Treatments for Sensorineural deafness
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Hearing Loss:
Treatment
(In a Page: Signs and Symptoms)
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In many cases, the physical exam is therapeutic, because it involves cleaning the ear canal
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For middle ear effusions, a course of antibiotics and observation is usually sufficient; if symptoms persist, myringotomy and tube placement may be indicated
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Hearing aids are helpful for most cases of conductive or sensorineural hearing loss
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Middle ear implantable devices for moderate to severe sensorineural hearing loss
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Cochlear implants may be indicated for severe to profound sensorineural hearing loss if hearing aids are of minimal or no benefit
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Reconstructive middle ear surgery may be necessary, and includes tympanoplasty and stapedectomy
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Prevention of additional hearing loss by ear protection
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hearing Loss – Acquired:
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Cerumen removal
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Tympanostomy tube placement for chronic MEE lasting >3 months if bilateral, >6 months if unilateral
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Tympanoplasty for TM perforation
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Tympanomastoidectomy for cholesteatoma
–Effort to keep external auditory canal wall intact, with second look procedure planned for 6 months later
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Ossicular chain reconstruction (OCR, ossiculoplasty) with prosthesis or incus graft for ossicular anomalies
–Including after cholesteatoma resection
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Exploratory tympanotomy for suspected PLF
–If present, seal off oval and round windows
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Resection of CPA tumor
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Steroids for autoimmune SNHL (systemic or intratympanic)
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Cochlear implants for profound pre- or postlingual deafness
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Habilitation of any post-treatment hearing loss
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hearing Loss – Congenital:
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Identify children with hearing loss early
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Treat medically treatable cause, if any
–Syphilis (steroids and penicillin), Lyme disease, toxoplasmosis, hypercholesterolemia
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Intravenous gancyclovir for congenital CMV
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Habilitate by age 6 months if possible
–Amplification
–Bone-anchored hearing aids
–Tympanostomy tube placement
–Middle ear reconstruction
–Perilymphatic fistula closure
–Cochlear implant (after age 12 months)
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Periodic follow-up necessary
–Ensure auditory habilitation is working
–Check for hearing loss progression
>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hearing loss:
Treatment
(Professional Guide to Diseases (Eighth Edition))
After the underlying cause is identified, therapy for congenital hearing loss refractory to surgery consists of developing the patient’s ability to communicate through sign language, speech reading, or other effective means. Measures to prevent congenital hearing loss include aggressively immunizing children against rubella to reduce the risk of maternal exposure during pregnancy; educating pregnant women about the dangers of exposure to drugs, chemicals, or infection; and careful monitoring during labor and delivery to prevent fetal anoxia.
Treatment for sudden deafness requires prompt identification of the underlying cause. Prevention necessitates educating patients and health care professionals about the many causes of sudden deafness and the ways to recognize and treat them.
Hyperbilirubinemia can be controlled by phototherapy and exchange transfusions. Children need the appropriate immunizations. Medications that may be ototoxic should be used judiciously in children and monitored closely. Reduction of exposure to loud noises generally prevents high-frequency hearing loss.
In people with noise-induced hearing loss, overnight rest usually restores normal hearing in those who have been exposed to noise levels greater than 90 dB for several hours; but not in those who have been exposed to such noise repeatedly. As hearing deteriorates, treatment must include speech and hearing rehabilitation, because hearing aids are seldom helpful. Prevention of noise-induced hearing loss requires public recognition of the dangers of noise exposure and insistence on the use, as mandated by law, of protective devices such as earplugs during occupational exposure to noise.
Amplifying sound, as with a hearing aid, helps some patients with presbycusis, but many patients have an intolerance to loud noise and wouldn’t be helped by a hearing aid.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hearing loss:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Instruct the patient to avoid exposure to loud noise and to use ear protection to arrest hearing loss. If the patient has an upper respiratory tract infection, tell him to avoid flying and driving.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Hearing loss:
Treatment
(Handbook of Diseases)
Measures for treating each type of hearing loss vary.
Congenital hearing loss
After identifying the underlying cause, therapy for congenital hearing loss refractory to surgery consists of developing the patient’s ability to communicate through sign language, speech reading, or other effective means.
Measures to prevent congenital hearing loss include aggressively immunizing children against rubella to reduce the risk of maternal exposure during pregnancy; educating pregnant women about the dangers of exposure to drugs, chemicals, or infection; and careful monitoring of the fetus during labor and delivery to prevent fetal anoxia.
Sudden hearing loss
Treatment of sudden hearing loss requires prompt identification of the underlying cause. Prevention requires educating patients and health care professionals about the many causes of sudden hearing loss and the ways to recognize and treat them.
Noise-induced hearing loss
Overnight rest usually restores normal hearing in those who have been exposed to noise levels greater than 90 dB for several hours but not in those who have been exposed to such noise repeatedly. As hearing deteriorates, treatment must include speech and hearing rehabilitation because hearing aids are seldom helpful.
Prevention of noise-induced hearing loss requires public recognition of the dangers of noise exposure and insistence on the use, as mandated by law, of protective devices, such as earplugs, during occupational exposure to noise.
Presbycusis
Patients with presbycusis usually require a hearing aid.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hearing loss:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to avoid exposure to loud noise and to use ear protection to arrest loss. If the patient has an upper respiratory tract infection, tell him to avoid flying and driving. Explain the importance of completing the full course of prescribed antibiotics.
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Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hearing loss:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ When talking with the patient, remember to face him and speak slowly.
▪ Don't shout, smoke, eat, or chew gum when talking.
▪ Prepare the patient for audiometry and auditory evoked-response testing.
▪ Provide an alternate means of communication, if necessary.
Patient teaching
▪ Explain interventions to the patient, such as a hearing aid or cochlear implant to improve his hearing.
▪ Discuss the importance of ear protection and avoidance of loud noise.
▪ Stress the importance of following instructions for taking prescribed antibiotics.
▪ Explain the underlying cause of the hearing loss and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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