Inner Ear Disorders

Cochlear or Sensory hearing loss Neural or retrocochlear hearing loss Sensorineural hearing loss - cochlea Neural or retrocochlear hearing loss Auditory nerve lesion Central hearing loss Lesion of the central auditory pathway

Symptoms of Inner Ear Disorder Hearing impairement Hearing loss or hypoacusis Distortion of hearing or dysacusis Tinnitus Vestibular symptoms Dysequilibrium Vertigo

Diagnostic Evaluation History Noise exposure, cranial trauma, family history, history of chronic otitis media, use of ototoxic medications Clinical Examination Inspection, otoscopy, Weber’s test, Rinne’s test, whispered speech test Audiometry Imaging Studies CT scan, MRI

Diagnostic Evaluation Audiometry Imaging Studies

Cochlear Hearing Loss with a Known Cause Hereditary Sensorineural Hearing Loss Noise-Induced Hearing Loss Traumatic Injury to the Inner Ear Labyrinthitis Ototoxicity Other Acquired Inner Ear Disorders Immunologic Causes, Decreased Blood Flow, Metabolic Disorders, Cochlear Otosclerosis

Hereditary Sensorineural Hearing Loss Syndromic Present at birth Autosomal recessive Non-syndromic Congenital form or Later-onset form Autosomal dominant Symmetrical Treatment Prevention of further acquired damage Rehabilitation with hearing aids and other assistive devices

Noise-Induced Hearing Loss Acute acoustic trauma Blast injury Acute noise-induced hearing loss Chronic noise-induced hearing loss

Noise-Induced Hearing Loss Acute acoustic trauma Sudden, intense sound event of short duration >140dB Gunshot, airbags, firecrackers, or aerial fireworks Blast injury Acute noise-induced hearing loss Chronic noise-induced hearing loss

Noise-Induced Hearing Loss Acute acoustic trauma Blast injury Pressure wave from an explosive blast that can rupture the tympanic membrane >140dB Acute noise-induced hearing loss Chronic noise-induced hearing loss

Noise-Induced Hearing Loss Acute acoustic trauma Blast injury Acute noise-induced hearing loss Chronic noise-induced hearing loss

Noise-Induced Hearing Loss Acute acoustic trauma Blast injury Acute noise-induced hearing loss Chronic noise-induced hearing loss

Noise-Induced Hearing Loss Symptoms Muffled sensation and tinnitus Irreversible, chronic noise-induced hearing loss = sensorineural hearing loss Loss of speech discrimination and tinnitus Prophylaxis Reduction of voice emissions Hearing protection and control of noise levels Regular screening

Traumatic Injury to the Inner Ear (Labyrinthine concussion and contusion; Labyrinthine trauma) Temporal bone fracture Barotrauma Symptoms Non-specific vertiginous complaints and hearing impairement that are usually obscured by symptoms of craniocerbral trauma or other injuries Treatment Protection from additional harmful influences

Labyrinthitis Tympanogenic Meningeal Hematogenous Symptoms Treatment Cochlear hearing loss Tinnitus Vestibular symptoms (vertigo, dysequilibrium, nystagmus) Treatment Decompression with myringotomy tube Mastoidectomy

Ototoxicity Symptoms Ototoxic substances Cochlear damage accompanied by tinnitus Symmetrical hearing loss Vestibular symptoms (oscillopsia, dysequilibrium) Ototoxic substances Drugs: Aminoglycosides, Cisplatin, Loop diuretics, Quinine, Salicylates Industrial toxins: Aminobenzenes, Lead, Mercury, Arsenic, Alcohol, Heroin, Tobacco, Cocaine

Ototoxicity Prophylaxis Patient’s cochlear function should first be tested if at all possible Special attention to dosage, renal function, adequate hydration