Lectures on Introduction/ rudiments of audiology

1. Dr. Ghulam Saqulain
M.B.B.S., D.L.O, F.C.P.S
Head of Department of E.N.T
Capital Hospital

2.  A disease within the labyrinth of the IE
 A cause of unilateral HL
 Could be extremely handicapping – interferes with driving
an automobile or the one’s job
 Called “ Labyrinthine storm” b/c of sudden and dramatic
appearance of symptoms

3.  Characteristics:
Sudden attacks of vertigo, tinnitus, vomiting and
unilateral HL
Symptoms may begin as sensation of fullness in one
ear followed by a LF roaring tinnitus, HL and great
difficulty in speech recognition
Not all symptoms will be present in each case
Symptoms characterized by remission and
exacerbations

4.  Symptoms
Tinnitus
Vertigo
Unilateral
sensorineural
hearing loss

5.  Inflammatory conditions that occur when the immune system
causes the body to attack its own tissues as it fails to
distinguish them from bacteria, viruses or cells from other
organisms
 AIED specifically attack IE
 Results in bilateral fluctuating and progressive SNHL
 May occur over several months
 Other symptoms: tinnitus, aural fullness and vertigo
 Prevalence is low
 Some bilateral symptoms of Meniere’s disease may be due to
AIED
 Treatment: steroids via a wick for absorption into IE through
RW

6.  When head injury results into HL, the audiogram is
quite similar those typical of acoustic trauma
 Notch at 3000 Hz to 6000 Hz range
 Damage to TM and ME mechanism
 IE structures may be torn, stretched or deteriorated
from the oxygen loss due to hemorrhage
 When a fracture line runs through the cochlea, HL
will be severe to profound or total

7. HCs may be lost
Organ of Corti may be flattened or destroyed
Otitis media
Meningitis
Sometimes HL occurs without fracture (cochlear
contusion)
OW membrane rupture
OW fistula with perilymph leak into ME

8.  No contributing factors to HL except AGE
 It is hearing loss due to aging
 Expected in men by the early 60s and women by the late 60s
 Produces alterations in many areas of the auditory system
(TM, ossicular chain, cochlear windows, CANS
 Characterized by difficulty in speech recognition “Phonemic
Regression” = understanding people when they speak
slowly than when they speak loudly

11.  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

13.  The external ear is composed of a flexible
potentially mobile auricle and attaches external
auditory canal formed of fibrous tissue and elastic
cartilage.
 The auricle develops from six separate hillocks on
the side of the embryo’s head
 Minor congenital abnormalities are not uncommon
and most do not require treatment.

14. “An abnormal smallness of the
auricle”

15. “the absence of
an opening of
the external
canal”

16.  Definition: Wax is normal formation in the
external audiotory meatus. It is secretion
of ceruminous glands. Initially the
secretions are liquid, but due to
evaporation of moisture the secretions dry
forming semi solid to solid brownish or
balck looking substance.
 Function: The normal function of wax is to
protect the tympanic membrane.
◦ Preventing excessive or loud sound
waves to strike the tympanic mebrane
directly
◦ Preventing the insects and foreign
bodies because of its sticky nature

17.  Clinical Features:
◦ Symptoms:
 Deafness is sudden
 May give rise to vertigo and dizziness
 Pain: Due to secondary infection. Wax also
becauses adherent to skin causing ulceration
◦ Signs:
 Blockage of ear due to wax in the external auditory
meatus resulting in deafness.

18.  Treatment:
◦ If little wax with no symptoms, no treatment required
◦ If symptoms are present, the treatment is REMOVAL OF WAX
Removal depends whether wax is hare or soft.
Hard Wax: it is not advisible to remove it straight away: because
it will produce pain and ulceration. The hard wax is made soft
by putting various substances and then remove the wax, the
softening substances are:
Olive Oil: 4-5 dropss 4 times a day for two days and then
remove wax
Soda glycerine drops.
Removal of wax is done by proble, bvlunt hook, syringing by
warm water, suction clearance.

20. Three examples of
the usual
characteristics of a
conductive hearing
loss arising from
otitis media

21.  OME
 AOM
 COM

22.  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
◦ Native Americans
◦ Urban poor
◦ Day care
◦ Secondhand smoke

23. “an epithelial pocket that forms on the tympanic
membrane. Once the pocket forms, the normal
shedding of epithelium results in growth of the
tumor”

24. n An example of the audiogram illustrating the flat,
mild, conductive hearing loss that can occur with a
perforated tympanic membrane

25. “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”

26.  Facts:
Hereditary
Women are more likely
to develop the disorder
Usually bilateral
progressive

27. Here’s an example of
an audiogram
resulting from
disarticulation of the
ossicular chain