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Introduction
  • Loss of hearing after having previous auditory functioning
  • Etiologies
    • presbycusis
      • age-related hearing loss
      • onset in the 5th-6th decade
      • predominantly a high frequency hearing loss 
    • drug-induced ototoxicity
      • loop diuretics 
      • aspirin
      • aminoglycosides
      • cisplatin
    • lymphadenopathy
      • may result in serous otitis media
    • bacterial meningitis
      • most common cause of hearing loss in children
      • meningitis patients should have their hearing tested following bacterial meningitis
    • otosclerosis
      • one of the most common cuases of hearing loss in adults
      • caused by fusion of otic bones resulting in conductive hearing loss
    • tympanic membrane rupture
      • blunt/penetrating trauma
      • barotrauma
        • etiologies include
          • airplanes
          • gunshots
          • diving
      • temporal bone fracture
    • malignancy
      • ex.) acoustic neuroma
    • multiple sclerosis
    • pseudotumor cerebri
    • sarcoidosis
Presentation
  • Symptoms
    • gradual to subacute to acute hearing loss
    • may or may not be associated with vestibular symptoms
  • Physical exam
    • Rhine and Weber tests to determine conductive vs sensorineural hearing loss 
    • Rinne test
      • tunning fork placed on the mastoid process
      • normal: air (AC) > bone conduction (BC)
    • Weber test
      • tunning fork placed in the middle of the forehead
    • Normal
      • sound should be of equal intensity in both ears
    • Conduction deafness
      • Rinne: BC > AC (in damaged ear)
      • Weber: lateralization to damaged ear
    • Sensorineural deafness
      • Rinne: AC > BC (in damaged ear)
      • Weber lateralizes to healthy ear
Evaluation
  • Audiometry
  • Brain imaging
Treatment
  • Supportive to surgical depending on cause
 

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