Introduction

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

 

Comparison

Cause
Conductive hearing loss
Sensorineural hearing loss
Congenital
Abnormalities of ossicles
Atresia
Genetic
Congenital rubella
Acquired
Otitis externa
Wax
Foreign body
Middle ear effusion
Cholesteatoma
Perforation
otosclerosis
Perinatal hypoxic injury
Perinatal jaundice
Trauma; injury, surgery, noise exposure
Chronic otitis media
Measles
Syphilis
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

References

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