Seminar DEAFNESS

Submitted to : Ms. Sucheta Yangad Professor (Medical-Surgical Nursing) Submitted by : Mr. Swapnil A Mahapure M.Sc. Nursing 1st year

Definition of deafness According to IDEA (INTERNATIONAL DEAF EDUCATION ASSOCIATION) Deafness is defined as a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification.

TYPES OF DEAFNESS 1. 2. 3. 4. 5. 6. 7. Sensorineural hearing Loss Conductive hearing loss Mixed hearing loss Pre-lingual hearing loss Post-lingual hearing loss Unilateral hearing loss Bilateral hearing loss

Quantification of hearing loss

Mild: for adults: between 26 and 40 dB HL for children: between 20 and 40 dB HL Moderate: between 41 and 55 dB HL Moderately severe: between 56 and 70 dB HL Severe: between 71 and 90 dB HL Profound: 91 dB HL or greater

CAUSES 1. Age 2. Long-term exposure to environmental noise 3. 4. 5. 6. 7. 8. 9. 10. 11. Noise induced hearing loss Genetic Disease Neurological disorder Medication Exposure to Ototoxic chemicals Trauma Otosclerosis Tumors

Diagnostic evaluation History collection Physical examination Whispered speech test: Whisper a combination of numbers and letters behind the patient and check if he can hear anything by asking the patient to repeat the combination. if unilateral deafness is suspected the good ear should be masked and the deaf ear tested RINNES TEST Air Conduction > Bone Conduction = normal or SNHL Bone Conduction > Air Conduction = Conductive HL or dead ear

WEBERS TEST In conductive deafness the sound is heard loudest in the affected ear. In sensorineural deafness the sound is heard louder in the un affected ear.

AUDIOMETRY Pure tone audiometry (PTA). It is the key hearing test used to identify hearing threshold levels of an individual . the lower the threshold the better hearing. AC threshold are obtained with headphones and measure outer , middle, inner ear and the auditory nerve function. BC threshold are obtained with bone conduction oscillators which effectively bypass outer and middle ear function CONDUCTIVE HEARING LOSS bone conduction threshold in normal rang . air conduction threshold outside of normal limits. gap between AC and BC threshold > 10 db ( air bone gab ).

SENSORINEURAL HEARING LOSS both air and bone conduction threshold below normal . gap between AC and BC less 10 db ( no air bone gap).

Tympanometry May be indicated if a problem with the tympanic membrane (eardrum) is suspected. This test evaluates the middle ears ability to receive sound waves

SURGICAL MANAGEMENT 1. TYMPANOPLASTY

Surgical repair of the tympanic membrane.

2. OSSICULOPLASTY.
Surgical reconstruction of the middle ear bones to restore hearing. Prostheses made of materials such as Teflon, stainless steel, and hydroxyapatite is used to reconnect the ossicles, thereby reestablishing the sound conduction mechanism. However, the greater the damage, the lower the success rate for restoring normal hearing

3. MASTOIDECTOMY.
A mastoidectomy is usually performed through a postauricular incision. Infection is eliminated by removing the mastoid air cells.

4. STAPEDECTOMY
A stapedectomy, performed through the canal, involves removing the stapes superstructure and part of the footplate and inserting a tissue graft and a suitable prosthesis.