上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件 hearing loss,prevention and management

Hearingloss,preventionandmanagementHearingloss,preventionandmOverview

27,800,000hearingdisabilityinChinaIncidenceofhearinglossincreasingDeaf-mutismOverview27,800,000hearingdiHowtohear?GyritemporalestransversiAcousticradiationMedialgeniculatebodyNucleuscochlearisposteriorNucleuscochlearisanteriorSpiralorganofcortiLaterallemniscusSuperiorolivarynucleusAuditoryossiclesExternalacousticmeatusVestibularfenestraHowtohear?GyritemporalestWhyishearingveryimportant?MeanstorecognizetheworldFoundationtodevelopspeechAffectionsharing,lifeenjoyingImportantmeansofcommunicationWhyishearingveryimportant?ClassificationofhearinglossBynatureConductiveSensorineuralMixedBybirthCongenitalAcquired

Byspeechabilitywhendeaf-Prelingual-postlingualClassificationofhearingloss

NormalHearing

NormalHearing

ConductiveHearingLoss

ConductiveHearingLoss

SensorineuralHearingLoss

SensorineuralHearingLoss

MixedHearingLoss

MixedHearingLossLevelofHearinglossLeveldBHLNormal≤25dBHLMild26～40dBHLModerate41～70dBHLSevere71～90dBHLProfound﹥90dBHLLevelofHearinglossLeveldBHCommencausesofhearinglossCauseConductiveSensorineuralCongenitalEardeformityAntepartum:

heritage,bastardmeaslesAcquiredExternalear:cerumenotitisexternaforeignbodyMiddleear:otitismediawitheffusionchronicotitismediaotospongiosistraumaticperforationofeardrumbrokenossicularchainperinatalperiod:hypoxia,jaundiceototoxicity:aminoglycosides,cytotoxicDegeneration:presbycusisTrauma:noise,headinjury,surgeryTumor:acousticneuromaIdiopathic:Menieredisease,suddendeafnessInflammation:meningitis,measles,parotitisCommencausesofhearinglossC

CongenitalhearinglossandhereditaryhearinglossCongenitalhearingloss:hearingdisturbancewhenbirthHereditaryhearingloss:derivefromgeneorchromosomalanomaly

CongenitalhearinglossandhCongenitalhearinglossAntenatalperiod,circumnatalperiodorperinatalperiodCausesGeneticfactor:geneofdeafness,50%±Factorsduringpregnancy:earlyviralinfection,drugintoxication,noiseFactorsduringcircumnatalperiod:jaundice,lowbirthweightinfant,neonatalasphyxia,birthtraumaCongenitalhearinglossAntenatGeneofdeafness50%ofcongenitalhearinglossCommongenesofdeafnessGJB2SLC26A4（PDS）-enlargedvestibularaqueductsyndromeMutationofmitochondrialgeneGeneofdeafnessUniversalnewbornhearingscreening(UNHS)Toidentifyhearingdisturbancewithin3monthsUniversalnewbornhearingscreSignificanceofUNHSEarlydiscoveryofdeafnessmakesthedeafundumbPossibilityofearlydiscoveryRegistrationandmanagementforhighriskfamily

:only50%canbeidentifiedRoutinemedicalexamination:hardlyidentifiedwithin1yearoldParents’awareness:hardlyidentifiedwithin1yearoldUNHS

:effectivemethodSignificanceofUNHSEarlydisc

耳聲發(fā)射法快速腦干誘發(fā)電位法MethodofotoacousticemissionMethodofquickbrainstemevokedpotential耳聲發(fā)射法StrategyofUNHSscreeningrescreeningBirthFollowupInterventionRigorousFollowupDiagnosistestpasspassnormalNopassNopassNopassEvaluationpredischarge42天內(nèi)3月內(nèi)6月內(nèi)StrategyofUNHSscreeningrescrClinicalcharacteristicsofPresbycusis

hearingofoldage,theeffectsofagingProgressivehearinglossBilateralsymmetricsensorineuralhearinglossNohistoryofnoisecontactSpeechdiscriminationscorebadthanpuretonetestClinicalcharacteristicsofPr上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件hearingloss,preventionandmanagement

Drug-inducedhearingloss,ototoxicityMechanismunclear,possibilyrelatedtodrugtype,dosage,route,geneticpredisposition,etc.

