Conductive hearing loss

Introduction Conductive deafness is also known as transsexual paralysis. The way in which external sound waves are transmitted to the inner ear is hampered by the pathological factors of the ear sound system. The ear sound transmission system has an external auditory canal, a tympanic membrane, a hearing bone, a snail window and the like. Therefore, damage to the above-mentioned parts for any reason can cause deafness. Such as external ear canal congenital atresia, paralysis, foreign body, inflammation and tumors; tympanic membrane diseases, such as tympanic membrane rupture, perforation; middle ear malformations, inflammation, trauma and tumors. However, it is more common in otitis media and obstructive lesions of the external auditory canal. Therefore, active prevention and treatment of otitis media is of great significance in preventing deafness. Treatment is mainly for the cause, such as the formation of external or middle ear malformation, the tympanoplasty caused by otitis media.

Cause

1. Congenital diseases: common abnormalities of external auditory canal atresia, tympanic membrane, auditory bone, snail window, vestibular window and tympanic cavity.

2. Acquired diseases: common such as external ear canal foreign body, sputum sputum, inflammatory swelling, tumor obstruction, scar atresia, tympanitis, tympanic membrane perforation. Acute and chronic exudative and suppurative otitis media and its complications and sequelae, ear sclerosis, middle ear tumors, etc.

an examination

Examine the external auditory canal and tympanic membrane; perform tuning fork examination and pure tone hearing threshold to find out the nature and extent of deafness. For children and non-cooperative adults, guest observations such as acoustic impedance measurement, auditory brainstem response audiometry and cochlear electrograms are also available.

There are many methods for hearing and vestibular function tests, and in recent years, research and clinical work in this area has made great progress. However, in general primary medical units, due to conditions, it is impossible to carry out advanced and complicated inspection equipment for difficult inspections. As patients and their families, they are even more powerless, so simple inspection methods should be adopted.

Hearing test: A sound test can be used on the watch. Before the medication, the test was used to test the hearing, and during the medication, the same watch was used to test the hearing. Pay attention to the position of the table, each time should be placed in the same orientation, and should not be attached to the ear skin or the upper end of the bone should make the watch a certain distance from the auricle. The sound that is heard in this way is the sound transmitted through the air. Otherwise, it is the sound transmitted through the bone, and the actual situation of hearing cannot be faithfully reflected. In the trial, if the hearing loss is found after administration, the possibility of cochlear system poisoning should be considered.

Vestibular function check: The head of the balance function is judged by the observation of the standing position and the gait posture. The position of standing still firstly uses two feet to stand together, and then the two feet stand in front and rear, and finally stand with one foot, the latter is the most difficult. If the balance function is normal, it can be maintained for more than 10 seconds by standing. If the balance is dysfunctional, the standing is difficult to maintain, and it will quickly fall to one side, swing side to side, or lean forward. For the observation of the gait posture, a walking test can be adopted, that is, the subject is closed and walked forward in a straight line. Normal people can do both feet on both sides of the straight line. If you walk abnormally, you will have obvious skewness. Walking is unstable, just like walking after drunkenness. Generally, walking ten steps is enough to tell whether the walking is stable or not. Before performing this test, it should be understood whether the examinee has physical defects, polio sequelae, hemiplegia, and poor mental development are not suitable for this test. When doing vestibular function examination, the inspected person should first stand and walk with a blink of an eye. If the standing posture and walking gait are stable, or it is difficult to distinguish whether it is stable or not, let the patient close his eyes to stand and walk to further understand. Balance the situation.

Differential diagnosis

Should pay attention to the identification of neurotic deafness:

Neurological deafness refers to a syndrome in which the auditory nerve of the inner ear and the auditory center of the brain occur, and causes hearing loss and even hearing loss, often accompanied by deafness. In the case of neurological deafness, it actually refers to "sensory neuropathic paralysis", including lesions of the cochlea, as well as lesions of the auditory nerve, and even some of the lesions of the central nervous system, and not simply the problem of the auditory nerve. Different types of neurological deafness showed slight differences. The main manifestations were gradual hearing loss to unilateral or bilateral ear to varying degrees of deafness, accompanied by tinnitus and nausea in the ear. About half of the patients were accompanied by dizziness and nausea. And vomiting symptoms.

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