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HEARING CONSERVATION PROGRAM EAR DISORDERS AND HEARING LOSS

HEARING CONSERVATION PROGRAM EAR DISORDERS AND HEARING LOSS. 26 Jan 2013. LEARNING OBJECTIVES. Define the five types of hearing loss Describe medical and communication symptoms that are characteristic of each type of hearing loss

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HEARING CONSERVATION PROGRAM EAR DISORDERS AND HEARING LOSS

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  1. HEARING CONSERVATION PROGRAM EAR DISORDERS AND HEARING LOSS 26 Jan 2013

  2. LEARNING OBJECTIVES • Define the five types of hearing loss • Describe medical and communication symptoms that are characteristic of each type of hearing loss • List common causes of and basic treatment for each type of hearing loss • Explain how impact and continuous noise exposure affects ear structures and functions

  3. OHC TECHNICIAN RESPONSIBILITY YES General Knowledge for Referrals NO Diagnosis of • Type of Hearing Loss • Ear Disease Recommendations of Treatments

  4. FIVE TYPES OF HEARING LOSS • Conductive hearing loss • Sensorineural hearing loss • Mixed hearing loss • Central hearing loss • Non-organic or Functional hearing loss

  5. Five Types of Hearing Loss cont… SENSORI-NEURAL CONDUCTIVE CENTRAL Central ear MIXED HEARING LOSS

  6. CONDUCTIVE HEARING LOSSSymptoms Outer & Middle Ears Talks softly or reports “talking in a barrel” Understands speech with increased volume Congestion – cold Low pitched ringing or crackling sounds Low frequency or flat hearing loss Hearing Test Results 500 1000 2000 3000 4000 6000Hz 35 30 25 15 10 10 dB Abnormal otoscopic exam tympanogram

  7. Normal Ear Canal and Eardrum

  8. CONDUCTIVE HEARING LOSSDiseases and Disorders Outer & Middle Ears Impacted Cerumen Complete Occlusion

  9. External Otitis or Infection Conductive Hearing Loss: Diseases/Disorder cont… Outer & Middle Ears

  10. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears DermatitisBasal Cell Carcinoma

  11. Conductive Hearing Loss:Diseases/Disorders…cont… Outer & Middle Ears Exotosis Bony Growths or Protrusions

  12. Conductive Hearing Loss:Diseases/Disorders…cont… Outer & Middle Ears • Foreign Objects • Ball Bearing Stick Insect

  13. Conductive Hearing Loss:Diseases/Disorders cont Outer & Middle Ears Ear Canal Fungus

  14. Conductive Hearing Loss:Diseases/Disorders cont Outer & Middle Ears Congenital Atresia

  15. Reminder: Normal Eardrum Outer & Middle Ears

  16. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears Tympanic Membrane Perforation

  17. Outer and Middle Ears Conductive Hearing Loss:Diseases/Disorders cont… Ossicle Related Detached Stiff – fixated Eroded Birth related

  18. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears Eustachian Tube Dysfunction

  19. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears Middle Ear Effusion Serous Otitis Media Fluid line (7:00 to 2:00)

  20. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears Otitis Media or Middle Ear Infection

  21. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears Cholesteatoma

  22. Conductive Hearing Loss:Diseases/Disorders cont… Outer & Middle Ears Otosclerosis

  23. CONDUCTIVE HEARING LOSSTreatment Outer & Middle Ears • Medications • Surgery • Good ear hygiene • Hearing aids Conductive a) temporary Hearing Loss b) loudness problem

  24. SENSORINEURAL HEARING LOSSSymptoms Inner Ear “Can hear but trouble understanding “ due to distorted speech sounds May hear well in quiet but difficulties in noise Talks loudly Tinnitus Balance difficulties Hx: illness, head trauma, noise exposure High frequency hearing loss Hearing Test Results 500 1000 2000 3000 4000 6000 Hz 15 20 30 45 55 60 dB Normal otoscopic exam tympanogram

  25. SENSORINEURAL HEARING LOSSDiseases & Disorders Inner Ear BASIC PROBLEM Organ of Corti and Hair Cells are • damaged • destroyed • undergoing pressure RESULT Complete sounds can’t be detected and/or transmitted creating… “distorted speech” ditoredseech

  26. SENSORINEURAL HEARING LOSSCauses of Inner Ear Damage Inner Ear Ototoxins drugs chemicals Head trauma Aging Auto-immune or unknown Diseases bacterial/viral fluid pressure Birth related genetic (DNA) fetal or birth Hazardous noise exposure

  27. Sensorineural Hearing Loss:Diseases & Disorders cont…. Inner Ear Noise Induced Hearing Loss (NIHL) prolonged exposure ≥ 85 dB HL sudden impulse/impact ≥ 140 dB Peak HL Normal Damage Normal Damage

  28. SENSORINEURAL HEARING LOSSTreatment Inner Ear • Medications & Surgery - limited • Hearing Aids • Adaptive Skills Sensorineural a) permanent Hearing Loss b) understanding problem

  29. MIXED HEARING LOSS Outer Middle Inner Ears MOST COMMON Permanent Sensorineural HL with Outer/Middle Ear disorder OR Impacted Cerumen (temporary conductive HL) COMB I NAT ION Symptoms Hearing Test Results Disease/Disorders Treatments A N Y Conductive + Sensorineural = Mixed HL

  30. CENTRAL HEARING LOSSSymptoms Auditory Nerves & Brain Asymmetrical hearing loss Tinnitus - typically constant Atypical difficulty with understanding speech in noisy conditions Balance difficulties Head trauma

  31. Central Hearing Loss:Symptoms cont… Auditory Nerves & Brain Often hearing for tones is normal Other neurological disorders present Easily distracted by other sounds May have learning difficulties Confused with behavioral problems

  32. CENTRAL HEARING LOSSTreatment Auditory Nerves & Brain Surgery for tumors/growths Educational therapy Adaptive techniques Central understanding Hearing Loss problem

  33. NON-ORGANIC HEARING LOSS Malingering History enlistment, deployment, discipline, avoid work, retirement, attention, monetary compensation Inconsistent behaviors Testing behaviors Hearing test results inconsistent with • hearing behaviors • previous tests • how ear functions

  34. Central Hearing Loss:Symptoms cont . . . Conversion or Psychological Trauma History Traumatic event – assault, rape, IED, war trauma Not trying to avoid work Not trying to obtain $$ Hearing test results inconsistent Flat affect Emotionless face Patient believes has hearing loss Very rare condition

  35. NON-ORGANIC HEARING LOSS“Treatment” Follow regular protocols Give reinstruction for test Give person an “out” Refer to audiologist special test techniques special tests counseling

  36. SUMMARY The five types of hearing loss are based on the divisions and functions of the ear • Conductive • Sensorineural • Mixed • Central • Non-Organic Q U E S T I ON S ?

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