Hearing

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Questions and Answers

During a pediatric audiology consultation, 5 yo Jacob, who was diagnosed with a bilateral cleft palate at birth, is being assessed for hearing problems. His mother reports that he often asks for things to be repeated and speaks louder than usual. Given Jacob's medical history, what type of hearing loss is he most likely experiencing?

  • Sensorineural hearing loss
  • Conductive hearing loss (correct)
  • Central hearing loss
  • Mixed hearing loss

A 35 yo pt reports gradual hearing loss in one ear, along with episodes of vertigo, and difficulty understanding speech, particularly when multiple people are talking. Audiometric testing indicates asymmetric sensorineural hearing loss. The pt's medical history is unremarkable. Which condition should the clinician suspect, and what is the next step in management?

  • Otosclerosis; recommend stapedectomy for ossicular fixation
  • Noise induced hearing loss; suggest hearing protection devices
  • Acoustic neuroma; refer for MRI to assess the auditory nerve (correct)
  • Meniere's disease; recommend endolymphatic sac decompression

A 45 yo patient with profound sensorineural hearing loss in both ears is being considered for a cochlear implant. This patient has tried hearing aids with no sufficient benefit. Which of the following best describes why a cochlear implant might be more beneficial than hearing aids for this patient?

  • Cls are less invasive than hearing aids
  • Cls provide electrical stimulation directly to the auditory nerve (correct)
  • Cls amplify sound more than hearing aids
  • Cls cue sensorineural hearing loss

A 35-year-old musician has been experiencing a gradual decline in hearing sensitivity and difficulty detecting soft sounds. He reports frequent exposure to loud music during concerts. Tympanometry is performed, showing normal impedance in both ears. However, acoustic reflex testing reveals an elevated reflex threshold. What might this indicate about the musician's auditory system?

<p>Early noise-induced hearing loss with possible cochlear damage (D)</p> Signup and view all the answers

A 70-year-old patient complains of difficulty hearing conversations, especially in noisy environments. Audiometry shows a pronounced loss at high frequencies with relatively normal low-frequency hearing. What is the most likely diagnosis?

<p>Presbycusis resulting from age-related changes (C)</p> Signup and view all the answers

What type of hearing loss is most likely with chronic otitis media and fluid buildup in a child with cleft palate?

<p>Conductive hearing loss (A)</p> Signup and view all the answers

Which audiogram pattern indicates normal hearing?

<p>Both AC and BC thresholds are within the normal range (B)</p> Signup and view all the answers

Which audiogram pattern suggests conductive hearing loss?

<p>AC thresholds are elevated, but BC thresholds are normal (A)</p> Signup and view all the answers

Which audiogram pattern is consistent with sensorineural hearing loss?

<p>Both AC and BC thresholds are elevated equally (A)</p> Signup and view all the answers

Which audiogram pattern would show a mixed hearing loss?

<p>Both AC and BC thresholds are elevated but AC thresholds are worse than BC (A)</p> Signup and view all the answers

A 5-year-old child with a recent history of acute otitis media reports severe ear pain and has developed a fever and vertigo. Examination shows a buildup of fluid in the middle ear and signs of pressure on the tympanic membrane. What is the immediate concern if this condition worsens?

<p>Rupture of the tympanic membrane (D)</p> Signup and view all the answers

What type of hearing loss is characterized by a sloping high-frequency loss due to aging?

<p>Presbycusis (D)</p> Signup and view all the answers

Which hearing loss type often presents with low-frequency loss, vertigo, and tinnitus?

<p>Meniere's Disease (D)</p> Signup and view all the answers

Which condition is known for a distinct dip at 2000 Hz in bone conduction?

<p>Carhart's Notch (C)</p> Signup and view all the answers

NIHL often shows reduced sensitivity after prolonged noise exposure. At which frequency range does this occur?

<p>3000-6000 Hz (D)</p> Signup and view all the answers

Which hearing loss type commonly presents unilaterally with high-frequency loss and balance issues?

<p>Acoustic Neuroma (A)</p> Signup and view all the answers

Where is the damage in conductive hearing loss?

<p>Outer or middle ear (C)</p> Signup and view all the answers

What pattern is typically seen in sensorineural hearing loss?

<p>Equally abnormal air and bone conduction (A)</p> Signup and view all the answers

In presbycusis, hearing loss typically worsens in which frequencies?

