Human Audiometric Thresholds Do Not Predict Specific Cellular Damage In
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Age-Related Hearing Loss
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ∙ National Institutes of Health NIDCD Fact Sheet | Hearing and Balance Age-Related Hearing Loss What is age-related hearing loss? The auditory system Age-related hearing loss (presbycusis) is the loss of hearing that gradually occurs in most of us as we grow older. It is one of the most common conditions affecting older and elderly adults. Approximately one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Having trouble hearing can make it hard to understand and follow a doctor’s advice, respond to warnings, and hear phones, doorbells, and smoke alarms. Hearing loss can also make it hard to enjoy talking with family and friends, leading to feelings of isolation. Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, if you have age-related hearing loss you Credit: NIH Medical Arts may not realize that you’ve lost some of your ability to hear. How do we hear? There are many causes of age-related hearing Hearing depends on a series of events that change loss. Most commonly, it arises from changes in sound waves in the air into electrical signals. Your the inner ear as we age, but it can also result auditory nerve then carries these signals to your from changes in the middle ear, or from complex brain through a complex series of steps. changes along the nerve pathways from the ear 1. -
HEARING LOSS, DEAFNESS Ear32 (1)
HEARING LOSS, DEAFNESS Ear32 (1) Hearing Loss, Deafness Last updated: May 11, 2019 CLASSIFICATION, DIAGNOSIS ................................................................................................................. 1 METHODS OF COMMUNICATION FOR DEAF ............................................................................................ 2 MANAGEMENT ......................................................................................................................................... 2 HEARING AIDS (S. AMPLIFICATION) ....................................................................................................... 2 COCHLEAR IMPLANTS ............................................................................................................................ 2 AUDITORY BRAINSTEM IMPLANTS .......................................................................................................... 4 PREVENTION .......................................................................................................................................... 4 PEDIATRIC HEARING DEFICITS ............................................................................................................... 4 ETIOLOGY .............................................................................................................................................. 4 DIAGNOSIS ............................................................................................................................................. 6 TREATMENT .......................................................................................................................................... -
Common Urgent ENT Problems APRIL 4, 2019 GERARD MACDONALD MD FRCS
3/21/2019 Common Urgent ENT Problems APRIL 4, 2019 GERARD MACDONALD MD FRCS 1 Course Objectives A review of common Urgent ENT problems presenting to office and ER Clinical Pearls to help you manage in a timely fashion Knowing when to refer 2 1 3/21/2019 I do not have any Conflicts of Interest 3 Top Ten List Of Urgent Calls 1.Acute Otitis Externa 2. Sudden Hearing Loss 3.Facial Palsy 4.Salivary Gland Stone /Infection 5.Peritonsillar Abscess 6.Neck Abscess 7.Nosebleeds 8.Hoarseness 9.Foreign Bodies Ear/Nose 10. Acute Vertigo 4 2 3/21/2019 Acute Otitis Externa Commonly associated with swimming ( swimmer’s ear) Common in diabetics and habitual Q-tip Users Usual presenting symptoms are itching, discharge, pain and swelling. More severe symptoms can include severe pain, parotid swelling,trismus and cellulitiis Most common organism