Deafness
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Deafness. Dr. Abdulrahman Alsanosi Associate professor King Saud University Otolaryngology consultant Otologist , Neurotologist &Skull Base Surgeon Head of otology and neurotology unit Director of cochlear implant program King Abdulaziz University Hospital.

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Deafness

Deafness

Dr. Abdulrahman AlsanosiAssociate professor King Saud University Otolaryngology consultant Otologist , Neurotologist &Skull Base Surgeon

Head of otology and neurotology unit Director of cochlear implant program

King Abdulaziz University Hospital


Questions you should be able to answer at the end of lecture

Questions you should be able to answer at the end of lecture

  • What is deafness ?

  • How common is the problem ?

  • What is the impact of deafness on the patient ?

  • Who is at risk for developing deafness ?


Deafness

  • What is the definition of deafness on pure tone audiogram ?

  • What are the classifications of deafness?


Deafness

  • What are the causes of conductive hearing loss ?

  • What are the causes of sensorineural hearing loss ?

  • What are the findings in the clinical examination you may see in patient with deafness ?


Deafness

  • How would you confirm hearing loss clinically ?

  • What are the tests you request to confirm deafness ?

  • How would you manage patient with deafness ?


Introduction

INTRODUCTION

  • Definition :

    Hearing impairment refers to complete or partial loss of the ability to hear from one or both ears.


Facts about and deafness

FACTS ABOUT AND DEAFNESS

  • 50% of deafness and hearing is avoidable through prevention, early diagnosis, and management


In saudi arabia

In Saudi Arabia ?


Deafness

  • In last study done 10years ago

  • 1.7% had profound SNHL

  • 7.7 % (2months -12years )had hearing loss


Deafness

  • Prevalence figures for permanent congenital sensorineural hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • In Saudi Arabia it is 0.9 to 1.5 percent i.e.: 9 to 15 per 1000, in developing countries, making it the most frequently occurring birth defect


Deafness

The impact of hearing impairment:

- Speech,

- Language,

- Education

- Social


High risk criteria for hearing loss in infants

High Risk Criteria For Hearing Loss in Infants

  • Family history of hereditary childhood sensorineural hearing loss

  • Hyperbilirubinemia

  • Ototoxic medications

  • Bacterial meningitis

  • Birth weight less than 1500 grams

  • In utero infections (cytomegalovirus, rubella, syphilis, herpes, and toxoplasmosis)


High risk criteria for hearing loss in infants1

High Risk Criteria For Hearing Loss in Infants

  • Craniofacial anomalies (including pinna and ear canal)

  • Birth asphexia

  • Mechanical ventilation lasting 5 days or longer

  • Stigmata or other findings associated with a syndrome known to include a sensorineural and/or conductive hearing loss


Definitions

Definitions

  • Impairment of sound perception more than 20 decibel on pure tone audiogram.


Hearing loss

Hearing loss

Types:

Conductive hearing loss

1. Concha

2. Ear Canal

3. Drum

4. Ossicular Chain

5. Eustachian Tube


Conductive hearing loss

Conductive hearing loss

  • Exteranal canal pathology :

  • Artesia


Deafness

  • Inflammatory

  • Acute otitis externa


External canal pathology

External canal pathology

  • Wax


External canal pathology1

External canal pathology

  • Foreign body


External canal pathology2

External canal pathology

Tumors:

  • Osteoma

  • exostosis


Conductive hearing loss1

Conductive hearing loss

  • Tympanic membrane:

  • Absent Perforated

  • Too thick tympansclerosis

  • Too thin SOM


Conductive hearing loss2

Conductive hearing loss

Ossicular chains

  • Absent &erosion

  • Fixation (otosclerosis

  • Disruptedtrauma


Conductive hearing loss3

Conductive hearing loss

EustachianTube dysfunction:

  • Retraction

  • Effusion


Sensorineural hearing loss

Sensorineural hearing loss

Two types :

  • Sensory (the pathology is within hair cells in cochlea)

  • Neural (the pathology is with in the auditory nerve and it’s connection


Etiologies

Etiologies

Congenital :

  • Inherited

  • (syndromic less common

  • Non- syndromic common

  • Congenital infection (TORCH)


Sensorineural hearing loss1

Sensorineural hearing loss

Acquired :

  • Inflammatory

    -labyrinthitis ,meningitis


1 what is noise induced hearing loss 2 what is the typical finding

1.What is noise-induced hearing loss ?2.what is the typical finding ?


Noise exposure

Noise exposure


Deafness

  • Autoimmune

    -Cogan syndrome

  • Ototoxic drugs

    -Aminoglycosides groups ,diruiti,….


1 what are the types of temporal bone fractures 2 how does patient present clinically

1.What are the types of temporal bone fractures?2. How does patient present clinically ?


Trauma

Trauma

  • Temporal bone fracture

    1.Longitudinal fracture

    2.Transeverse fracture


Longitudinal fracture

Longitudinal fracture

  • Bleeding from ear

  • Conductive hearing loss

  • Uncommon facial nerve paralysis

  • CSF


Transverse fracture

Transverse fracture

  • SNHL

  • Facial nerve paralysis common

  • CSF


Examination

Examination

  • General look ( syndromic )

  • Complete head and neck exam

  • Otoscopic / microscopic ear exam of both ears

  • Tuning fork test


What is tunning fork test how to conduct the test

What is tunning fork test ?How to conduct the test ?


What tests you want to request in patient with hearing loss and why

What tests you want to request in patient with hearing loss and why?


Clinical testing of hearing

Clinical testing of hearing

Audiogram battery:

Pure tone audiogram

Speech audiogram

  • Impedance

  • Acoustic reflex

  • Tympanogram

  • Volume

  • Acoustic reflex decay


Pure tone audiogram normal hearing

pure tone audiogram Normal hearing


Conductive hearing loss4

Conductive hearing loss


Pure tone audiogram

pure tone audiogram

  • Sensorineural hearing loss


Pure tone audiogram1

Pure tone audiogram

  • Mixed hearing loss


Tympanogram

Tympanogram


How would you classify the degree of hearing loss

How would you classify the degree of hearing loss?


Degree of hearing impairment

Degree of hearing impairment


Managemnt of deafness

Managemnt of deafness

  • Medical management

  • Hearing aids


Management of deafness

Management of deafness

  • Surgery

    A.Myringotomy and ventilation tube Otitis media with effusion


Management of deafness1

Management of deafness

  • Surgery

    B. Myringplasty &tympanoplasty in case of CSOM


Management of deafness2

Management of deafness

C.Ossiculoplassty


Management of deafness conductive

Management of deafness(conductive )

  • BAHA (Bone anchored hearing aid)

    -Atersia of external canal

    -Chronic drainage ear not responding to surgery


Management of snhl

Management of SNHL

Surgery :

D. Cochlear implant

- prelingual children and postlingual adult

-it pass by the external ,middle and inner ear to stimulate auditory nerve directly


Pre lingual deafness

Pre lingual deafness


Any question

Any question


Deafness

Thank you


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