Sensorineural hearing loss is not amenable to treatment 2014,tenis futsal nike 5,my ear makes noise when i chew gum,earrings manufacturer india - Easy Way

Most hearing loss is easy to diagnose as either a well-defined conductive or sensorineural type.
The tuning fork, when held in the mid-line on the forehead, is heard in the ear with the conductive hearing loss.
Total hearing loss in one ear is frequently wrongly diagnosed as a conductive hearing loss. There are still difficulties to overcome in designing a hearing aid that can provide good speech discrimination for this type of hearing loss, although the move recent digital aids have made a significant improvement. Patience and advice are needed to adapt to the use of a hearing aid, and in this and other forms of hearing loss management, hearing therapists have an important role.
With ear discharge not controlled medically or surgically, the fitting of a conventional aid for conductive hearing loss is also not practical, and bone-anchored aids may be used. Magnetic resonance imaging is the single most important investigation for acoustic neuroma.
This test is very sensitive, and if the meatus is occluded with the finger, the tuning fork will be heard in that ear. The Rinne is negative because the tuning fork, although not heard in front of the ear, is heard by the better ear when placed on the mastoid process of the deaf ear, with the sound being transmitted by the bone (false-negative Rinne). Meningitis is also a cause, but mumps is probably the commonest cause, and an acoustic neuroma must be excluded.
Aids containing a microphone, amplifier, battery, and earphone can be fitted either behind the ear, to spectacles, or as an in-the-ear aid. It is an efficient sound conductor for those with congenital absence or deformity of the ear canal and pinna, in whom a conventional hearing aid cannot be fitted.
1.24 The cochlear implant has proved a great advance in the management of profound hearing loss in children and adults, where conventional aids are ineffective to restore hearing. 1.26 The MRI and CT scan are two important radiograph innovations developed in Great Britain. The prognosis for larger neuromas is less good, with risk of permanent damage to the facial nerve and increased morbidity from intracranial surgery. Electrocochleography (ECoG) involves placing fine electrodes through the drum to pick up auditory nerve reaction potential in response to sound. 1.30 Impendance audiometry involves performing several measurements to obtain a wide range of information about the middle and inner ear. 1.31 Impendance measurements are particularly helpful in the differential diagnosis of conductive and sensorineural hearing losses, as they give information about middle-ear pressure, eustachian tube function, middle-ear reflexes, and the level of a lower motor neuron facial nerve palsy. Hearing loss to the right of the blue line is due to a sensorineural lesion, and is usually not so amenable to treatment. A conductive loss of as little as 5 dB will result in the Weber test being referred to that ear. The Weber test gives the clue that the Rinne is false, as the sound will not lateralize to the deaf ear.
The new range of digital hearing aids are, in many cases, much more efficient and effective at reducing background noise. The most common early presentation of an acoustic neuroma is a unilateral sensorineural hearing loss. This can be removed with preservation of the facial nerve to which it is adjacent in the internal auditory meatus, and the hearing too may be preserved.
The audiogram on the left shows a typical sensorineural hearing loss; a sharp dip at 4000 cps, as on this chart, is typical of inner ear damage due to noise trauma. With unilateral hearing loss, noise is used to mask the better ear, so that this ear does not hear the sound transmission from the deaf ear and give a false reading. This refined test gives a good hearing assessment for infants in whom a hearing loss is suspected. A criticism of pure-tone audiometry is that an assessment of the ability to hear pure-tone sounds may not reflect the ability to hear speech. A probe with a rubber tip and containing three small patent tubes is fitted into the meatus to make an airtight seal. It is an essential basic step in diagnosis of hearing loss to distinguish between these two.
The Rinne and Weber tests enable the diagnosis of a conductive or sensorineural hearing loss to be made. The tuning fork is held on the mastoid process and the tragus lightly pushed to occlude the meatus. The problem with background noise has, in the past, been the main complaint of many hearing aid users. Sound is converted to electric signals to a processor and transmitted to electrodes inserted into the cochlear (a). The readings are recorded on a chart with intensity (0-120 dB) and frequency (usually 250-8000 cps). Hearing assessment under the age of three years, or in children who are unable to cooperate with audiometry, requires special skills and techniques. One tube delivers the tone to the ear, a second tube is attached to a microphone to monitor the sound pressure level within the ear canal, and a third tube is attached to a manometer to vary the air pressure in the ear.
If the tuning fork is heard louder on the mastoid process than in front of the ear, the Rinne test is negative, and the hearing loss conductive.
The tuning fork is heard louder, in conductive hearing loss, even of a slight degree, there is no change when the meatus is occluded.
The audiogram on the right shows a conductive hearing loss with the sound heard better on the bone, typical of otosclerosis or otitis media. This objective test of hearing acuity is also of help in the diagnosis of psychosomatic hearing loss or malingering. The percentage of those correctly detected is used as the index to plot a speech discrimination chart. If the tuning fork is heard better in front of the ear, the Rinne test is positive, and the hearing is either normal or there is sensorineural hearing loss. The Rinne test does not become negative until there is a marked degree of conductive loss (about a 20-dB air—bone gap).
Most commonly, however, sensorineural hearing loss affects the high tones, with relatively good hearing at low frequencies.
This test is accurate to about 10 dB only, as there are variables due to the patient's responses and the accuracy of both the audiometrician and the machine. The auditory brain stem response (ABR), in which electroencephalogram recordings are made following auditory stimulus, is another useful audiometric test.
The ability to understand speech is obviously reduced with all hearing loss but particularly with sensorineural loss in which the high tones are involved. It is therefore possible to have a slight conductive hearing loss with a positive Rinne test. The nuclear contour device contains 22 electro-terminals, which can be seen on the radiograph showing the implant in place in the inner ear (d).
Hearing is tested in front of the ear (air conduction—recorded in black) and over the mastoid process (bone conduction—recorded in red).
An additional help in the diagnosis of acoustic neuromas may be poor speech discrimination, in excess of that expected from the level of the pure-tone audiogram.

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30.07.2014 admin

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