Hearing Loss

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Etiology 4 Epidemiology 5 Pathology 6 Clinical-manifestations 7 Laboratory 8 Diagnostic-procedures 9 Radiology 10 Complications 11 Differential-diagnosis 12 Management 13 More General Terms 14 Additional Terms 15 References

More Specific Terms

• age-associated changes in hearing
• conductive hearing loss
• deafness
• functional hearing loss
• mixed hearing loss
• sensorineural hearing loss
• sociocusis

Introduction

• A reduction in the ability to perceive sound.

Etiology

• conductive hearing loss
• sensorineural hearing loss

• presbycusis (most common cause in elderly)

• central hearing loss
• risk factors

• age
• diabetes mellitus (weak association)
• Alzheimer's disease
• systolic hypertension [6]

Epidemiology

• affects 10% of the general population
• prevalence increase with age
• affects 35-40% of individuals over 65 years of age
• prevalence in nursing homes is 50-100%
• hearing declines faster in men

Pathology

• SLC44A2 may be an autoantigen for autoimmune hearing loss

Clinical-manifestations

• (associated findings)
• tinnitus
• earache
• vertigo
• impaired ability to hear in noisy environment suggests sensorineural hearing loss
• muffled hearing suggests conductive hearing loss

Laboratory

• RPR ( rapid plasma reagin) or VDRL to rule out/in syphilis

Diagnostic-procedures

• Weber test
• Rinne test
• Schwabach test
• whispering is normally heard from about 2 feet: patients with presbycusis have great difficulty hearing a whisper because of high frequency loss
• Hearing Handicap Inventory in the Elderly-Screening Version ( HHIE-S)

• screens for functional hearing loss
• most reliable screening tool [6]

• office screening with audioscope (hand held)

• most accurate with 40 dB tone at 2000 Hz
• 94% sensitivity, 70-70% specificity
• detects mild hearing loss

• audiometry
• brain stem auditory evoked response

• sensorineural loss caused by retrocochlear pathology

• acoustic neuroma

• neonatal screening

Radiology

• computed tomography ( CT)
• magnetic resonance imaging ( MRI)

• assymmetric sensorineural hearing loss
• visualize internal auditory canal [3]

Complications

• impact of hearing loss with visual impairment compromises mobility & functional status
• social isolation/withdrawal from conversations
• frustration/resentment
• mislabeled as dementia
• depression [9]
• impaired mobility & greater risk of falling
• cognitive impairment
• difficulty accessing health care [9]

Differential-diagnosis

• hearing loss accompanied by ear pain & drainage is more likely to be conductive hearing loss
• hearing loss associated with dizziness &/or vertigo is more likely to be sensorineural hearing loss

Management

• depends upon etiology
• general measures

• ear exam
• remove earwax (see ear irrigation) [7]

• cerumen impactation can cause conductive hearing loss

• audiometry

• prednisone & urgent ENT referral for sudden, explained hearing loss (possible Cogan's syndrome)
• hearing aid
• complementary amplification devices

• available for television & telephone

• telephone device for the deaf (TDD)

• without excess noise for others

• screening is appropriate for all elderly persons (see hearing evaluation)
• treatment improves depression & quality of life [5]

More General Terms

• sign/symptom

Additional Terms

• auditory processing disorder (APD); central auditory processing disorder (CAPD); auditory perception problem; auditory comprehension deficit; central auditory dysfunction; central deafness; word deafness
• hearing aid
• hearing evaluation
• hearing; audition
• noise
• sound

References

1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
2. Harrison's Principles of Internal Medicine, 13th ed. Companion Handbook, Isselbacher et al (eds), McGraw-Hill Inc. NY, 1995, pg 829-39
3. Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, American College of Physicians, Philadelphia 1998, 2006, 2009
4. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 42-44
5. UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
6. Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004; 7th edition 2010
7. Geriatrics at your Fingertips, 13th edition, 2011 Reuben DB et al (eds) American Geriatric Society
8. Stachler RJ et al Clinical practice guideline: Sudden Hearing Loss Otolaryngology -- Head and Neck Surgery 2012 146: S1 [1]
9. Fellinger J et al Mental health of deaf people The Lancet, 2012, 379(9820):1037-1044 <PubMed> PMID: [2] <Internet> [3]
   - Alexander A et al Deafness might damage your health The Lancet, 2012, 379(9820):977 <PubMed> PMID: [4] <Internet> [5]
   - Anonymous The health of deaf people: communication breakdown The Lancet, 2012, 379(9820):979-981 <PubMed> PMID: [6] <Internet> [7]
10. Hearing, Ear Infections, and Deafness [NIDCD Health Information] [8]
11. Hearing Loss and Bone Disorders [9]
12. Hearing Disorders & Deafness: NIH Institute and Center Resources [10]
13. National Guideline Clearinghouse Vertigo and hearing loss. (American College of Radiology) ngc-guideline: [11]
    - Nursing management of hearing impairment in nursing facility residents. University of Iowa Gerontological Nursing Interventions Research Center, Research Translation and Dissemination Core ngc-guideline: [12]
    - Universal screening for hearing loss in newborns: U.S. Preventive Services Task Force recommendation statement. ngc-guideline: [13]
    - Clinical practice guideline: sudden hearing loss. American Academy of Otolaryngology - Head and Neck Surgery Foundation ngc-guideline-synthesis: 36054

hearing loss (hearing impairment, hard of hearing, HOH)