is Pseudomonas Aeruginosa May go on to develop secondary otomycosis if frequent use of topical antibiotics. Malignant External Otitis rare but serious 5 Acute Otitis Externa 6 3 3/21/2019 Acute Otitis Externa - Treatment Debridement/Suctioning ? Culture Avoid syringing Ototopicals : Tobradex, Sofracort, Ciprodex Otowick if canal swollen shut Oral Antibiotic ( Cipro ) and single dose Steroid if severe When to refer : Unrelenting pain and swelling, facial nerve weakness,dysphagia , fever 7 Sudden hearing Loss UNEXPLAINED sudden sensorineural hearing loss occurring over 3 days Not AOM, trauma, acoustic trauma , ototoxicity Often confused with ETD , “fluid” Poorer outcome if not recognized -
Pediatric Sensorineural Hearing Loss, Part 2: Syndromic And
Published May 19, 2011 as 10.3174/ajnr.A2499 Pediatric Sensorineural Hearing Loss, Part 2: REVIEW ARTICLE Syndromic and Acquired Causes B.Y. Huang SUMMARY: This article is the second in a 2-part series reviewing neuroimaging in childhood SNHL. C. Zdanski Previously, we discussed the clinical work-up of children with hearing impairment, the classification of inner ear malformations, and congenital nonsyndromic causes of hearing loss. Here, we review and M. Castillo illustrate the most common syndromic hereditary and acquired causes of childhood SNHL, with an emphasis on entities that demonstrate inner ear abnormalities on cross-sectional imaging. Syndromes discussed include BOR syndrome, CHARGE syndrome, Pendred syndrome, Waardenburg syndrome, and X-linked hearing loss with stapes gusher. We conclude the article with a review of acquired causes of childhood SNHL, including infections, trauma, and neoplasms. ABBREVIATIONS: BOR ϭ branchio-oto-renal; CISS ϭ constructive interference in steady state; IAC ϭ internal auditory canal; NF-2 ϭ neurofibromatosis type II; SCC ϭ semicircular canal; SNHL ϭ sensorineural hearing loss; T1WI ϭ T1-weighted image; T2 WI ϭ T2-weighted image he estimated prevalence of SNHL in patients younger than Table 1: Selected hereditary syndromes commonly associated with 1 T18 years of age is 6 per 1000, making it one of the leading SNHL causes of childhood disability and a common reason for oto- Inner Ear Malformations on Inner Ear Malformations laryngology referrals. Cross-sectional imaging is now rou- Imaging Not Common on Imaging tinely performed in these patients because it provides impor- Alagille syndrome Alport syndrome tant information about potential etiologies for hearing loss, Branchio-oto-renal syndrome Biotinidase deficiency defines the anatomy of the temporal bone and the central au- CHARGE syndrome Jervell and Lange-Nielsen syndrome ditory pathway, and identifies additional intracranial abnor- Klippel-Feil syndrome Norrie syndrome malities that may require further work-up. -
PRESBYCUSIS Diagnosis and Treatment
Hear the FACTS about PRESBYCUSIS Diagnosis and Treatment NORMAL HEARING What is Presbycusis? FREQUENCY (in Hertz) . A gradual reduction in hearing as we get older, typically affecting both 250 500 1000 2000 4000 8000 -10 ears equally. 0 X 10 X X Common in men and women, with men typically having greater X •X . 20 • •X • • • 30 hearing loss than women of the same age. 40 Typically a greater hearing loss for high frequency sounds than for low 50 . (in dBHL) 60 INTENSITY frequency sounds. 70 80 A treatable condition that can benefit greatly from technological 90 . advances in various amplification or hearing assistance devices, along 100 • Right Ear 110 X Left Ear with counseling on effective communication strategies. PRESBYCUSIS HEARING LOSS What causes Presbycusis? FREQUENCY (in Hertz) . Family history or hereditary factors. 250 500 1000 2000 4000 8000 -10 Changes in the inner ear blood supply related to heart disease, 0 . 10 •X diabetes, high blood pressure and smoking. 20 •X 30 •X A loss of sound sensitivity from cumulative exposure to loud sounds. 40 •X . 50 (in dBHL) 60 INTENSITY X 70 • Symptoms: X 80 • •X 90 . Frequently asking people to repeat what they say, especially in 100 Right Ear “difficult listening places”. 110 X Left Ear . Ability to hear lower-pitched men's voices easier than higher-pitched NORMAL INNER EAR PRESBYCUSIC INNER EAR women’s or children’s voices. People complaining that the TV is being played too loud. Tinnitus, also known as “head noise”, which produces buzzing or ringing sounds in the ear. Diagnosis: . Talk honestly with your Hearing Healthcare Provider about daily hearing problems. -
