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1.3.2 Conduction vs. Sensoneural Deafnness Causes and Corrections • Conductive hearing problems are those that disrupt the conduction of sound through the outer and middle ear. Conductive Hearing Loss • Affects hearing before the sound reaches the cochlea and the nerve receptors of the inner ear. The Good News • Conduction deafness is often temporary or curable Causes of Conduction Deafness • Otitis Media • • Middle ear infection Chronic suppurative otitis media – 1.Peferation of the tympanic membrane 2. Bacterial infection l “Glue Ear” Collection of fluid in the middle ear - (otitis media with effusion) • Thick, sticky fluid collects behind the eardrum. • The fluid blocks the middle part of the ear and can cause impaired hearing. • It usually affects children. Interventions for “Glue Ear” • Antibiotics • Ear Tubes (grommet) Cerumen • Ear Wax Blockage of the outer ear, usually by wax. Otosclerosis • Ossicles of the middle ear harden and become less able to vibrate. Otosclerosis • Approximately one-third of all persons with impaired hearing have this condition. • Hereditary • Damage to the ossicles, e.g. by serious infection or head injury. • Perforated (pierced) eardrum, which can be caused by an untreated ear infection (chronic suppurative otitis media), head injury or a blow to the ear, or from poking something in your ear. Interventions • Hearing aids -usually effective for conductive hearing loss. http://www.nlm.nih.gov/medlineplus/ency/imagepages/8685.htm Interventions • Stapedectomy - top part of the stapes is removed. A laser beam is used to create a small hole in the footplate and a metal tube is inserted. A wire attached to the tube connects to the incus and transmits vibrations to the inner ear. Sensorineural deafness • Sensorineural deafness is decreased hearing or hearing loss that occurs from damage to the inner ear, the auditory nerve, or the brain. • Sensorineural hearing loss is most often due to a loss of hair cells (sensory receptors in the inner ear). • Sensorineural deafness can be present at birth (congenital), or it can develop later in life • (SNHL) accounts for about 90% of all hearing loss • Found in 23% of population older than 65 years of age Causes of Sensorineural Deafness • Presbycusis - hearing loss that gradually occurs in most individuals as they grow older Presbycusis • Aging • Loud noises (acoustic trauma)- http://www.healthpractical.com/tag/great-stressors Duration • The period of time the sound continues to exist. • “Exposure to sound levels of 85 decibels, the equivalent of a lawn mower or food blender, may cause permanent hearing loss if endured for 8 hours per day for a prolonged period” Healthy Cochlea The cilia ( sensory hairs) appear normal Damaged Cochlea Loss of cilia as a result of Noise Occupational Risk • Some jobs carry a high risk for hearing loss, such as: • Airline ground maintenance • Construction • Farming • Jobs involving loud music or machinery Interventions: • Hearing aid • Hearing aids will not restore normal hearing or eliminate background noise. • Amplfies sound • Adjusting to a hearing aid is a gradual process that involves learning to listen in a variety of environments and becoming accustomed to hearing different sounds. Prevention http://www.rainbowsafety.co.uk/warning-noise-levels--wear-ear-protection-sign-map-43-1438 Cochlear Implants • Auditory understanding of the environment and helps in understanding speech. • Does not reinstate or generate normal hearing. • Compensates for damaged or non-working parts of the inner ear. • Surgically implanted under the skin behind the ear, this device is made of four basic parts: • microphone picks up sound from the environment • speech processor translates the sounds picked up by the microphone into signals • transmitter and receiver/stimulator receive these signals and convert them into electric impulses • electrodes send these impulses to the brain. Cholesteatoma • Benign skin growth in the middle ear, causing deafness and vertigo Intervention • surgical removal of the cyst. Acoustic neuroma • A benign (non-cancerous) tumor affecting the auditory nerve http://med.mui.ac.ir/slide/clinical/ent/AcousticNeuroma.jpg Intervention • Radiosurgery The use of ionizing radiation, either from an external source such as an xray machine or from an implant, to destroy cancerous or other diseased tissue. http://www.health.wvu.edu/services/neurosurgery/gamma-knife/images/header.jpg Tinnitus • Ringing in the ears • Most tinnitus comes from damage to the microscopic endings of the hearing nerve in the inner ear.