AUD 1

• Deliberate and potentially deceptive exaggeration of hearing loss
• Non-organic hearing loss
• Functional hearing loss

• 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

When a sound is presented to both ears, the listener is aware of its presence only in the ear where it is louder.

refers to the abnormal perception of loudness that sometimes can occur with a sensorineural hearing loss

as amp increases the loundness stays steady/ becomes harder to hear (not loud enough)

ESPECIALLY in retrocochlear pt. / cannot sustain percept of tone and no acoustic reflex

w hearbeat/ vascular/ associated w neoplasm

maskers/ no caffeine and nicotine/ meds/ rinnitus retraining therapy/ sugery of 8th nerve/ support group

sense of dizziness w a spinning or rotating sensation/ vestibular system may be affected

meds/ vestibular rehab/ surgery of vestibular portion of 8th nerve

• Conducted by ENT
• Gathers history
• Uses otoscopy
• May order images (xray, MRI, CT scans)

Ear pain

• Ear pain
• Hearing loss
• Tinnitus
• Discharge (otorrhea)
• Dizziness

• microtia - abnormally small pinna
• agenesis - absent pinna
• atresia - closure of external aud. meatus
• external otitis - swimmer's ear (viral or bacterial)

Abnormally small pinna

absent pinna

closure of external aud. meatus

swimmer's ear (viral or bacterial)

• Cerumen - ear wax
• Foreign bodies
• Cysts and tumors
• Exostoses - abnormal outgrowth of bony portion

abnormal outgrowth of bony portion

• Otitis media
• 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

• Air is trapped in middle ear space
• Retraction of TM
• Secretion of clear fluid
• Effusion may become thickened or mucoid

• Fluid in middle ear is infected
• infection may have come from nasopharynx
• often comes with upper resp. symptoms
• may or may not have fever

Filled with excessive blood

Culture medium build up for purulent organisms

Scar tissue on the eardrum

• 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

• conductive
• unilateral or bilateral
• Type B (flat) tympanograms
• absent reflexes

• Build-up of spongy bone in area of oval window
• footplate of stapes is immobilized
• Tympanogram A_s because ossicular chain is less mobile

• conductive
• middle

Mixed

• progressive conductive hearing loss
• see notch in bone conduction thresholds at 2000 Hz, called Carhart notch
• Type A_s tympanogram

• T - Toxoplasmosis
• O - other (Hep B and other viruses)
• R - Rubella
• C - Cytomegalovirus (CMV)
• H - Herpes symplex virus
• S - Syphilis

• Bacterial meningitis
• Mumps
• Measles

• caused by overproduction of endolymph fluid
• Symptom complex affecting membranous inner ear
• Progessive or fluctuating sensorineural hearing loss - low frequency
• often unilateral

• 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

High frequencies, but can gradually move to low frequencies

Caucasian males

4000 Hz and 6000 Hz

• 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

sensorineural loss caused by aging

• bilateral
• sensorineural
• sloping or ski slope audiogram

• part of sensorineural hearing loss
• retrocochlear refers to neural loss
• OAE would be normal