<p>High frequencies (B)</p> Signup and view all the answers

An audiogram shows a characteristic notch at which frequency, commonly seen in cases of Carhart's Notch?

<p>2000 Hz (B)</p> Signup and view all the answers

Which hearing loss type involves both conductive and sensorineural components?

<p>Mixed Hearing Loss (C)</p> Signup and view all the answers

During a follow-up, a patient with a diagnosis of otosclerosis asks how Carhart's notch differs from hearing loss seen in noise-induced hearing loss (NIHL). What is an accurate explanation the SLP could provide?

<p>Carhart's notch at 2000 Hz; NIHL is usually at 4000 Hz (B)</p> Signup and view all the answers

A 9-year-old child with mild high-frequency hearing loss is struggling in class. The clinician plots the child's audiogram on the speech banana and notes difficulty perceiving /s/, /f/, and /th/. What is the most likely communication issue the child faces?

<p>Difficulty perceiving high-frequency consonants (C)</p> Signup and view all the answers

A 45-year-old patient undergoes speech audiometry testing. The clinician records a speech reception threshold (SRT) of 30 dB. The patient's pure-tone average (PTA) is found to be 45 dB. What does this difference between the SRT and PTA suggest?

<p>The SRT and PTA differ by more than 12 dB, concerns about reliability. (D)</p> Signup and view all the answers

What type of hearing loss is shown on this audiogram?

<p>Conductive (D)</p> Signup and view all the answers

The audiogram slopes from...

<p>Moderately severe to mild (B)</p> Signup and view all the answers

The speech reception threshold (SRT) is a basic component of an evaluation of hearing function. Which of the following statements about the SRT is most accurate?

<p>It is measured in decibels and corresponds to the intensity level at which spondaic words can be recognized approximately 50% of the time. (A)</p> Signup and view all the answers

Which of the following constitutes the major component of an audiologic rehabilitation program for infants with a moderate sensorineural hearing loss?

<p>Parent-mediated auditory stimulation (C)</p> Signup and view all the answers

Hearing loss in infants who are born with a cleft palate is usually related to which of the following?

<p>Eustachian tube dysfunction (A)</p> Signup and view all the answers

Which of the following is the most common form of acquired hearing disorder?

<p>Noise-induced hearing loss (C)</p> Signup and view all the answers

Cecilia is a 4-year-old with a history of cleft to the secondary palate. She has difficulty sleeping, irritability, ear pulling, and clumsiness. What should the SLP most closely consider as the cause?

<p>Otitis media with effusion (A)</p> Signup and view all the answers

Bob, a 76-year-old male, is being treated for a hearing disorder. Bob speaks soft, often much too quiet. He explains that it seems as though he is speaking loud. Bob may have THIS form of hearing loss.

<p>Conductive (B)</p> Signup and view all the answers

Flashcards

Conductive Hearing Loss

Hearing loss due to problems with the outer or middle ear.

Acoustic Neuroma

Refer for MRI to assess the auditory nerve.

Cochlear Implants

Electrical stimulation directly to the auditory nerve.

Elevated reflex threshold

Early noise-induced hearing loss with possible cochlear damage.

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Presbycusis

Hearing loss resulting from age-related changes, affecting ability to hear conversations in noisy environments.

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Conductive hearing loss

Hearing loss likely chronic otitis media and fluid buildup with cleft palate.

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Conductive Hearing Loss

AC thresholds are elevated, but BC thresholds are normal.

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Sensorineural Hearing Loss

Equally abnormal Air and Bone Conduction.

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Complication of Otitis Media

Rupture of the tympanic membrane

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Carhart's Notch

A distinct dip at 2000 Hz in bone conduction.

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Conductive hearing loss

Outer or middle ear damage.

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Presbycusis and Hearing Loss

High frequencies are worsened.

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Mixed Hearing Loss

Involves both conductive and sensorineural components.

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Reliability Concern

A speech reception threshold (SRT) and a pure-tone average (PTA) differ by more than 12 dB.

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Carhart's notch at 2000 Hz

Disorder which NIHL is usually at 4000 Hz.

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Mild High-Frequency Hearing Loss

Difficulty perceiving high-frequency consonants.

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Hearing loss in infants

The infant is inability to create positive pressure in the oral cavity

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Speech reception threshold

A.It is measured in decibels and corresponds to the intensity level at which spondaic words can be recognized approximately 50% of the time.

