H earing loss and deafness - PowerPoint Presentation

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earing loss and deafness

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Hearing loss, or hearing impairment happens when one or more parts of the ear or ears are not functioning  OrHearing loss, hearing impairment, or deafness, is a partial or total inability to hear

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Aging (presbycusis)N0ise exposureDiseaseInjury to the earChinldren – ear infections, congenital defectsAt age 50, one of every eight persons is hearing impaired.

Etiological factors

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Conductive hearing lossSensorineural hearing lossMixed hearing lossCentral and functional hearing lossNoise induced hearing loss

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ypes

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Conductive hearing loss results form interference with the conduction of sound impulses through the external auditory canal, tympanic membrane or the ossicles of the middle ear.It can caused by anything that blocks the external ear such as cerumen, infection or a foreign body.It may also be caused by thickening, retraction, scarring or perforation of the tympanic membrane or any pathophysiologic change in the middle ear (tumours, previous surgeries, otosclerosis)

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onductive hearing loss

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It results form disease or trauma to the inner ear, neural structures, or nerve pathways leading to the brain stemDiseases that effect may be systemic or local infections or may be drug induced.Systemic diseases – diabetes mellitus, arteriosclerosis and infectious disease such as measles, mumps and meningitis Local diseases - neuromas of the eighth cranial nerve, otospongiosis, trauma to the head or ear, degeneration of the organ of corti

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ensorineural hearing loss

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It is caused by a combination of conductive and sensorineural losses

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ixed hearing loss

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Central auditory dysfunction- it is a rare form of sensorineural hearing loss in which hearing ability remains intact but the patient is deaf because the central nervous system is unable to interpret normal auditory stimuli.Central deafness can results from tumors or strokeFunctional hearing loss – by an emotional or a psychologic factor. The patient does not seem to hear or respond to hearing tests, but no organic cause can be identified.

Central and functional hearing loss

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The decibel (dB)is a measure of the loudness or intensity of sound.A hearing loss of 15 to 50 dB is a mild to moderate loss (impaired hearing)A loss of 50 to 80 dB is severe hearing lossA loss of more than 80 dB in both ears is a profound hearing loss and referred as DEAF.

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lassification of hearing loss (based on severity)

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Hearing loss due to exposure to noise accounts hearing impairment among people between 35 to 65 years.If hearing loss results from a single exposure to a sudden loud noise or blast is referred as ACOUSTIC TRAUMA.Hearing loss occurs over time from repeated injury from noise is referred as NOISE – INDUCED HEARING LOSS.

Noise induced hearing loss

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OSHA (OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION) has establish acceptable noise levels in work environment.Ordinary speech is 60 dB and in heavy traffic it is 80 DbExposure to 85 to 90 dB for months can cause cochlear damage.Based on OSHA regulations, the work environment exceeding noise above designated limits should wear EAR PROCTECTION DEVICES.

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Hearing loss associated with aging that becomes more common after 50 Changes in the delicate labyrinth structures over decades cause hearing loss

PRESBYCUSIS

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Asking others to speak up

Straining to hearCupping hand around earAnswering questions inappropriatelyNot responding when not looking at the speakerShowing irritability with othersIncreasing sensitivity to slight increases in noise level.Family and friends who get tired of repeating or talking loudly are often first to notice hearing loss

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linical features

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Ringing noise Tinnitus accompanies most sensorineural hearing losses and is often a warning of impending or worseing hearing lossPersistent tinnitus is very annoying and the only cure is correct the underlying condition.

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innitus

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Deafness is often called the UNSEEN HANDICAP.Patient refuses to admit or unaware of impaired hearingWithdrawal, suspicion, loss of self esteem and insecurity are commonly associated with advancing hearing loss

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History collection from the family members or friendsPhysical examination All diagnostic measures for testing ear function should done to rule out the exact cause of the hearing loss and also to treat the underlying disordersCT scan, MRI, Blood test and cultures, audiometry, tympanometry, electronystagmograpy, arteriograpy.

