • external otitis - swimmer's ear (viral or bacterial)
  15. Microtia
    Abnormally small pinna
  16. agenesis
    absent pinna
  17. atresia
    closure of external aud. meatus
  18. external otitis
    swimmer's ear (viral or bacterial)
  19. Outer ear disorders
    • Cerumen - ear wax
    • Foreign bodies
    • Cysts and tumors
    • Exostoses - abnormal outgrowth of bony portion
  20. Exostoses
    abnormal outgrowth of bony portion
  21. Middle Ear disorders
    • Otitis media
    • Otitis media with effusion
  22. Otitis media with effusion
    • serous otitis media
    • serous fluid is a watery, clear fluid from the tissues of the middle ear
    • caused by eustachian tube malfunction
    • prevents the ear from ventilating
  23. Effects of otitis media with effusion
    • Air is trapped in middle ear space
    • Retraction of TM
    • Secretion of clear fluid
    • Effusion may become thickened or mucoid
  24. Acute otitis media
    • Fluid in middle ear is infected
    • infection may have come from nasopharynx
    • often comes with upper resp. symptoms
    • may or may not have fever
  25. Suppurative otitis media
    Filled with excessive blood
  26. Purulent otitis media
    Culture medium build up for purulent organisms
  27. Tympanosclerosis
    Scar tissue on the eardrum
  28. Cholesteatoma
    • Accumulation of cellular debris from perforation of TM
    • Pseudo tumor (outgrowth of tissue)
    • May cause erosion of ossicles
    • HL may vary from 15-55 dB
  29. Hearing loss from otitis media
    • conductive
    • unilateral or bilateral
    • Type B (flat) tympanograms
    • absent reflexes
  30. Otosclerosis
    • Build-up of spongy bone in area of oval window
    • footplate of stapes is immobilized
    • Tympanogram As because ossicular chain is less mobile
  31. Otosclerosis causes only ______ hearing loss because it is part of the _____ ear.
    • conductive
    • middle
  32. Cochlear otosclerosis occurs when bone invades the cochlea. This can produce what kind of hearing loss?
  33. Hearing loss from otosclerosis
    • progressive conductive hearing loss
    • see notch in bone conduction thresholds at 2000 Hz, called Carhart notch
    • Type As tympanogram
  34. TORCH complex (associated with sensorineural hearing loss)
    • T - Toxoplasmosis
    • O - other (Hep B and other viruses)
    • R - Rubella
    • C - Cytomegalovirus (CMV)
    • H - Herpes symplex virus
    • S - Syphilis
  35. Postnatal infections that can cause hearing loss
    • Bacterial meningitis
    • Mumps
    • Measles
  36. Meniere's disease
    • caused by overproduction of endolymph fluid
    • Symptom complex affecting membranous inner ear
    • Progessive or fluctuating sensorineural hearing loss - low frequency
    • often unilateral
  37. Symptoms of Meniere's Disease
    • Tinnitus (low pitched)
    • Feeling of fullness or pressure in the ear
    • Episodic vertigo
    • Most often seen between 30-50 years of age
    • Called endolymphatic hydrops
  38. Ototoxic drugs tend to cause more loss at what frequencies?
    High frequencies, but can gradually move to low frequencies
  39. Noise induced hearing loss tends to be more prevalent in what demographic?
    Caucasian males
  40. Noise induced hearing loss will show a notch in both air and bone conduction at what frequencies?
    4000 Hz and 6000 Hz
  41. Reasons for notch in noise-induced hearing loss
    • Resonances of outer ear @ 2000Hz - 4000 Hz increases the level
    • Cochlear structure - basilar end of cochlea is hit first. Basilar end is responsible for high frequencies
    • Damage to outer hair cells
  42. Presbycusis
    sensorineural loss caused by aging
  43. Characteristics of Presbycusis
    • bilateral
    • sensorineural
    • sloping or ski slope audiogram
  44. Retrocochlear pathology
    • part of sensorineural hearing loss
    • retrocochlear refers to neural loss
    • OAE would be normal
Card Set
Audiological disorders review