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Sensorineural hearing loss hereditary factors,tinnitus british association kl,t?nis new balance 1260v3 - PDF 2016

Author: admin | 07.09.2013 | Category: Treatment For Ear Ringing

Figure: The outer ear consists of the auricle (unlabelled), the external auditory canal, and the lateral surface of the tympanic membrane (TM). Surprisingly perhaps, hypertension, obesity and diabetes is not associated with an increased risk of hearing loss(Shargorodsky et al 2010).
Dance clubs are often very loud and may be the main source of loud noise exposure outside of occupational exposure. Musician's earplugs are available in ER-9, ER-15, and ER-25, according to ones need for noise reduction. Although diabetes per se is not associated with an overall greater risk of hearing loss (Shargorodsky et al 2010), hearing loss starts at an early age than the normal population.
Diabetics are also more prone to get external and middle ear infections, as well as more prone to develop cranial nerve palsies and stroke.
As diabetes is commonly an autoimmune disorder, autoimmune inner ear disease may also contribute. Sensorineural Hearing Loss is a hearing loss due to impairment or degeneration of the cochlear (inner ear) resulting in an irreversible hearing loss. Bilateral Hearing Loss is a hearing loss, either sensorineural or conductive, in both ears. Unilateral Hearing Loss is a hearing loss, either sensorineural or conductive, in one ear only. Also referred to as noise-induced hearing loss, sensorineural hearing loss is caused by damaged or destroyed hair cells in the inner ear that no longer transfer sound information to the brain. Sensorineural hearing loss can rarely be corrected medically or surgically, so hearing aids are the primary solution. Since sensorineural hearing loss is typically caused by exposure to loud noises, we highly recommend the use of ear protection if you find yourself around loud noises frequently. If you have any questions about sensorineural hearing loss or hearing loss in general, please contact one of our locations to speak with an audiologist. Send Home Our method Usage examples Index Contact StatisticsWe do not evaluate or guarantee the accuracy of any content in this site. Persons with cochlear deficits fail OAE testing, while persons with 8th nerve deficits fail ABR testing. The middle ear includes the medial surface of the eardrum, the ossicular chain, the eustachian tube, and the tympanic segment of the facial nerve. Postmeningitic hearing loss can be due to lesions of the cochlea, brainstem and higher auditory pathways, but usually is related to suppurative labyrinthitis (cochlear). It is a subtype of sensorineural hearing loss, and because it is due to cochlear damage, it is more specifically a cochlear problem.
We have encountered several patients in our practice with transient hearing loss after going to a loud club. These ear plugs require a visit to a clinic to get an impression made, so that they are specific for the ear being fitted. The effects of type I diabetes mellitus on the cochlear structure and vasculature in human temporal bones.
A long-term study on hearing status in patients with nasopharyngeal carcinoma after radiotherapy.
Unsuccessful cochlear implantation in two patients with superficial siderosis of the central nervous system. Sensorineural hearing loss can be caused by aging, noise exposure, birth defects, medication and viral or bacterial infections.
This can be caused by impacted cerumen (wax), punctured eardrum, birth defects or otosclerosis. Hearing loss of this sort is often caused by prolonged exposure to very loud noise, though auditory pathways (or hair cells that transfer sound) in the brain are sometimes abnormal at birth, resulting in some level of hearing loss.
Correctly fitted hearing aids amplify tones based on an individual’s unique sound deficiencies. Most cases of tinnitus are subjective, but occasionally the tinnitus can be heard by an examiner.


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The inner ear includes the auditory-vestibular nerve, the cochlea and the vestibular system (semicircular canals).
The piccolo generates sound levels up to 112db…roughly equivalent to a jackhammer at 30 feet. Pathological studies suggest that it is due to microangiopathic involvement of inner ear blood vessels and subsequent stria vascularis atrophy and hair cell loss (Fukushima et al, 2004).
There is no cure for this type of hearing ,loss; however, most patients with sensorineural hearing loss can be helped with hearing aids. Surgery or medication can be an appropriate therapy for conductive hearing loss in some cases. Typically, sensorineural hearing loss reduces the ability to hear faint sounds or causes speech to sound faint or muffled, which results in the need for sound amplification. In most cases, total communication is greatly improved through the addition of hearing aids. Otologic problems, especially hearing loss, are the most common causes of subjective tinnitus. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Common causes of conductive hearing loss include external ear infection, cerumen impaction, and middle ear effusion.
Sensorineural hearing loss may be caused by exposure to excessive loud noise, presbycusis, ototoxic medications, or Meniere's disease. Objective tinnitus usually is caused by vascular abnormalities of the carotid artery or jugular venous systems. Initial evaluation of tinnitus should include a thorough history, head and neck examination, and audiometric testing to identify an underlying etiology. Unilateral or pulsatile tinnitus may be caused by more serious pathology and typically merits specialized audiometric testing and radiologic studies.
In patients who are discomforted by tinnitus and have no remediable cause, auditory masking may provide some relief.
Epidemiologic data reveal that approximately one fourth of persons with tinnitus are discomforted by it, whereas the remaining three fourths experience the condition without significant symptoms.3Tinnitus takes different forms and has different classification proposals. One classification system stresses distinctions between vibratory and nonvibratory types, while another system groups the different forms of tinnitus into subjective or objective classes.Vibratory tinnitus is caused by transmission to the cochlea of vibrations from adjacent tissues or organs. Nonvibratory tinnitus is produced by biochemical changes in the nerve mechanism of hearing.Subjective tinnitus, which is more common, is heard only by the patient. Objective tinnitus can be heard through a stethoscope placed over head and neck structures near the patient's ear.The mechanism that produces tinnitus remains poorly understood. Tinnitus may originate at any location along the auditory pathway from the cochlear nucleus to the auditory cortex.
Some leading theories include injured cochlear hair cells that discharge repetitively and stimulate auditory nerve fibers in a continuous cycle, spontaneous activity in individual auditory nerve fibers, hyperactivity of the auditory nuclei in the brain stem, or a reduction in the usual suppressive activity of the central auditory cortex on peripheral auditory nerve activity.4This article discusses the causes of subjective and objective tinnitus, and techniques used for evaluating tinnitus. A thorough history and physical examination should be directed at ruling out serious disorders.
Conductive hearing loss is caused by the inhibition of sound transmission to the inner ear. The most common etiologic factors are noise-induced hearing loss (NIHL), or the progressive loss of acuity that occurs with advancing age (presbycusis).NIHL is the most common type of acquired hearing loss. Screening for exposure to excessive or loud noises can be performed during routine health maintenance visits.11 Continued counseling about the risk of hearing loss is warranted if the patient is exposed to damaging sounds. Patients should be encouraged to avoid long-term exposure to hazardous noises and to use hearing protection when necessary.
It is continuous and less disturbing than the tinnitus of Meniere's disease.14Ototoxic medications or substances are another common cause of bilateral tinnitus. Currently, almost every major group of medication includes one or more compounds with ototoxic properties (Table 2).2,10,15 Ototoxicity may affect hair cells, the eighth cranial nerve, or their central nervous connections.


