Overview of Hearing Loss
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Hearing loss can be:
  1. Sensorineural
  2. Conductive
  3.  Mixed
Hearing loss is quantified by audiological assessment and the production of an audiogram which quotes air and bone hearing thresholds in dB.

Sensorineural hearing loss

  • pathology in cochlear or CN VIII
  • commonly due to irreversible loss of hair cells on organ of Corti
  • Permanent hearing loss
  • Audiometry; loss in the high frequencies

Conductive hearing loss

  • pathology in outer or middle ear
  • Commonly responds to surgery



Conductive hearing loss
Sensorineural hearing loss
Abnormalities of ossicles
Congenital rubella
Otitis externa
Foreign body
Middle ear effusion
Perinatal hypoxic injury
Perinatal jaundice
Trauma; injury, surgery, noise exposure
Chronic otitis media
Ototoxic drugs; aminoglycacides and cytotoxics
Acoustic neuroma
Meniere’s disease


History Taking

Taking a general hearing loss Hx
Taking a paediatric hearing loss Hx
  • Onset
  • Rate of progression
  • Pain?
  • Discharge?
  • Tinnitus?
  • Dizziness?
  • Noise exposure history
  • Drug history
  • Family history
  • Developmental history especially age of first word
  • Extent of vocabulary
  • Understanding of conversation and commands
  • Attention span and concentration
  • Social interaction and background
  • Family history
  • Questions as for adult hearing loss history
  • Incidence of sore throats
  • Sleep apnoea
  • Atopic?
  • Parental smoking


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Dr Tom Leach

Dr Tom Leach MBChB DCH EMCert(ACEM) FRACGP currently works as a GP and an Emergency Department CMO in Australia. He is also a Clinical Associate Lecturer at the Australian National University, and is studying for a Masters of Sports Medicine at the University of Queensland. After graduating from his medical degree at the University of Manchester in 2011, Tom completed his Foundation Training at Bolton Royal Hospital, before moving to Australia in 2013. He started almostadoctor whilst a third year medical student in 2009. Read full bio

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