1-Causes of Hearing Impairment

CAUSES OF HEARING
IMPAIRMENT
BY
G. NJOROGE
Outer and Middle Ear Disorders
• Structural defects due to embryologic

malformations
• Structural changes secondary to infection or

trauma
Outer Ear Disorders
• Microtia and atresia
• Impacted cerumen
• Perforation of the tympanic membrane
Outer Ear Disorders
• Microtia--“an abnormal smallness of the
auricle”
• Atresia--“the absence of an opening of the
external canal”
Perforation of the TM
• Perforation of the tympanic membrane--
These usually occur either by trauma or
secondary to OM.
Perforation of the TM
n An example of the audiogram illustrating the flat, mild,

conductive hearing loss that can occur with a perforated
tympanic membrane
Outer Ear Disorders
• Microtia and atresia
• Impacted cerumen
• Perforation of the tympanic membrane.
Middle Ear Disorders
• Otitis Media
• Most common cause of transient
conductive hearing loss in
children
• Inflamation of the middle ear
• Caused by eustachian tube
failure
Ways to Classify Otitis Media
 With or without effusion
 Fluid type
 Serous
 Suppurative
 Mucoid
Ways to Classify Otitis Media
 With or without effusion

 Fluid type
 Duration
 Acute
 Chronic
 Subacute
 Persistent
 Recurrent
Otitis Media Facts
• 76-95% of all kids will have one episode of OM by age 6

• Prevalence is highest during the first two years of life
• 50% of all kids with one episode before their first birthday
will have 6 or more bouts within two years
• Most episodes occur in winter and spring
• Risk factors
– Cleft palate
– Down syndrome
– Urban poor
– Day care
– Secondhand smoke
• Otitis media
• Otosclerosis
Otosclerosis
“a bone disorder that affects the stapes and the

bony labyrinth of the inner ear. The disease
process is characterized by resorption of bone
and new spongy formation around the stapes
and oval window”
• Otitis media
• Otosclerosis
• Cholesteatoma
Cholesteatoma
“an epithelial pocket that forms on the tympanic

membrane. Once the pocket forms, the normal
shedding of epithelium results in growth of the
tumor” tumor, which is capable of reabsorbing
adjacent bone
• Otitis media
• Otosclerosis
• Cholesteatoma
• Other
– Physical trauma
Physical Trauma of the Middle
Ear
Here’s an example of an
audiogram resulting
from disarticulation of
the ossicular chain
• Otitis media
• Otosclerosis
• Cholesteatoma
• Other
– Physical trauma
– Barotrauma
– Middle ear tumors
• Glomus tumor
Cochlear Disorders
• Syndromes and inherited disorders
• Noise induced hearing loss
• Other trauma
• Infections
• Ototoxicity
• Meniere’s Disease
• Presbycusis
Noise Induced Hearing Loss
The degree of SNHL depends on
 The intensity of the noise
 The spectral composition of the noise
 The duration of exposure
 Individual susceptibility
Infections
• Congenital
– Cytomegalovirus
– HIV
– Rubella
– Syphilis
– Toxoplasmosis
Infections
• Acquired
– Herpes Zooster Oticus (Chicken Pox)

– Mumps
– Syphilis
Ototoxicity
 Some antibiotics that are often ototoxic:
 Amikacin
 Dihydrostreptomycin
 Garamycin
 Gentamicin
 Kanamycin
 Neomycin
 Netilmicin
 Streptomycin
 Tobramycin
 Viomycin
Ototoxicity
 Chemotherapy
 Carboplatin
 Cisplatin
 Drugs that cause reversible hearing loss

 Quinine
 Salicylates (aspirin)
 Loop diuretics
 Drugs that may be harmful during pregnancy

 Accutane
 Dilantin
 Quinine
 Thalidomide
Cochlear Disorders
• Syndromes and inherited disorders
• Noise induced hearing loss
• Other trauma
• Infections
• Ototoxicity
• Meniere’s Disease
Meniere’s Disease
• Symptoms
 Tinnitus
 Vertigo
 Unilateral
sensorineural
hearing loss
Presbycusis
Central Auditory Disorders
• VIII Nerve tumors
• Other diseases of the VIII Nerve
• Neural disorders
 Cochlear neuritis
 Diabetes mellitus
• Brain Stem disorders
 Infarcts
 Gliomas
 Multiple sclerosis
• Temporal Lobe disorders

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CAUSES OF HEARING

• Structural defects due to embryologic

• Structural changes secondary to infection or

n An example of the audiogram illustrating the flat, mild,

 With or without effusion

• 76-95% of all kids will have one episode of OM by age 6

“a bone disorder that affects the stapes and the

“an epithelial pocket that forms on the tympanic

 The spectral composition of the noise

 The duration of exposure

– Herpes Zooster Oticus (Chicken Pox)

 Drugs that cause reversible hearing loss

 Drugs that may be harmful during pregnancy

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