Conductive Hearing Loss |
- Otitis Media: Ear pain, discharge, reduced hearing.
- Otitis Externa: Ear canal pain, redness, swelling.
- Earwax Impaction: Feeling of fullness, difficulty hearing.
- Otosclerosis: Gradual hearing loss, more pronounced in low frequencies.
- Tympanic Membrane Perforation: History of trauma or infection, sudden hearing loss.
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- Otoscopy: Examination of the ear canal and tympanic membrane.
- Tuning Fork Tests: Rinne and Weber tests to differentiate between conductive and sensorineural hearing loss.
- Audiometry: Pure tone audiometry to quantify hearing loss.
- Imaging: CT or MRI if structural abnormalities are suspected.
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- Medical Treatment: Antibiotics for infections, removal of earwax, and treatment of otitis media/externa.
- Surgical Intervention: Tympanoplasty for perforated eardrum, stapedectomy for otosclerosis.
- Hearing Aids: For cases of chronic or irreversible conductive hearing loss.
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Sensorineural Hearing Loss |
- Presbycusis: Gradual hearing loss in both ears, difficulty hearing high-pitched sounds.
- Noise-Induced Hearing Loss: History of exposure to loud noises, tinnitus, hearing loss.
- Meniere's Disease: Episodic vertigo, fluctuating hearing loss, tinnitus, and a feeling of fullness in the ear.
- Acoustic Neuroma: Unilateral hearing loss, tinnitus, imbalance, possibly facial numbness.
- Ototoxic Medications: History of using medications such as aminoglycosides, loop diuretics, or chaemotherapy agents, with bilateral hearing loss.
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- Audiometry: Pure tone and speech audiometry to assess the degree and type of hearing loss.
- Otoacoustic Emissions (OAE): To assess cochlear (outer hair cell) function.
- Auditory Brainstem Response (ABR): To assess neural pathways from the ear to the brainstem, especially for acoustic neuroma.
- MRI: To detect acoustic neuroma or other central causes of hearing loss.
- Vestibular Testing: For patients with suspected Meniere's disease or balance issues.
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- Hearing Aids: For most cases of sensorineural hearing loss, especially presbycusis.
- Cochlear Implants: For severe or profound sensorineural hearing loss that does not benefit from hearing aids.
- Treatment of Meniere's Disease: Low-sodium diet, diuretics, and intratympanic steroid injections. Surgical options include endolymphatic sac decompression or vestibular nerve section.
- Management of Acoustic Neuroma: Observation, stereotactic radiosurgery, or microsurgical removal depending on size and symptoms.
- Avoidance of Ototoxic Drugs: Discontinuation or substitution of the offending medication if possible.
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Mixed Hearing Loss |
- A combination of conductive and sensorineural hearing loss symptoms, depending on the underlying conditions contributing to both types of loss.
- Examples include chronic otitis media with sensorineural loss or a combination of otosclerosis and presbycusis.
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- Comprehensive Audiometry: To assess both conductive and sensorineural components.
- Imaging: CT or MRI if structural abnormalities are suspected, especially if surgical intervention is considered.
- Tympanometry: To assess middle ear function.
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- Medical and Surgical Treatment: Combination of treatments depending on the conductive and sensorineural components. For example, surgery for conductive issues like otosclerosis combined with hearing aids for sensorineural loss.
- Hearing Aids: May be beneficial for mixed hearing loss, particularly in mild to moderate cases.
- Cochlear Implants: In cases where severe sensorineural loss predominates and traditional hearing aids are ineffective.
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Central Hearing Loss |
- Difficulty understanding speech, especially in noisy environments, despite normal or near-normal hearing on audiometric tests.
- May be associated with neurological symptoms such as cognitive decline, stroke, or multiple sclerosis.
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- Auditory Processing Tests: To evaluate central auditory processing abilities.
- MRI: To assess for central nervous system lesions, such as stroke, tumours, or demyelination.
- Neuropsychological Testing: To evaluate cognitive function, especially if cognitive decline is suspected.
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- Rehabilitation: Auditory training and speech therapy to improve auditory processing skills.
- Management of Underlying Neurological Condition: Treating the primary condition such as stroke, multiple sclerosis, or dementia.
- Assistive Listening Devices: Such as FM systems to improve hearing in noisy environments.
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