conductive hearing loss
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Etiology
- acute otitis media: most common cause of acquired hearing loss, especially in children
- impacted cerumen (most common in nursing home residents)
- foreign body
- chronic (serous) otitis media:
- otitis externa
- perforation of tympanic membrane (TM)
- TM needed for sound transduction to mechanical impulses
- otosclerosis
- fixation of stapes over oval window
- prevents propagation of mechanical impulse to inner ear
- present in 10% of autopsies
- conductive hearing loss (low-frequency range)[6]
- exostoses
- bony outgrowths in the external auditory canal
- repetitive exposure to cold water
- developmental defects
- canal atresia - Treacher Collins syndrome
- malformation of the ossicles
- tumors - middle ear mass effect
- Paget's disease
- Eustachian tube obstruction[6]
- age-related thickening of the tympanic membrane with loss of elasticity & efficiency of ossicle articulation[6]
- osteoarthrits is a risk factor in older adults[6]
Pathology
- decreased hearing acuity resulting from a mechanical defect in transmission of sound between the eardrum & oval window (tissue dividing the middle & inner ears).
- thickening of tympanic membrane
- described as decreased efficiency of ossicular articulations[6]
- exacerbation by otosclerosis
- bone conduction > air conduction
- these deficits are generally reversible
Clinical manifestations
- predominantly affects low frequency sounds
Diagnostic procedures
Differential diagnosis
- hearing loss accompanied by ear pain & drainage is more likely to be conductive hearing loss
- hearing loss associated with dizziness &/or vertigo or tinnitus is more likely to be sensorineural hearing loss[5]
Management
- treatment of underlying disorder (deficits generally reversible)
- referral to otolaryngologist for evaluation[6]
- amplification
- bone-anchored hearing aid may be appropriate[6]
- referral to otolaryngologist for evaluation 1st[6]
- bone-anchored hearing aid may be appropriate[6]
More general terms
Additional terms
- exostosis; hyperostosis; osteoma; osteoncus
- otitis media
- otosclerosis
- Paget's disease of the bone; osteitis deformans
References
- ↑ Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998
- ↑ Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 42-44
- ↑ Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 392, 407
- ↑ Mangione C. In: UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 5.0 5.1 Medical Knowledge Self Assessment Program (MKSAP) 15, 18 American College of Physicians, Philadelphia 2009, 2018
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ McColgan P, Tabrizi SJ. Huntington's disease: a clinical review. Eur J Neurol. 2018 Jan;25(1):24-34. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28817209 Review.