Deafness

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Deafness

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Deafness

  1. 1.   Part of ear not working Includes:  outer ear  middle ear  inner ear  hearing acoustic nerve  auditory system
  2. 2.    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.
  3. 3. Causes of Conductive deafness EXTERNAL EAR:  Wax,  Fungus,  Otitis Externa,  Foreign Bodies,  Polyps,  Myringitis,  Stenosis,  Atresia,  Tumours.
  4. 4. 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 
  5. 5. EUSTACHIAN TUBE Eustachian catarrh Eustachian tube dysfunction due to diseases of the nose, paranasal sinuses & pharynx  Barotrauma   CATARRH = EXCESSIVE DISCHARGE FROM NOSE / THROAT / EAR
  6. 6. 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, fruse mide and quinine.
  7. 7. 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 agerelated hearing loss
  8. 8. 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.
  9. 9. Causes of Mixed deafness     Trauma: Blast injury, acoustic trauma, head injury. CSOM with labyrinthitis. Otosclerosis Senile deafness superimposed on conductive deafness.
  10. 10.  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.
  11. 11.  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
  12. 12.   Conductive deafness: Hearing aid Sensori-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]
  13. 13.  For chronic deafness  Hearing aids  Cochlear implants  Conversation should be slow, clear & not too clear  Auditory training & lip reading.
  14. 14.   Removal of ear wax Hearing aids  Amplify sound  Cochlear Implant
  15. 15.  Small electronic device  Simulates auditory nerve ▪ Provides “sense” of sound  Used by ▪ Profoundly deaf ▪ Children age 2-6  Aided by speech therapy
  16. 16.     Immunizations for childhood diseases Avoid high decibels Have hearing tested Use hearing protectors ▪ Earmuffs ▪ Earplugs
  17. 17.    Hearing aid orientation Sign Language Lip reading
  18. 18.  Visually transmitted sign pattern     Hand shapes Orientation Movement of hands, arms, body Facial expressions
  19. 19.   Surgery 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
  20. 20.         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 aid Encourage client to read lips, if that helps
  21. 21.      Lower pitch of voice Direct speech to stronger ear but do not shout Use gestures when possible to clarify statements Write when necessary Learn basic signing, if appropriate

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