A Molecular and Genetic Analysis of Otosclerosis
A molecular and genetic analysis of otosclerosis Joanna Lauren Ziff Submitted for the degree of PhD University College London January 2014 1 Declaration I, Joanna Ziff, confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. Where work has been conducted by other members of our laboratory, this has been indicated by an appropriate reference. 2 Abstract Otosclerosis is a common form of conductive hearing loss. It is characterised by abnormal bone remodelling within the otic capsule, leading to formation of sclerotic lesions of the temporal bone. Encroachment of these lesions on to the footplate of the stapes in the middle ear leads to stapes fixation and subsequent conductive hearing loss. The hereditary nature of otosclerosis has long been recognised due to its recurrence within families, but its genetic aetiology is yet to be characterised. Although many familial linkage studies and candidate gene association studies to investigate the genetic nature of otosclerosis have been performed in recent years, progress in identifying disease causing genes has been slow. This is largely due to the highly heterogeneous nature of this condition. The research presented in this thesis examines the molecular and genetic basis of otosclerosis using two next generation sequencing technologies; RNA-sequencing and Whole Exome Sequencing. RNA–sequencing has provided human stapes transcriptomes for healthy and diseased stapes, and in combination with pathway analysis has helped identify genes and molecular processes dysregulated in otosclerotic tissue. Whole Exome Sequencing has been employed to investigate rare variants that segregate with otosclerosis in affected families, and has been followed by a variant filtering strategy, which has prioritised genes found to be dysregulated during RNA-sequencing. -
Acoustic Trauma and Hyperbaric Oxygen Treatment
Acoustic Trauma and Hyperbaric Oxygen Treatment Mesut MUTLUOGLU Department of Underwater and Hyperbaric Medicine Gulhane Military Medical Academy Haydarpasa Teaching Hospital 34668, Uskudar, Istanbul TURKEY [email protected] ABSTRACT As stated in the conclusions of the HFM-192 report on hyperbaric oxygen therapy (HBOT) in military medical setting, acoustic trauma is a frequent consequence of military activity in operation. Acoustic trauma refers to an acute hearing loss following a single sudden and very intense noise exposure. It differs from chronic noise induced hearing (NIHL) loss in that it is usually unilateral and causes sudden profound hearing loss. Acoustic trauma is a type of sensorineural hearing loss affecting inner ear structures; particularly the inner and outer hair cells of the organ of Corti within the cochlea. Exposure to noise levels above 85 decibel (dB) may cause hearing loss. While long-term exposure to repetitive or continuous noise above 85 dB may cause chronic NIHL, a single exposure above 130-140 dB, as observed in acoustic trauma, may cause acute NIHL. The loudest sound a human ear may tolerate without pain varies individually, but is usually around 120dB. Military personnel are especially at increased risk for acoustic trauma due to fire arm use in the battle zone. While a machine gun generates around 145dB sound, a rifle generates 157- 163dB, a 105 mm towed howitzer 183dB and an improvised explosive device around 180dB sound. Acoustic trauma displays a gradually down-slopping pattern in the audiogram, particularly after 3000Hz and is therefore described as high-frequency hearing loss. Tinnitus is almost always associated with acoustic trauma. -
ICD-9/10 Mapping Spreadsheet
