1. Director of cochlear implant program at KFMC
Deafness
Dr. Abdulrahman Alsanosi Assistant professor King Saud University Otolaryngology consultant Otologist , Neurotologist &Skull Base Surgeon King Abdulaziz University Hospital
Director of cochlear implant program at KFMC

3. Definitions
Impairment of sound perception more than 20 (15) decibel on pure tone audiogram.

4. Hearing loss Types: Conductive hearing loss 1. Concha 2. Ear Canal
3. Drum
4. Ossicular Chain
5. Eustachian Tube

5. Conductive hearing loss
Exteranal canal pathology :
Artesia

6. Inflammatory
Acute otitis externa

7. External canal pathology
Wax

8. External canal pathology
Foreign body

9. External canal pathology
Tumors:
Osteoma
exostosis

10. Conductive hearing loss
Tympanic membrane:
Absent Perforated
Too thick tympansclerosis
Too thin SOM

11. Conductive hearing loss
Ossicular chains
Absent &erosion
Fixation (otosclerosis
Disrupted trauma

12. Conductive hearing loss
EustachianTube dysfunction:
Retraction
Effusion

13. Sensorineural hearing loss
Two types :
Sensory (the pathology is within hair cells in cochlea)
Neural (the pathology is with in the auditory nerve and it’s connection

14. Etiologies
Congenital :
Mondeni deformity

15. Sensorineural hearing loss
Acquired :
Inflammatory
-labyrinthitis ,meningitis

16. Noise exposure

17. Autoimmune
-Cogan syndrome
Ototoxic drugs
-Aminoglycosides groups ,diruiti,….

18. Trauma Temporal bone fracture 1.Longitudinal fracture
2.Transeverse fracture

19. Examination Complete head and neck exam
Otoscopic / microscopic ear exam of both ears

20. Clinical testing of hearing
Tuning forks
Audiogram battery:
Pure tone audiogram
Speech audiogram
Impedance
Acoustic reflex
Tympanogram
Volume
Acoustic reflex decay

27. pure tone audiogram Normal hearing

28. Conductive hearing loss

29. pure tone audiogram
Sensorineural hearing loss

30. Pure tone audiogram
Mixed hearing loss

31. Tympanogram

32. Degree of hearing impairment

33. Managemnt of deafness
Medical management
Hearing aids

34. Management of deafness
Surgery
A.Myringotomy and ventilation tube Otitis media with effusion

35. Management of deafness
Surgery
B. Myringplasty &tympanoplasty in case of CSOM

36. Management of deafness
C.Ossiculoplassty

37. Management of deafness
BAHA (Bone anchored hearing aid)
-Atersia of external canal
-Chronic drainage ear not responding to surgery

38. Management of SNHL Surgery : D. Cochlear implant
- prelingual children and postlingual adult
-it pass by the external ,middle and inner ear to stimulate auditory nerve directly

39. D. Cochlear implant

40. Thank you