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OUTLINE

Hearing loss – S ensorineural and Conductive Hearing Loss, Meniere’s disease , otitis externa , Otosclerosis BY SUCCESS IMOKE # 702. OUTLINE. DEFINITION ETIOLOGY CLINICAL DIAGNOSTIC TOOLS PATHOPHYSIO/PATHOGENESIS CLINICAL FEATURES MANIFESTATION TREATMENT/MANAGEMENT.

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OUTLINE

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  1. Hearing loss – Sensorineural and Conductive Hearing Loss, Meniere’sdisease, otitisexterna, Otosclerosis BY SUCCESS IMOKE #702

  2. OUTLINE • DEFINITION • ETIOLOGY • CLINICAL DIAGNOSTIC TOOLS • PATHOPHYSIO/PATHOGENESIS • CLINICAL FEATURES • MANIFESTATION • TREATMENT/MANAGEMENT

  3. Situation of the Ear

  4. Anatomy of the Ear Ossicles: Hammer, Anvil, Stirrup Semicircular Canals Pinna Auditory (or Cochlear) Nerve Cochlear Inner Ear Vestibule External Auditory Canal Tympanic Membrane (Ear Drum) Eustachian Tube (to nose and throat) Outer Ear Middle Ear

  5. Terminology Normal Hearing: PTAs < 25 dB Hearing Impairment: PTAs 25-92 dB Deaf: PTAs > 92 dB The term deafness is reserved for cases in which “ … the handicap for hearing everyday speech … [is] … total” (Davis & Silverman, 1979).Pure Tone Audiometry(PTA).

  6. OTITIS EXTERNAL • INFLAMMATION OF EAR CANAL SKIN. • THE SKIN WHICH LINES THE OUTER EAR CANAL BECOMES RED AND SWOLLEN DUE TO INFECTION BY BACTERIA OR FUNGUS.

  7. ETIOLOGIC FACTOR • Bacterial – Pseudomonas, Staph aureus, Proteus • Fungal – Aspergillusniger, candidaalbicans • Viral – Herpes simplex, Herpes Zoster • Reactive – Eczema, Psoriasis • Predisposing factors: humidity, trauma, canal stenosis, eczema, diabetes.

  8. Pathophysiology Clinical course of otitisexterna can be dividedinto: ● Pre-inflammatory stage ● Acute inflammatory stage ● Chronic inflammatory stage

  9. Clinical features • Otalgia – severe (bacterial) • Purulent otorrhea • Hearing loss • Inflammation of ear canal +/- pinna • Itching (fungal) • Mild otalgia • Fullness • Greyish white debris +/- fungal spores

  10. Malignant OtitisExterna • Osteomyelitis of temporal bone • Immunocompromized patients e.g diabetes • Usually Pseudomonas • Extremely painful • May be associated with cranial nerve palsy • Treat with IV antibiotics for at least 6 weeks

  11. Aural Discharge and Causes: Brown “coffee ground” like discharge Brown or Grey discharge: Malassezia Yellow-white discharge: Ceruminous Yellow-green discharge: Bacteria Diagnosis of OE History, clinical signs, physical exam findings, cytologic examination.

  12. TREATMENT • Aural toilet and keep dry • Swab for sensitivities • Splinting of ear canal • Topical antibiotics e.g. Sofradex (dexamethasone, framycetin and gramicidin) • Topical antifungal agents e.g. Canestan (clotrimazole).

  13. Normal EarEar w/ Endolymphatic Hydrops Note bulging of membranous labyrinth (www.tchain.com/otoneurology/disorders/menieres/men_eti.html)

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