ICD-9-CM to ICD-10-CM Mappings for Audiology Related Disorders Updated 7/16/2015 Disclaimer: This product is NOT comprehensive and consists only of codes commonly related to audiology services. Mappings are only to ICD-10-CM codes, not ICD-10-PCS. Every effort was made to accurately map codes using detailed analysis. Keep in mind, however, that while many codes in ICD-9-CM map directly to codes in ICD-10, in some cases, additional clinical analysis may be required to determine which code or codes should be selected for your situation. Always review mapping results before applying them. ICD-9-CM ICD-9-CM Description ICD-10- ICD-10-CM Description Notes Code CM Code 315.32 Mixed receptive-expressive F80.2 Mixed receptive-expressive language language disorder disorder Central auditory processing Developmental dysphasia or aphasia, disorder receptive type Developmental Wernicke's aphasia Excludes1: central auditory processing disorder (H93.25), dysphasia or aphasia NOS (R47.-), expressive language disorder (F80.1), expressive type dysphasia or aphasia (F80.1), word deafness (H93.25) Excludes2: acquired aphasia with epilepsy [Landau-Kleffner] (G40.80-), pervasive developmental disorders (F84.-), selective mutism (F94.0), intellectual disabilities (F70-F79) H93.25 Central auditory processing disorder Congenital auditory imperception Word deafness Excludes1: mixed receptive-epxressive language disorder (F80.2) 380.00 Perichondritis of pinna, unspecified H61.001 Unspecified perichondritis of right external ear H61.002 Unspecified perichondritis -
Vestibular Neuritis and Labyrinthitis
Vestibular Neuritis and DISORDERS Labyrinthitis: Infections of the Inner Ear By Charlotte L. Shupert, PhD with contributions from Bridget Kulick, PT and the Vestibular Disorders Association INFECTIONS Result in damage to inner ear and/or nerve. ARTICLE 079 DID THIS ARTICLE HELP YOU? SUPPORT VEDA @ VESTIBULAR.ORG Vestibular neuritis and labyrinthitis are disorders resulting from an 5018 NE 15th Ave. infection that inflames the inner ear or the nerves connecting the inner Portland, OR 97211 ear to the brain. This inflammation disrupts the transmission of sensory 1-800-837-8428 information from the ear to the brain. Vertigo, dizziness, and difficulties [email protected] with balance, vision, or hearing may result. vestibular.org Infections of the inner ear are usually viral; less commonly, the cause is bacterial. Such inner ear infections are not the same as middle ear infections, which are the type of bacterial infections common in childhood affecting the area around the eardrum. VESTIBULAR.ORG :: 079 / DISORDERS 1 INNER EAR STRUCTURE AND FUNCTION The inner ear consists of a system of fluid-filled DEFINITIONS tubes and sacs called the labyrinth. The labyrinth serves two functions: hearing and balance. Neuritis Inflamation of the nerve. The hearing function involves the cochlea, a snail- shaped tube filled with fluid and sensitive nerve Labyrinthitis Inflamation of the labyrinth. endings that transmit sound signals to the brain. Bacterial infection where The balance function involves the vestibular bacteria infect the middle organs. Fluid and hair cells in the three loop-shaped ear or the bone surrounding semicircular canals and the sac-shaped utricle and Serous the inner ear produce toxins saccule provide the brain with information about Labyrinthitis that invade the inner ear via head movement. -
Vestibular Neuritis, Labyrinthitis, and a Few Comments Regarding Sudden Sensorineural Hearing Loss Marcello Cherchi
Vestibular neuritis, labyrinthitis, and a few comments regarding sudden sensorineural hearing loss Marcello Cherchi §1: What are these diseases, how are they related, and what is their cause? §1.1: What is vestibular neuritis? Vestibular neuritis, also called vestibular neuronitis, was originally described by Margaret Ruth Dix and Charles Skinner Hallpike in 1952 (Dix and Hallpike 1952). It is currently suspected to be an inflammatory-mediated insult (damage) to the balance-related nerve (vestibular nerve) between the ear and the brain that manifests with abrupt-onset, severe dizziness that lasts days to weeks, and occasionally recurs. Although vestibular neuritis is usually