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HEARING
Anatomy of the Ear
Areas of the Ear
   Outer Ear (Hearing)
       Pinna(Auricle)
       External Auditory Canal/Meatus
            Ceruminous glands
       Tympanic Membrane(Eardrum)
Areas of the Ear
   Middle Ear (Hearing)
       Auditory Ossicles
            Malleus/Hammer
            Incus/Anvil
            Stapes/Stirrup
       Tiny Muscles
            Tensor tympani
            Stapedius
       Eustachian tube
Areas of the Ear
   Inner Ear
       Hearing and Equilibrium
            Oval Window
            Round WIndow
            Bony Labyrinth with perilymph
              • Membranous Labyrinth with endolymph
   Bony Labyrinth
         Vestibule
           • Equilibrium Receptors
           • Utricle and Saccule
         Semicircular Canals
           • Equilibrium Receptors
           • Ampulla
         Cochlea
           •   Hearing receptors
           •   Modiolus
           •   Scala Vestibuli, Scala Tympani, Scala Media
           •   Organ of Corti with Hair cells
Physiology of Hearing
   The auricle directs sound waves into the
    external auditory canal
   When sound waves strike the eardrum, the
    pressure of air cause the eardrum to vibrate
   Vibration of the eardrum cause the malleus,
    incus and stapes to vibrate.
   As the stapes move back and forth, it pushes the
    membrane of the oval window in and out.
   The movement of the oval window sets up flid
    pressure waves in the perilymph of the cochlea.
    As the oval window bulges inward, it pushes the
    perilymph of the scala vestibuli.
   Pressure waves are transmitted from the scala
    vestibuli to the scala tympani and eventually to
    the round window, causing it to bulge outward in
    the middle ear.
   As the pressure waves deform the walls of the
    scala vestibuli and scala tympani, they also push
    the vestibular membrane back and forth creating
    pressure waves in the endolymph inside the
    scala media.
   The pressure waves in the endolymph cause the
    basilar membrane to vibrate, which moves the
    hair cells of the spiral organ against the tectorial
    membrane. Bending of the stereocilia produces
    receptor potentials that ultimately lead to the
    generation of nerve impulses.
Ear Disorders
Deafness
   Conductive Hearing Loss
     Occurs   when sound cannot reach the cochlea

     Causes
       Obstruction (Cerumen Impaction)
       Mass loading ( Middle ear effusion)

          • Ear canal is very sensitive
          • Removal with a loop or hook
       Stiffness effect (Otosclerosis)
       Discontinuity (Ossicular disruption)

          • Resorption of bone
          • Stapedectomy
   Symptoms
     Tinnitus      -      clicking in the ears
     Feeling of fullness in the ear

     Sounds are faint or non existent

     Needing everything to be repeated

     Withdrawal from social activities

     Depression and embarrassment
   Treatment
     Removal   of the offending obstruction
     Surgery

     Hearing  Aids
     Draining of fluids that have built up

     Softening and removal of excessive ear wax

     Antibiotics such as oral medication or ear drops
   Sensorineural Hearing Loss
     Disturbance in the inner ear in the cochlea
      or the acoustic nerve to the brain

     Causes
        Long-term exposure to loud sounds
        Ototoxic medications

        Trauma

        Aging
   Symptoms:
     Unable  to hear high tones (high frequency
      hearing loss)
     Can not understand or hear speech

     Loud TV volume

     Always needing conversation repeated

     Retreat from social activities and interaction
      with others
     Depression
   Treatment
     Remove   ear wax or use of antibiotics to treat
      an ear infection
     Intratympanic steroids may be effective
     Hearing aids
     Surgery:
        Tympanoplasty for repair of a perforated eardrum
        Myringotomy tubes surgically inserted to drain the
         ear of fluids caused by infections.
     Cochlear   implant
   Presbycusis
     Causes
       Atrophy of the sensory cells
       Loss of neuron in the cochlea and CNS

       Atrophy of the wall of cochlea

       Mechanical change of the outer ear
   Meniere’s Disease
     Disorderof the middle ear with an increase
      amount of endolymph that enlarges the
      membranous labyrinth

