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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


Deafness


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



Deafness


Deafness


Deafness

The impact of hearing impairment: hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

- Speech,

- Language,

- Education

- Social


High risk criteria for hearing loss in infants
High Risk Criteria For Hearing Loss in Infants hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • 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 hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • 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 hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

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


Hearing loss
Hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

Types:

Conductive hearing loss

1. Concha

2. Ear Canal

3. Drum

4. Ossicular Chain

5. Eustachian Tube


Conductive hearing loss
Conductive hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Exteranal canal pathology :

  • Artesia


Deafness

  • Inflammatory hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Acute otitis externa


External canal pathology
External canal pathology hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Wax


External canal pathology1
External canal pathology hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Foreign body


External canal pathology2
External canal pathology hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

Tumors:

  • Osteoma

  • exostosis


Conductive hearing loss1
Conductive hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Tympanic membrane:

  • Absent Perforated

  • Too thick tympansclerosis

  • Too thin SOM


Conductive hearing loss2
Conductive hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

Ossicular chains

  • Absent &erosion

  • Fixation (otosclerosis

  • Disruptedtrauma


Conductive hearing loss3
Conductive hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

EustachianTube dysfunction:

  • Retraction

  • Effusion


Sensorineural hearing loss
Sensorineural hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

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 hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

Congenital :

  • Inherited

  • (syndromic less common

  • Non- syndromic common

  • Congenital infection (TORCH)


Sensorineural hearing loss1
Sensorineural hearing loss hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

Acquired :

  • Inflammatory

    -labyrinthitis ,meningitis


1 what is noise induced hearing loss 2 what is the typical finding
1.What is noise-induced hearing loss ? hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries 2.what is the typical finding ?


Noise exposure
Noise exposure hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries


Deafness

  • Autoimmune hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

    -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? hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries 2. How does patient present clinically ?


Trauma
Trauma hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Temporal bone fracture

    1.Longitudinal fracture

    2.Transeverse fracture


Longitudinal fracture
Longitudinal fracture hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • Bleeding from ear

  • Conductive hearing loss

  • Uncommon facial nerve paralysis

  • CSF


Transverse fracture
Transverse fracture hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • SNHL

  • Facial nerve paralysis common

  • CSF


Examination
Examination hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries

  • 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 ? hearing loss are 1.5 to 2.2 per 1000 live birth for developed countries How to conduct the test ?



Clinical testing of hearing
Clinical testing of hearing and why?

Audiogram battery:

Pure tone audiogram

Speech audiogram

  • Impedance

  • Acoustic reflex

  • Tympanogram

  • Volume

  • Acoustic reflex decay


Pure tone audiogram normal hearing
pure tone audiogram and why?Normal hearing



Pure tone audiogram
pure tone audiogram and why?

  • Sensorineural hearing loss


Pure tone audiogram1
Pure tone audiogram and why?

  • Mixed hearing loss


Tympanogram
Tympanogram and why?




Managemnt of deafness
Managemnt of deafness and why?

  • Medical management

  • Hearing aids


Management of deafness
Management of deafness and why?

  • Surgery

    A.Myringotomy and ventilation tube Otitis media with effusion


Management of deafness1
Management of deafness and why?

  • Surgery

    B. Myringplasty &tympanoplasty in case of CSOM


Management of deafness2
Management of deafness and why?

C.Ossiculoplassty


Management of deafness conductive
Management of deafness(conductive ) and why?

  • BAHA (Bone anchored hearing aid)

    -Atersia of external canal

    -Chronic drainage ear not responding to surgery


Management of snhl
Management of SNHL and why?

Surgery :

D. Cochlear implant

- prelingual children and postlingual adult

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



Any question
Any question and why?


Deafness

Thank you and why?


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