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Eustachian tube

Malformation of the middle-ear ossicles associated with malformation of the palate

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Most Common Acquired Hearing

Noise induced hearing loss

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Study Notes

  • A 5-year-old named Jacob, diagnosed with a bilateral cleft palate at birth, is being assessed for hearing problems and likely experiencing conductive hearing loss due to his history.
  • A 35-year-old experiencing gradual hearing loss in one ear, vertigo, and difficulty understanding speech amidst multiple speakers, with audiometric testing showing asymmetric sensorineural hearing loss, should be referred for an MRI to assess the auditory nerve for acoustic neuroma.
  • For a 45-year-old with profound sensorineural hearing loss in both ears who hasn't benefited from hearing aids, cochlear implants provide electrical stimulation directly to the auditory nerve, making them more beneficial.
  • A 35-year-old musician experiencing gradual hearing loss and difficulty detecting soft sounds, with normal tympanometry but an elevated acoustic reflex threshold, likely has early noise-induced hearing loss with possible cochlear damage.
  • A 70-year-old patient who complains of difficulty hearing conversations, especially in noisy environments and audiology shows a pronounced loss at high frequencies with relatively normal low-frequency hearing is likely experiencing presbycusis as a direct result of age-related changes.
  • Chronic otitis media and fluid buildup in a child with a cleft palate is expected to cause conductive hearing loss.
  • Normal hearing is indicated when both air conduction (AC) and bone conduction (BC) thresholds are within the normal range.
  • Conductive hearing loss is suggested when air conduction thresholds are elevated, but BC thresholds are normal.
  • Sensorineural hearing loss is consistent with both air and bone conduction thresholds being elevated equally.
  • Both air and bone conduction thresholds are elevated, but AC thresholds are worse than BC in mixed hearing loss audiogram patterns.
  • In a 5-year-old with a recent history of acute otitis media reporting severe ear pain, fever, and vertigo, and examination showing fluid buildup in the middle ear and pressure signs on the tympanic membrane, the immediate concern if this condition worsens is the rupture of the tympanic membrane.
  • Presbycusis is characterized by a sloping high-frequency hearing loss due to aging.
  • Meniere's Disease presents with low-frequency loss, vertigo, and tinnitus.
  • Carhart's Notch is known for a distinct dip at 2000 Hz in bone conduction.
  • Noise-induced hearing loss (NIHL) shows reduced sensitivity at 3000-6000 Hz following prolonged noise exposure.
  • Acoustic neuroma commonly presents unilaterally with high-frequency loss and balance issues.
  • Damage in conductive hearing loss is located in the outer or middle ear.
  • Sensorineural hearing loss typically shows equally abnormal air and bone conduction.
  • In presbycusis, hearing loss typically worsens in high frequencies.
  • An audiogram showing a characteristic notch at 2000 Hz is commonly seen in cases of Carhart's Notch.
  • Mixed hearing loss involves both conductive and sensorineural components.
  • Carhart's notch is usually at 2000 Hz, while noise-induced hearing loss (NIHL) is usually at 4000 Hz.
  • A 9-year-old child with mild high-frequency hearing loss struggling in class and difficulty perceiving sounds like /s/, /f/, and /th/ most likely has difficulty perceiving high-frequency consonants.
  • If the speech reception threshold (SRT) and pure-tone average (PTA) differ by more than 12 dB, there are concerns about reliability.
  • Conductive hearing loss is indicated in the provided audiogram.
  • The audiogram slopes from moderately severe to mild.
  • Speech reception threshold (SRT) is measured in decibels and corresponds to the intensity level at which spondaic words can be recognized approximately 50% of the time.
  • Parent-mediated auditory stimulation constitutes the major component of an audiologic rehabilitation program for infants with a moderate sensorineural hearing loss.
  • Hearing loss in infants born with a cleft palate is usually related to Eustachian tube dysfunction.
  • Noise-induced hearing loss is the most common form of acquired hearing disorder.
  • Cecilia, a 4-year-old with a history of cleft to the secondary palate, experiencing difficulty sleeping, irritability, ear pulling, and clumsiness, most likely has otitis media with effusion.
  • Bob, a 76-year-old who speaks softly and explains that it only sounds loud to him, may have conductive hearing loss.

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