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Transcript 
sensorineural
hearing loss
AHMED ALARFAJ
EVALUATION FOR
HEARING LOSS
HISTORY
•
•
•
•
Character of Hearing Loss:
Prenatal and perinatal history:
Contributing Factors:
Associated Symptoms:
PHYSICAL EXAMINATION
• Otoscopy/Microscopy/
Pneumatoscopy:
• Inspection and Palpation:
• Other Physical Exam:
HEARING TEST
• Objective Measures:
• Behaviour Observation
Audiometry:
• By 3 years old may consider
conventional testing
ANCILLARY TEST
(may be consider for select cases)
•
•
•
•
CT of Temporal Bones:
Complete Blood Count:
Treponemal Studies:
Perchlorate Test and Thyroid
Function Tests:
• Lipid Profile:
ANCILLARY TEST
(may be consider for select cases)
• Immune Function Tests:
• Electrocardiogram:
• Urine Analysis Blood Urea Nitrogen,
Serum Creatinine:
• TORCH Studies:
GENERAL MANAGEMENT
CONCEPTS
• If suspects syndromic hearing loss
consider genetic evaluation
(chromosomal analysis) and
counseling
• Hearing amplification devices should
be offered early to prevent speech
and developmental delays.
COMMON INNER EAR
DYSMORPHOLOGIES
•
•
•
•
Michel’s Aplasia
Mondini Aplasia
Scheibe Aplasia
Alexander Aplasia
Common Differential Diagnosis of
Hearing Loss: KITTENS Method
Congenital
Infectious &
Peripheral
Hereditary
Progressive
SNHL
Labyrinthitis
Congenital
Auricular
malformations
Luetic hearing loss
Presbycusis
Congenital
Hearing loss
Toxins &
Trauma
Ototoxic
medication
Otitis Media
Noise induced
hearing loss
Head trauma
Lead & mercury
toxicity
Barotrauma
Common Differential Diagnosis of
Hearing Loss: KITTENS Method
Tumor
(Neoplasms) Endocrine Neurologic
Systemic/
Psychological
Temporal Hypothyroiditis Multiple Sclerosis Meniere’s Disease
Bone
Neoplasms
Hyperlipidemia Meningitis
Paget’s Disease
Cholesteatomas
Stroke
Otosclerosis
Central auditory Presbycusis
processing
disorder
Cerumen
impaction
Pseudohypacusis
Autoimmune
disorders
PRESBYCUSIS
• Presbycusis:
progressive
deterioration of hearing associated
with aging
• Most common cause:
• Pathophysiology:
• Sign & Symptoms:
• Diagnosis:
• Treatment:
NOISE-INDUCED HEARING
LOSS
•
•
•
•
•
•
Temporary Threshold Shift (TTS)
Permanent Threshold Shift (PTS)
Pathophysiology
Sign & Symptoms
Diagnosis
Treatment
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