     Treatment
          Symptomatic relief
   Symptoms
       Hearing loss of several hours or more
       Vertigo,
       severe nausea,
       vomiting
       sweating
       Tinnitus
       Feelings of fullness or pressure in the ear
       Headache
       Abdominal pain
       Diarrhea
   Otitis Media
     Infectionof the middle ear caused mainly by
      bacteria and associated with infections of the
      nose and throat.
     Causes
        Allergies
        Persistent infections

        Ear trauma

        Swelling of the adenoids
   Symptoms
     Pain

     Malaise

     Fever

     Reddening

     Outward   bulging of eardrum
   Treatment
       Oral or ear drop antibiotics
       Adenoidectomy
       Surgical repair of ruptured eardrum

   Otitis media complications may include:
       Cyst of the middle ear (cholesteatoma)
       Facial paralysis
       Mastoiditis
       Epidural abscess (inflammation surrounding the brain)
       Partial or profound hearing loss
   Mixed Hearing Loss
     Combination   of conductive and sensorineural
      losses
     Chronic ear infection that is a fairly common
      diagnosis could result in a defect ear drum
      and/or middle ear ossicle damages. Surgery
      is often attempted but not always successful.
   Functional Hearing Loss
     Individual
               does not respond to voice and
      appears not to hear
Treatments
   Hearing Aid
       an  electroacoustic device which typically
        fits in or behind the wearer's ear, and is
        designed to amplify and modulate sound
        for the wearer.
       receives sound, amplifies it, and

        transmits this stronger sound down the
        ear canal into the ear.
       sound is amplified to make the weak and

        distorted signals more audible.
The microphone - picks
up the sound and sends it
to the amplifier.
The amplifier - makes
the sound louder.
The receiver - sends the
amplified sound into the
ear canal.
The battery - supplies
the power to the hearing
aid.
Cochlear Implants
   Surgically implanted electronic device
   Provides a sense of sound to a person who
    is profoundly deaf or severely hard of hearing.
   Referred to as bionic ear
   can restore hearing in patients suffering
    deafness due to loss of sensory hair cells in
    their cochlea
   electrical hearing is much less rich than natural
    hearing, and offers only very limited
    appreciation of musical melody, or speech
    understanding in noisy environments.
 Sound no longer travels via the ear canal
  and middle ear
 It will be picked up by a microphone and
  sent through the device's speech
  processor to the implant's electrodes
  inside the cochlea.
Hearrrrrrrr
Hearrrrrrrr
Hearrrrrrrr

