HEARING CONSERVATION PROGRAM
EAR DISORDERS AND
HEARING LOSS
126 Jan 2013
LEARNING OBJECTIVES
1.Define the five types of hearing loss2.Describe medical and communication
symptoms that are characteristic of each type of hearing loss
3.List common causes of and basic treatment for each type of hearing loss
4.Explain how impact and continuous noise exposure affects ear structures and functions
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OHC TECHNICIAN RESPONSIBILITY
YESGeneral
Knowledge for
Referrals
NODiagnosis of Type of Hearing
Loss Ear Disease
Recommendations of Treatments
3
FIVE TYPES OF HEARING LOSS
1. Conductive hearing loss2. Sensorineural hearing loss3. Mixed hearing loss4. Central hearing loss
5. Non-organic or Functional hearing loss
4
Five Types of Hearing Loss cont…
Central earCONDUCTIVE CENTRAL
MIXED HEARING LOSS
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SENSORI-NEURAL
CONDUCTIVE HEARING LOSS
Symptoms
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Talks softly or reports“talking in a barrel”
Understands speech with increased volume
Congestion – coldLow pitched ringing or
crackling sounds
Low frequency or flat hearing loss
Hearing Test Results500 1000 2000 3000 4000 6000Hz 35 30 25 15 10 10 dB
Abnormalotoscopic examtympanogram
Outer &
MiddleEars
Normal Ear Canal and Eardrum
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CONDUCTIVE HEARING LOSSDiseases and Disorders
Impacted Cerumen Complete Occlusion
Outer
&Middle
Ears
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External Otitis or Infection
9
Outer &
Middle
Ears
Conductive Hearing Loss:Diseases/Disorder cont…
Conductive Hearing Loss:Diseases/Disorders cont…
Dermatitis Basal Cell
Carcinoma
Outer &
Middle
Ears
Conductive Hearing Loss:Diseases/Disorders…cont…
Exotosis Bony Growths or Protrusions
Outer &
Middle
Ears
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Conductive Hearing Loss:Diseases/Disorders…cont…
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Outer &
Middle
Ears
Foreign ObjectsBall Bearing Stick Insect
Conductive Hearing Loss:Diseases/Disorders contOuter &
Middle
Ears
Ear Canal Fungus
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Conductive Hearing Loss:Diseases/Disorders contOuter &
Middle
Ears
Congenital Atresia
14
Reminder: Normal Eardrum
15
Outer &
Middle
Ears
Conductive Hearing Loss:Diseases/Disorders cont…
Tympanic Membrane Perforation
Outer &
Middle
Ears
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Conductive Hearing Loss:Diseases/Disorders cont…
Ossicle Related
Detached
Stiff – fixated
Eroded
Birth related
Outer
and
Middle
Ears
Conductive Hearing Loss:Diseases/Disorders
cont…
Eustachian Tube DysfunctionOuter &
Middle
Ears
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19
Conductive Hearing Loss:Diseases/Disorders cont…
Middle Ear Effusion Serous Otitis Media
Fluid line (7:00 to 2:00)
Outer &
Middle
Ears
Conductive Hearing Loss:Diseases/Disorders cont…Outer &
Middle
Ears
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Otitis Media or Middle Ear Infection
Conductive Hearing Loss:Diseases/Disorders cont…Outer &
Middle
Ears
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Cholesteatoma
Conductive Hearing Loss:Diseases/Disorders cont…Outer &
Middle
Ears
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Otosclerosis
CONDUCTIVE HEARING LOSSTreatment
1. Medications2. Surgery3. Good ear hygiene4. Hearing aids
Conductive a) temporaryHearing Loss b) loudness
problem
Outer
&
Middle
Ears
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SENSORINEURAL HEARING LOSS
Symptoms“Can hear but trouble
understanding “ due to distorted speech sounds
May hear well in quiet but difficulties in noise
Talks loudlyTinnitusBalance difficultiesHx: illness, head
trauma, noise exposure
High frequency hearing loss
Hearing Test Results500 1000 2000 3000 4000
6000 Hz 15 20 30 45 55 60
dB
InnerEar
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Normal otoscopic exam tympanogram
SENSORINEURAL HEARING LOSS
Diseases & DisordersBASIC PROBLEM
Organ of Corti and Hair Cells are damaged destroyedundergoing pressure
RESULT Complete sounds can’t
be detected and/or transmitted creating…
“distorted speech”
InnerEar
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Ototoxinsdrugschemicals
Head traumaAgingAuto-immune or
unknown
Diseases bacterial/viral fluid pressure
Birth related genetic (DNA) fetal or birth
Hazardous noise exposure
InnerEar
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SENSORINEURAL HEARING LOSS
Causes of Inner Ear Damage
Sensorineural Hearing Loss:Diseases & Disorders cont….
Noise Induced Hearing Loss (NIHL)prolonged exposure ≥ 85 dB HLsudden impulse/impact ≥ 140 dB Peak HL
Normal Damage Normal Damage
InnerEar
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SENSORINEURAL HEARING LOSS
Treatment1.Medications & Surgery -
limited
2.Hearing Aids
3.Adaptive Skills
Sensorineural a) permanentHearing Loss b) understanding problem
InnerEar
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Conductive + Sensorineural = Mixed HL
MIXED HEARING LOSS
ANY
COMBINATION
Symptoms
Hearing Test Results
Disease/Disorders
Treatments
MOST COMMON
Permanent Sensorineural HL
with Outer/Middle Ear disorder
ORImpacted Cerumen
(temporaryconductive HL)
Outer
Middle
Inner
Ears
CENTRAL HEARING LOSSSymptoms
Asymmetrical hearing lossTinnitus - typically constantAtypical difficulty with
understanding speech in noisy conditions
Balance difficultiesHead trauma
Auditory
Nerves
&Brain
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Central Hearing Loss:Symptoms cont…
Often hearing for tones is normal
Other neurological disorders present
Easily distracted by other sounds
May have learning difficulties
Confused with behavioral problems
Auditory
Nerves &
Brain
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CENTRAL HEARING LOSSTreatment
1. Surgery for tumors/growths
2. Educational therapy
3. Adaptive techniques
Central understanding
Hearing Loss problem
Auditory
Nerves &Brain
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NON-ORGANIC HEARING LOSS
History enlistment, deployment,
discipline, avoid work, retirement, attention, monetary compensation
Inconsistent behaviors
Testing behaviors
Hearing test results
inconsistent with
hearing behaviors previous tests how ear functions
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Malingering
Central Hearing Loss:Symptoms cont . . .
History Traumatic event –
assault, rape, IED, war trauma
Not trying to avoid work
Not trying to obtain $$
Hearing test results
inconsistentFlat affect Emotionless facePatient believes has hearing loss
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Very rare condition
Conversion or Psychological Trauma
NON-ORGANIC HEARING LOSS“Treatment”
1. Follow regular protocols2. Give reinstruction for test3. Give person an “out”4. Refer to audiologist
• special test techniques• special tests• counseling
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SUMMARYThe five types of hearing loss
are based on the divisions and functions of the ear
1. Conductive2. Sensorineural3. Mixed4. Central
5. Non-Organic
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Q U E S TION S?