regarded as a process affecting the vestibular nerve itself, damage restricted to the vestibule (balance components of the inner ear) would manifest clinically in a similar way, and might be termed “vestibulitis,” although that term is seldom applied (Izraeli, Rachmel et al. 1989). Thus, distinguishing between “vestibular neuritis” (inflammation of the vestibular nerve) and “vestibulitis” (inflammation of the balance-related components of the inner ear) would be difficult. §1.2: What is labyrinthitis? Labyrinthitis is currently suspected to be due to an inflammatory-mediated insult (damage) to both the “hearing component” (the cochlea) and the “balance component” (the semicircular canals and otolith organs) of the inner ear (labyrinth) itself. Labyrinthitis is sometimes also termed “vertigo with sudden hearing loss” (Pogson, Taylor et al. 2016, Kim, Choi et al. 2018) – and we will discuss sudden hearing loss further in a moment. Labyrinthitis usually manifests with severe dizziness (similar to vestibular neuritis) accompanied by ear symptoms on one side (typically hearing loss and tinnitus). -
ICD-9 Diseases of the Ear and Mastoid Process 380-389
DISEASES OF THE EAR AND MASTOID PROCESS (380-389) 380 Disorders of external ear 380.0 Perichondritis of pinna Perichondritis of auricle 380.00 Perichondritis of pinna, unspecified 380.01 Acute perichondritis of pinna 380.02 Chronic perichondritis of pinna 380.1 Infective otitis externa 380.10 Infective otitis externa, unspecified Otitis externa (acute): NOS circumscribed diffuse hemorrhagica infective NOS 380.11 Acute infection of pinna Excludes: furuncular otitis externa (680.0) 380.12 Acute swimmers' ear Beach ear Tank ear 380.13 Other acute infections of external ear Code first underlying disease, as: erysipelas (035) impetigo (684) seborrheic dermatitis (690.10-690.18) Excludes: herpes simplex (054.73) herpes zoster (053.71) 380.14 Malignant otitis externa 380.15 Chronic mycotic otitis externa Code first underlying disease, as: aspergillosis (117.3) otomycosis NOS (111.9) Excludes: candidal otitis externa (112.82) 380.16 Other chronic infective otitis externa Chronic infective otitis externa NOS 380.2 Other otitis externa 380.21 Cholesteatoma of external ear Keratosis obturans of external ear (canal) Excludes: cholesteatoma NOS (385.30-385.35) postmastoidectomy (383.32) 380.22 Other acute otitis externa Excerpted from “Dtab04.RTF” downloaded from website regarding ICD-9-CM 1 of 11 Acute otitis externa: actinic chemical contact eczematoid reactive 380.23 Other chronic otitis externa Chronic otitis externa NOS 380.3 Noninfectious disorders of pinna 380.30 Disorder of pinna, unspecified 380.31 Hematoma of auricle or pinna 380.32 Acquired -
Etiologies and Characteristics of Deaf-Blindness
Etiologies and Characteristics of Deaf-Blindness Kathryn Wolff Heller, R.N., Ph.D. Geor gia State Uni ver sity Cheryl Ken nedy Uni ver sity of Pitts burgh Edited by: Louis Cooper , M.D. Law rence T. Eschelman, M.D., P.C. James W. Long, M.D., P.C. Rosanne K. Silberman, Ed., D. Contents Pref ace··························3 Sec tion I Foun da tions ······················5 Chap ter 1 Def i ni tions and Ter mi nol ogy Per tain ing to Deaf-Blind ness ···················6 Chap ter 2 Nor mal Anatomy of the Eye and Ear ········16 Chap ter 3 Common Disor ders of the Eye and Ear ·······22 Sec tion II Causes of Deaf-Blind ness ···············36 Chap ter 4 He red i tary Syn dromes and Dis or ders········37 Chap ter 5 Con gen i tal In fec tions and Teratogens ········50 Chap ter 6 Prematurity and Small for Gesta tional Age·····65 Chap ter 7 Ad ven ti tious Con di tions ···············68 APPENDIX Ref er ences························75 Pref ace here are sev eral dis or ders, syn dromes, in fec tious dise ases, and ad ven ti tious con - di tions that may re sult in an in di vid ual be ing deaf-blind. As a re sult of these var i - Tous eti ol o gies, an in di vid ual who is deaf-blind may ex hibit a range of vi sion and hear ing losses. Sen sory loss may range from mild im pair ment to to tal loss of the abil ity to see and/or hear.