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Hearrrrrrrr

  • 3. Areas of the Ear  Outer Ear (Hearing)  Pinna(Auricle)  External Auditory Canal/Meatus  Ceruminous glands  Tympanic Membrane(Eardrum)
  • 4. Areas of the Ear  Middle Ear (Hearing)  Auditory Ossicles  Malleus/Hammer  Incus/Anvil  Stapes/Stirrup  Tiny Muscles  Tensor tympani  Stapedius  Eustachian tube
  • 5.
  • 6. Areas of the Ear  Inner Ear  Hearing and Equilibrium  Oval Window  Round WIndow  Bony Labyrinth with perilymph • Membranous Labyrinth with endolymph
  • 7. Bony Labyrinth  Vestibule • Equilibrium Receptors • Utricle and Saccule  Semicircular Canals • Equilibrium Receptors • Ampulla  Cochlea • Hearing receptors • Modiolus • Scala Vestibuli, Scala Tympani, Scala Media • Organ of Corti with Hair cells
  • 8.
  • 9.
  • 10. Physiology of Hearing  The auricle directs sound waves into the external auditory canal  When sound waves strike the eardrum, the pressure of air cause the eardrum to vibrate  Vibration of the eardrum cause the malleus, incus and stapes to vibrate.  As the stapes move back and forth, it pushes the membrane of the oval window in and out.
  • 11.
  • 12. The movement of the oval window sets up flid pressure waves in the perilymph of the cochlea. As the oval window bulges inward, it pushes the perilymph of the scala vestibuli.  Pressure waves are transmitted from the scala vestibuli to the scala tympani and eventually to the round window, causing it to bulge outward in the middle ear.
  • 13.
  • 14. As the pressure waves deform the walls of the scala vestibuli and scala tympani, they also push the vestibular membrane back and forth creating pressure waves in the endolymph inside the scala media.  The pressure waves in the endolymph cause the basilar membrane to vibrate, which moves the hair cells of the spiral organ against the tectorial membrane. Bending of the stereocilia produces receptor potentials that ultimately lead to the generation of nerve impulses.
  • 15.
  • 16.
  • 17.
  • 19. Deafness  Conductive Hearing Loss  Occurs when sound cannot reach the cochlea  Causes  Obstruction (Cerumen Impaction)  Mass loading ( Middle ear effusion) • Ear canal is very sensitive • Removal with a loop or hook  Stiffness effect (Otosclerosis)  Discontinuity (Ossicular disruption) • Resorption of bone • Stapedectomy
  • 20. Symptoms  Tinnitus - clicking in the ears  Feeling of fullness in the ear  Sounds are faint or non existent  Needing everything to be repeated  Withdrawal from social activities  Depression and embarrassment
  • 21. Treatment  Removal of the offending obstruction  Surgery  Hearing Aids  Draining of fluids that have built up  Softening and removal of excessive ear wax  Antibiotics such as oral medication or ear drops
  • 22. Sensorineural Hearing Loss  Disturbance in the inner ear in the cochlea or the acoustic nerve to the brain  Causes  Long-term exposure to loud sounds  Ototoxic medications  Trauma  Aging
  • 23. Symptoms:  Unable to hear high tones (high frequency hearing loss)  Can not understand or hear speech  Loud TV volume  Always needing conversation repeated  Retreat from social activities and interaction with others  Depression
  • 24. Treatment  Remove ear wax or use of antibiotics to treat an ear infection  Intratympanic steroids may be effective  Hearing aids  Surgery:  Tympanoplasty for repair of a perforated eardrum  Myringotomy tubes surgically inserted to drain the ear of fluids caused by infections.  Cochlear implant
  • 25. Presbycusis  Causes  Atrophy of the sensory cells  Loss of neuron in the cochlea and CNS  Atrophy of the wall of cochlea  Mechanical change of the outer ear
  • 26. Meniere’s Disease  Disorderof the middle ear with an increase amount of endolymph that enlarges the membranous labyrinth  Treatment  Symptomatic relief
  • 27. Symptoms  Hearing loss of several hours or more  Vertigo,  severe nausea,  vomiting  sweating  Tinnitus  Feelings of fullness or pressure in the ear  Headache  Abdominal pain  Diarrhea
  • 28. Otitis Media  Infectionof the middle ear caused mainly by bacteria and associated with infections of the nose and throat.  Causes  Allergies  Persistent infections  Ear trauma  Swelling of the adenoids
  • 29. Symptoms  Pain  Malaise  Fever  Reddening  Outward bulging of eardrum
  • 30. Treatment  Oral or ear drop antibiotics  Adenoidectomy  Surgical repair of ruptured eardrum  Otitis media complications may include:  Cyst of the middle ear (cholesteatoma)  Facial paralysis  Mastoiditis  Epidural abscess (inflammation surrounding the brain)  Partial or profound hearing loss
  • 31. Mixed Hearing Loss  Combination of conductive and sensorineural losses  Chronic ear infection that is a fairly common diagnosis could result in a defect ear drum and/or middle ear ossicle damages. Surgery is often attempted but not always successful.  Functional Hearing Loss  Individual does not respond to voice and appears not to hear
  • 32. Treatments  Hearing Aid  an electroacoustic device which typically fits in or behind the wearer's ear, and is designed to amplify and modulate sound for the wearer.  receives sound, amplifies it, and transmits this stronger sound down the ear canal into the ear.  sound is amplified to make the weak and distorted signals more audible.
  • 33. The microphone - picks up the sound and sends it to the amplifier. The amplifier - makes the sound louder. The receiver - sends the amplified sound into the ear canal. The battery - supplies the power to the hearing aid.
  • 34.
  • 35. Cochlear Implants  Surgically implanted electronic device  Provides a sense of sound to a person who is profoundly deaf or severely hard of hearing.  Referred to as bionic ear
  • 36. can restore hearing in patients suffering deafness due to loss of sensory hair cells in their cochlea  electrical hearing is much less rich than natural hearing, and offers only very limited appreciation of musical melody, or speech understanding in noisy environments.
  • 37.  Sound no longer travels via the ear canal and middle ear  It will be picked up by a microphone and sent through the device's speech processor to the implant's electrodes inside the cochlea.