Deafness

Hearing Loss

Part of ear not working Includes:

outer ear middle ear inner ear hearing acoustic nerve auditory system

Types

Conductive deafness: due to defect in the conducting mechanism of the ear namely external and middle ear.

Sensori-neural deafness / Perceptive deafness: due to lesions in the labyrinth, 8th nerve & central connections. It includes psychogenic deafness.

Mixed deafness: both the above mentioned types are present.

EXTERNAL EAR:

Wax,Fungus, Otitis Externa,

Foreign Bodies,

Polyps,

Myringitis, Stenosis, Atresia, Tumours.

Causes of Conductive deafness

MIDDLE EAR

Congenital defects of the ear drum and ossicles.

Traumatic: Barotrauma, rupture of ear drum, # of the base of the skull

Inflammation: AOM, COM, Serous OM, Adhesive OM.

Tuberculosis and syphilitic OM

Neoplasms Otosclerosis

Causes of Conductive deafness

EUSTACHIAN TUBE

Eustachian catarrh Eustachian tube

dysfunction due to diseases of the nose, paranasal sinuses & pharynx

Barotrauma

CATARRH = EXCESSIVE DISCHARGE FROM NOSE / THROAT / EAR

Causes of Conductive deafness

LOCAL CAUSES (INNER EAR) Congenital Trauma: Head injury,

surgical injury to labyrinth, loud sounds (acute or chronic acoustic trauma) producing concussion.

Infections: mumps, syphilis, tuberculous meningitis, enteric fever, labyrinthitis.

Tumours: Acoustic neuroma (Schwanoma of C8 nerve)

Meniere’s disease Ototoxic drugs:

streptomycin, Kanamycin, neomycin, salicylates, frusemide and quinine.

Causes of Sensori-neural deafness

GENERAL CAUSES

Presbyacusis CVS: atherosclerosis,

HTN CNS: disseminated

sclerosis DM Avitaminosis Hypothyroidism Smoking Alcoholism

Presbyacusis: is a progressive bilateral symmetrical age-related sensorineural hearing loss. It is also known as age-related hearing loss

Causes of Sensori-neural deafness

Causes of Sensori-neural deafness

PSYCHOGENIC DEAFNESS: Functional: due to

emotional cause, but the patient is not aware of the cause.

2 TYPES

Malingering: no organic or psychological cause. The patient is aware that he is pretending to be deaf for personal gains.

Trauma: Blast injury, acoustic trauma, head injury.

CSOM with labyrinthitis.OtosclerosisSenile deafness superimposed on

conductive deafness.

Causes of Mixed deafness

Decibels

Decibel Level Examples include: Rock concerts, firecrackers (140 decibels) Loud bass in cars, snowmobiles (120 decibels) Chainsaw (110 decibels) Wood shop (100 decibels) Lawn mowers, motorcycles (90 decibels) City traffic noise (80 decibels) Normal conversation (60 decibels) Refrigerator humming (40 decibels)

To reduce potential hearing loss, avoid prolonged exposure to sound above 90 decibels.

Quantification of Hearing Loss

Unable to hear sound at “Mild” Hearing Loss

▪ 26 – 40 dB “Moderate” Hearing Loss

▪ 41-55 dB “Severe” Hearing Loss

▪ 56- 70 dB “Profound” Hearing Loss

▪ 91 dB & greater

Treatment

Conductive deafness: Hearing aidSensori-neural deafness:

For sudden deafness: ▪ Steroids▪ Vasodilators▪ Vit. B1, B6 & B12

▪ Vit. A, C & E▪ Carbogen (5% CO2 with 95% O2) [to imrove blood

circulation in the cochlea]

For chronic deafness Hearing aids Cochlear implants Conversation should be slow, clear & not

too clear Auditory training & lip reading.

Treatment

Removal of ear wax

Hearing aids Amplify sound

Cochlear Implant

Cochlear Implant

Small electronic device Simulates auditory

nerve▪ Provides “sense” of

sound Used by

▪ Profoundly deaf▪ Children age 2-6

Aided by speech therapy

Preventions

Immunizations for childhood diseases

Avoid high decibels

Have hearing tested

Use hearing protectors

▪ Earmuffs▪ Earplugs

Aural rehabilitation

Hearing aid orientationSign LanguageLip reading

Sign Language

Visually transmitted sign pattern Hand shapes Orientation Movement of hands, arms,

body Facial expressions

Surgical managementSurgery is indicated for conductive or

mixed hearing loss.To restore conductive hearing

Myringotomy Stapedectomy

Assisted hearing in profound deafness Cochlear implants Temporal bone stimulators (Bone hearing

devices) Middle ear implants (Semi-implantable

hearing device)Tumour excision for acoustic neuroma

Role of nurse in communicating with the hearing impaired and muteness

Speak clearly and naturally.Move closer to the listener.Face the listener while speaking.Restate your message, if needed.Do not cover your mouth.Be patient.Encourage to use hearing aidEncourage client to read lips, if that

helps

Lower pitch of voiceDirect speech to stronger ear but do

not shout Use gestures when possible to clarify

statementsWrite when necessaryLearn basic signing, if appropriate

Thank you for “LISTENING”