Deafness

Deafness

1. Deafness

2. Hearing Loss Part of ear not working Includes: outer ear middle ear inner ear hearing acoustic nerve auditory system

3. Types Conductive deafness: due to defect in the conducting mechanism of the ear namely external and middle ear. Sensori -neural deafness / Perceptive deafness: due to lesions in the labyrinth, 8 th nerve & central connections. It includes psychogenic deafness. Mixed deafness: both the above mentioned types are present.

4. External ear: Wax, Fungus, Otitis Externa , Foreign Bodies, Polyps, Myringitis , Stenosis , Atresia , Tumours . Causes of Conductive deafness

5. Middle Ear Congenital defects of the ear drum and ossicles . Traumatic: Barotrauma , rupture of ear drum, # of the base of the skull Inflammation: AOM, COM, Serous OM, Adhesive OM. Tuberculosis and syphilitic OM Neoplasms Otosclerosis Causes of Conductive deafness

6. Eustachian tube Eustachian catarrh Eustachian tube dysfunction due to diseases of the nose, paranasal sinuses & pharynx Barotrauma Catarrh = excessive discharge from nose / throat / ear Causes of Conductive deafness

7. Local causes (inner ear) Congenital Trauma: Head injury, surgical injury to labyrinth, loud sounds (acute or chronic acoustic trauma) producing concussion. Infections: mumps, syphilis, tuberculous meningitis, enteric fever, labyrinthitis . Tumours: Acoustic neuroma ( Schwanoma of C8 nerve) Meniere’s disease Ototoxic drugs: streptomycin, Kanamycin , neomycin, salicylates , frusemide and quinine. Causes of Sensori -neural deafness

8. General causes Presbyacusis CVS: atherosclerosis, HTN CNS: disseminated sclerosis DM Avitaminosis Hypothyroidism Smoking Alcoholism Presbyacusis : is a progressive bilateral symmetrical age-related sensorineural hearing loss. It is also known as age-related hearing loss Causes of Sensori -neural deafness

9. Causes of Sensori -neural deafness Psychogenic deafness: Functional: due to emotional cause, but the patient is not aware of the cause. 2 types Malingering: no organic or psychological cause. The patient is aware that he is pretending to be deaf for personal gains.

10. Trauma: Blast injury, acoustic trauma, head injury. CSOM with labyrinthitis . Otosclerosis Senile deafness superimposed on conductive deafness. Causes of Mixed deafness

11. Decibels Decibel Level Examples include: Rock concerts, firecrackers (140 decibels) Loud bass in cars, snowmobiles (120 decibels) Chainsaw (110 decibels) Wood shop (100 decibels) Lawn mowers, motorcycles (90 decibels) City traffic noise (80 decibels) Normal conversation (60 decibels) Refrigerator humming (40 decibels) To reduce potential hearing loss, avoid prolonged exposure to sound above 90 decibels.

12. Quantification of Hearing Loss Unable to hear sound at “Mild” Hearing Loss 26 – 40 dB “Moderate” Hearing Loss 41-55 dB “Severe” Hearing Loss 56- 70 dB “Profound” Hearing Loss 91 dB & greater

13. Treatment Conductive deafness: Hearing aid Sensori -neural deafness: For sudden deafness: Steroids Vasodilators Vit . B 1 , B 6 & B 12 Vit . A, C & E Carbogen ( 5% CO 2 with 95% O 2 ) [to imrove blood circulation in the cochlea]

14. For chronic deafness Hearing aids Cochlear implants Conversation should be slow, clear & not too clear Auditory training & lip reading.

15. Treatment Removal of ear wax Hearing aids Amplify sound Cochlear Implant

16. Cochlear Implant Small electronic device Simulates auditory nerve Provides “sense” of sound Used by Profoundly deaf Children age 2-6 Aided by speech therapy

17. Preventions Immunizations for childhood diseases Avoid high decibels Have hearing tested Use hearing protectors Earmuffs Earplugs

18. Aural rehabilitation Hearing aid orientation Sign Language Lip reading

19. Sign Language Visually transmitted sign pattern Hand shapes Orientation Movement of hands, arms, body Facial expressions

20. Surgical management Surgery is indicated for conductive or mixed hearing loss. To restore conductive hearing Myringotomy Stapedectomy Assisted hearing in profound deafness Cochlear implants Temporal bone stimulators (Bone hearing devices) Middle ear implants (Semi-implantable hearing device) Tumour excision for acoustic neuroma

21. Role of nurse in communicating with the hearing impaired and muteness Speak clearly and naturally. Move closer to the listener. Face the listener while speaking. Restate your message, if needed. Do not cover your mouth. Be patient. Encourage to use hearing aid Encourage client to read lips, if that helps

22. Lower pitch of voice Direct speech to stronger ear but do not shout Use gestures when possible to clarify statements Write when necessary Learn basic signing, if appropriate

23. Thank you for “LISTENING”