Drugs particularly notorious for ototoxicity include the aminoglycoside antibiotics (streptomycin, kanamycin, neomycin, gentamicin, and viomycin), salicylates, the diuretics ethacrynic acid and furosemide, and quinine or chloroquine. Although both the vestibular and auditory portions of the inner ear can be affected, streptomycin, gentamicin, and viomycin are especially toxic to the vestibular system, while neomycin, kanamycin, and [...]
Tumors that affect hearing include paraganglioma and vestibular schwannoma. PARAGANGL?OMA Tumors of the middle ear and mastoid are rare. Of these, the most common tumors are paragangliomas, derived from paraganglion tissue (eg, the carotid body). Otherwise known as glomus tumors, these benign lesions generally cause a conductive hearing loss and pulsatile tinnitus. Tumors originating in [...]
Tumors of the middle ear and mastoid are rare. Of these, the most common tumors are paragangliomas, derived from paraganglion tissue (eg, the carotid body). Otherwise known as glomus tumors, these benign lesions generally cause a conductive hearing loss and pulsatile tinnitus. Tumors originating in the middle ear (glomus tympanicum) are clinically evident even when [...]
A benign tumor that develops from the Schwann cells forming the sheaths of the vestibular nerves. Vestibular schwannomas most commonly arise in or immediately medial to the internal auditory canal; with growth, they present as a cerebellopontine angle mass. Patients usually complain of a unilateral hearing loss accompanied by tinnitus and, occasionally, disequilibrium. Large tumors [...]
A patient’s ability to hear should be roughly estimated in a general office setting. In the Weber test, a vibrating 512-Hz tuning fork is placed on the midline of the forehead. Patients with normal hearing perceive the vibratory sound as equally loud in each ear. Patients with conductive hearing loss perceive the vibratory sound as [...]
Screening for hearing loss is strongly recommended for all elderly persons. Older persons often hide their hearing loss, embarrassed by it and equating it with aging. Those who are not employed and who have few social interactions may remain unaware of mild hearing loss, which places them at risk of injury and further social isolation. [...]
Amplification is the best rehabilitative strategy if the hearing loss cannot be treated medically or surgically. A sensorineural hearing loss does not preclude benefit from a hearing aid. Likewise, audiometric configuration (pattern of loss across frequencies), decreased speech discrimination, and the presence of recruitment (an abnormally rapid rise in perceived loudness with increased signal level) [...]
Certain guidelines help when communicating with any hearing-impaired person. Communication is most effective when competing environmental sound is absent or minimal. The speaker must first ensure that his face is well illuminated and that the listener is attentive. Optimally, the speaker should be about 3 ft from the listener’s better or aided ear, lips and [...]
These devices help hearing-impaired persons overcome problems using the telephone, television, or radio and communicating in small or large groups. Portable and nonportable amplifiers boost telephone speaker output, and special devices signal an incoming call with either a louder ring or a flashing light. Other devices can sufficiently amplify television and radio signals for the [...]
Amplification with hearing aids can help persons with conductive or sensorineural hearing losses. Although hearing aids vary in size and power, they share certain features. A microphone receives the sound, transforms it into electrical energy, and sends this signal to an amplifier that increases its energy. How much the incoming signal is amplified, as manifested [...]
