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Change in hearing

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Definition

A change in hearing, admittedly usually hearing loss.

Epidemiology

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Pathophysiology

Differential Diagnosis

Basically, it's either:

  • Conductive deafness is where there is an abnormality between the sound getting to the outer ear and the nerves to the brain.
  • Sensorineural deafness is where there is a problem with the nerves from the cochlea to the brain.

Conductive

Sensorineural

An endolymph. Probably. Not. Well, actually it's South Park's represntation of God.

Clinical and Associated Features

The first thing to do is differentiate between the two types of hearing loss. The key to this is Weber's test and Rinne's test.

Test Conductive Sensorineural
Weber Loudest in affected ear. Blockage masks ambient sounds Loudest in unaffected ear. Conduction is fine therefore the affected ear is just not working as well
Rinne Bone conduction > Air conduction. The air canal is screwed so sound conducts better down the bone on the affected ear. Air conduction > bone conduction. No problems with conducting sound and bone isn't as good as the air

Investigations

Management