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iagnostic features

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Health promotion Use of ear protectors while working in noisy conditions Treating the ear disorders as early as possibleAvoiding drinking and drivingAvoid alcoholism Organize health teaching programs in schools, communities and factories for preventing the hearing impairment

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anagement

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Various viruses can cause deafness as a result of fetal damage and malformations affecting the earMumps, measles and rubella immunization should be providedInfection during the first 8 week of pregnancy with rubella can leads to sensorineural deafness

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mmunizations

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Chemicals used in industry (toluene, carbon disulfide and mercury) may damage the inner earDrugs – antibiotics, salicylates, diuretics and antineoplastic drugsSymptoms of ototoxicity are tinnitus, impaired hearing and vestibular dysfunction If symptoms develop immediate withdrawal of the drug may prevent further damage.

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totoxic substances

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Hearing aids – can assist individuals with hearing impairments. Hearing aids should be fitted by an audiologist or a speech and hearing specialist after a through physical examination and hearing tests.Hearing aids amplify sound in a controlled manner.

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ssistive devices and techniques

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Hearing aids consist of

A microphone to receive sound waves from the air and change sounds into electrical signals

An amplifier to increase the strength of the electrical signals

A battery to provide the electrical energy to needed to operate the hearing aid

A receiver (loudspeaker) to change the electrical signals back into sound waves.

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Five basic types MICRO CIC (completely in the canal) hearing aidITC (in the canal ) hearing aidHS (half shell) hearing aidITE (in the ear) hearing aidBTE (behind the ear)hearing aid

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ypes of hearing aids

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IN THE EAR

HALF SHELL

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The nurse should explain the uses of it in detailThe patient must adjust the voices and household soundsExperiment by increasing and decreasing the volume If the patient is adjusted to the background noise, the patient is ready to go for a small party where several peoples talk simultaneouslyAfter adapting to controlled situations, the patient can encounter environments such as shopping mall etc

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djusting with the hearing aids

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When the hearing aid is not being worn, it should be keep in a dry, cool areaThe battery should be disconnected or removedBattery life is 1 -4 week (different based on the types)Wash the ear mold frequently with mild soap and water Toothpicks and pipe cleaners may be used to clear a clogged ear tip.Turn the hearing aid off when not in use Keep an extra battery Do not wear ear aid if an ear infection is present

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are of a hearing aid

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Check the on-off switchInspect the ear mold for cleanlinessExamine the battery for correct insertionChange the battery Check for any break in the aid

If the Hearing

aid fails to work -

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They are of two types Cochlear implants Bone conduction devices

Implantable hearing devices

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It is used as a hearing device for people with severe to profound deafness who get little or no benefit from a hearing aidThe implant is an electronic hearing device that stimulates nerves within the inner earThe system consists of a surgically implanted induction coil beneath the skin behind the ear and an electrode wire placed in the cochleaThe implanted parts interface with an externally worn speech processorThe device does not allow the person to hear speech but creates an awareness of environmental sounds such as doorbells or telephones etc.

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ochlear implant devices

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It transmit sound through the skull to the inner earSurgically implanted titanium screw implanted under the skin into the skull behind the earOnce it heals, it is loaded with a vibrating hearing aid.

Bone conduction devices

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If hearing loss is irreversible and not surgically correctable, AURAL REHABILITATION is recommendedIt includes auditory training, speech reading, speech training, sign language to maximize the communication of a hearing impaired person

AURAL REHABILITATION

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It is also called as lip reading – helps in increasing communication skills.The patient is able to use visual cues associated with the speech, such as gestures and facial expression to clarify the spoken messageIn speech reading several words will look like alike (for ex: Oman, women )The nurse should help the patient by using and teaching verbal and nonverbal communication techniques.

Speech reading

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Draw attention with hand movements Have speakers face in good lightAvoid covering mouth or face with handsAvoid chewing, eating, smoking while talkingMaintain eye contactAvoid distracting environmentsAvoid careless expression Use touchMove close to better ear

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onverbal aids

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Speak normally and slowly Do not over exaggerate facial expressionsUse simple sentences Write name or difficult wordsAvoid shouting

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erbal aids

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Sign language is used as a form of communication for deaf people

It is a visual – spatial language that involves gestures and facial features such as eyebrow motion and lip mouth movements.Sign languages is not universal.

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ign language

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Bluetooth® and Wireless Accessories

Allows users to connect hearing instruments directly to peripheral accessories such as:Cellular and home phoneTelevision and music playersSignaling devices like door bells and fire alarms With this technology, hearing instruments are becoming more like personal communication devices.

Updates in hearing aids