Drug-inducedhearingloss,ot

Ototoxicdrug(morethan90)AminoglycosideantibioticsAntitumordrug-cisplatin,carboplatinDiuretic-furosemide,ethacrynicacidSalicylate-aspirinantimalarialdrug-quininOtotoxicdrug(morethan90)Clinicalcharacteristicsof

ototoxicdeafnessBilateralhearinglossHearinglosshappensathighfrequencyReversibleorprogressiveWithtinitus,vertigoClinicalcharacteristicsof

oClinicalcharacteristicsof

noise-inducedhearinglossLongtermexposuretonoiseBilateralsymmetricEvidenthearinglossathighfrequency

:3-6kHzReversibleifseparatedfromnoiseProundhearinglossrareClinicalcharacteristicsof

nClinicalcharacteristics

ofidiopathicsuddenhearinglossSensorineuralhearinglosswithin3daysorless,morethan30dBHLUsuallyunilateralWithtinitus,vertigoEtiology:possibleviralinfectionanddisorderofbloodsupplyintheinnerearClinicalcharacteristics

ofiClinicalcharacteristics

ofacousticneuroma

Unilateralprogressivehearingloss,tinnitusClinicalcharacteristics

ofa

SystematicorinfectiousdiseasesKidneydiseaseDiabetesMeningitisViralinfectionSystematicorinfectiousdiseDiagnosisofhearinglossDetailedhistoryAge,time,symptomHistoryofusingototoxicdrug,familyhistoryofdeafness,historyofnoiseexposureExamination

:auralandgeneralExaminationofauditoryfunctionDiagnosisofhearinglossDetaiExaminationofauditoryfunction

PuretonetestSpeechaudiometryTympanogramandacousticreflectionAuditorybrainstemresponseOtoacousticemissionExaminationofauditoryfuncti上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件hearingloss,preventionandmanagement上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件hearingloss,preventionandmanagementImagingevaluation

HighdefinitionCTTemporalanatomyOsseousabnormalityFractureInfectiousdiseasesMagneticresonanceimaging(MRI)CerebellopontineangleVIIIcranialnerveLabyrinthImagingevaluationHighdefini上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件hearingloss,preventionandmanagement上海交通大學(xué)耳鼻咽喉科學(xué)英文版課件hearingloss,preventionandmanagementProtectivemeasurefordeafnessPreventionofcongenitaldeafnessGeneticcounselingandprenataldiagnosisPregnantwomenareprohibitedtouseototoxicdrugsToavoidviralinfectionwhenpregnantPreventionofviralandbacterialinfectionMeaslesVaricellaParotitisEpidemicmeningitisRhinitisOtitismediaProtectivemeasurefordeafnesTokeepfavourablementalstatusandavoidover-tiredToavoidexposuretonoiseforlongtimeTolowerlevelofsoundsourceTodecreaseexposuretimeTouseearprotectorToprotectfromototoxicdeafnessTounderstandfamilyhistoryandsusceptivityTocontrolsuitabledosageandcourseoftreatmentProtectivemeasurefordeafnessTokeepfavourablementalstatManagementofhearinglossMedicine-corticosteroid,peripheralvasodilatorOtomicrosurgeryHearingaidCochlearimplantSpeechtrainingManagementofhearinglossMedi

Aimatsuddenorrecenthearingloss

CorticosteroidsPeripheralvasodilator

VitaminMedicaltherapy

AimatsuddenorrecentheariOtomicrosurgeryOtomi