Temporomandibular joint disorder has been associated with vertigo and tinnitus, although the exact mechanism is unclear.Various metabolic abnormalities may be associated with tinnitus.
These abnormalities include hypothyroidism, hyperthyroidism, hyperlipidemia, anemia, and vitamin B12 or zinc deficiency.Many patients with tinnitus exhibit signs of psychologic disorders. Although tinnitus may be a contributing factor to the development of depression, the common association of tinnitus and depression may be the result when depressed patients, particularly those with sleep disturbances, focus and dwell on their tinnitus more than patients who are without an underlying psychologic disorder.OBJECTIVE TINNITUSObjective tinnitus is rare. Patients with objective tinnitus typically have a vascular abnormality, neurologic disease, or eustachian tube dysfunction.4Patients with vascular abnormalities complain of pulsatile tinnitus. Arterial bruits may be transmitted to the ear from arterial vessels near the temporal bone. The petrous carotid system is the most common source.2 Patients experience worsening of symptoms at night and usually do not have other otologic complaints. Venous hums may be heard in patients with hypertension or abnormally high placement of the jugular bulb. This type of tinnitus is a soft, low-pitched venous hum, which can be altered by head position, activity, or pressure over the jugular vein.4Congenital arteriovenous shunts are usually asymptomatic, while the acquired type often are associated with pulsatile tinnitus. Glomus tumor is a vascular neoplasm arising from the paraganglia around the carotid bifurcation, the jugular bulb, or the tympanic arteries.
The symptoms may disappear with Valsalva's maneuver or when the patient lies down with the head in a dependent position.Evaluation of TinnitusHISTORYThe evaluation of a patient with tinnitus begins by taking a thorough history. Precipitous onset can be linked to excessive or loud noise exposure or head trauma.LocationUnilateral tinnitus can be caused by cerumen impaction, otitis externa, and otitis media. Tinnitus associated with unilateral sensorineural hearing loss is the hallmark of acoustic neuroma.PatternContinuous tinnitus accompanies hearing loss. The external canal and tympanic membrane should be inspected for signs of cerumen impaction, perforation, or infection.
The cranial nerves should be examined for evidence of brain-stem damage or hearing loss.9 Auscultation over the neck, periauricular area, orbits, and mastoid should be performed. Tinnitus of venous origin can be suppressed by compression of the ipsilateral jugular vein.Specific testing for sensorineural or conductive hearing loss is the next part of the examination.
In the Weber test, the tuning fork is struck and placed on the midline of the forehead, the nasal bridge, or the chin. The sound lateralizes to the opposite ear in patients with a sensorineural hearing loss, but to the same side in those with a conductive hearing loss.
Patients with normal hearing or equal deafness in both ears hear the sound at the same level in both ears.In the Rinne test, the tuning fork is placed against the mastoid process to measure the conduction of sound by bone. When the sound can no longer be heard, the tuning fork is placed in front of the auditory canal to test air conduction.
If air conduction is greater than bone conduction, hearing is normal or sensorineural hearing loss is present.
A formal audiogram establishes a base from which to pursue more advanced diagnostic testing.
Pure tone testing primarily tests the function of the peripheral portion of the hearing apparatus.
Sound must be interpreted in the central nervous system before it can be useful to the patient. Further investigation should be dictated by the index of suspicion created by the history, physical examination, and audiometric profile (Figure 1). Patients with unilateral or pulsatile tinnitus are more likely to have serious underlying disease and typically merit referral to an otolaryngologist.2,5 A full clinical evaluation should precede radiologic studies.
Because pulsatile tinnitus suggests a vascular abnormality, the preferred imaging study is contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) of the brain21 (Figure 2).



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