Deafness

Deafness

A partial or complete inability to hear is referred to as deafness or hearing impairment.

Types of deafness

• Conductive deafness
  • Any interruption to the passage of sound from the external ear to the middle ear is conductive deafness
  • If something is blocking the ear canal, like ear wax, there is a conductive hearing loss
  • Generally, a conductive hearing loss doesn’t cause a total inability to hear, but it does cause a loss of loudness and a loss of clarity. In other words, sounds are heard, but they are weak, muffled, and distorted.
  • Causes
    • External ear- wax, foreign body
    • Middle ear- traumatic rupture of the tympanic membrane
    • Abnormal growth- malignant
    • Inflammation- acute otitis media, CSOM
    • Eustachian tube block and dysfunction due to disease of the nose, sinuses, and pharynx
  • Sensory- neural deafness
    • Sensory neural deafness is a hearing loss that occurs from damage to the inner ear, the nerve that runs from the ear to the brain (auditory nerve), or the brain.
    • Can be present st birth (congenital) most often due to Genetic syndromes and infections that the mother passes to her baby in the womb
    • May develop in children or adults later in life (acquired) as a result of:
    • Age-related hearing loss (presbycusis)
    • Disease of the blood vessels
    • Immune disease
    • Infections, such as meningitis, mumps, scarlet fever and measles
    • Injury
    • Loud noises or sounds, or loud sounds that last for a long time
• Mixed deafness:
  • In this both conductive and sensory- neural deafness is present.
  • Causes
    • Trauma: blast injury, head injury, acoustic trauma
    • CSOM with labyrinthitis
    • Otosclerosis

Causes of deafness

• Age- presbycusis, the progressive loss of ability to hear high frequency with increasing age, begins in early adulthood but doesn’t usually interfere with the ability to understand conversation until much later.
• Long-term exposure to environment noise
• Hereditary
• Injuries in ear
• Disease or illness
• Medication- some medication cause irreversible damage to the ear.

Sign and symptoms

• In children
  • Delayed in learning to talk, or they are not clear when they speak
  • Often asks you to repeat yourself
  • Often talks very loudly
  • Often turns up the volume of the tv so that it is very loud

• In adult
  • Muffing of speech and another sound
  • Difficulty understanding words, especially against background noise or in a crowd of people
  • Frequency asking others to speak more slowly, clearly and loudly
  • Withdrawal from conversation

Diagnostic tests

• History taking and physical examination
• Otoscopy
• Tuning fork test.

Management of deafness

Medical management

The goal of medical, management of the client with hearing impairment are

• To restore hearing loss
• To assist hearing
• To manage tinnitus and
• To implement aural rehabilitation

Mangement

Treatment for conductive hearing loss: Administer the proper antibiotics to treat CHL brought on by otitis media or its aftereffects. The evacuation of the middle ear fluid and myringotomy are beneficial for patients who have had serous otitis media for longer than three months. Amplification with a hearing aid might be required if the hearing loss worsens.

A foreign body or cerumen occlusion of the auditory canal should be removed in order to treat CHL. Speech therapy is rarely required unless the loss is severe and cannot be rectified with amplification.

There is no medicinal cure for SNHL. Amplification with hearing aids is utilized to provide the youngster with as much auditory input as feasible when they have mild to moderate hearing loss. Speech treatment might be advantageous. If the kid needs specialized instruction, the school should decide how much speech therapy is typically included in the school day.

There are 2 main goals of amplification

• The initial step is to offer language. The hearing aid is evaluated to determine how well it meets the goals for loudness at various frequencies after being properly fitted using molds.
• The provision of environmental stimuli is the second objective of amplification.

Surgical Management: Some cause of Conductive hearing loss may be managed or aided surgically.

• Placing Myringotomy tubes to ventilate the middle ear space can help children with persistent, recurrent, or chronic otitis media with effusions avoid negative pressure in this region.
• Surgery may enhance ossicular function if otitis causes the ossicles to be destroyed or fixed.
• Cochlear implantation is the only surgical option for the treatment of sensory neurological disorders.
• For some kids, cochlear implantation might be an option, but it's important to remember that it's not a cure.

Nursing management

• Children with persistent, recurrent, or chronic otitis media with effusions might minimize negative pressure in this area by placing Myringotomy tubes to ventilate the middle ear cavity.
• If otitis results in the destruction or repair of the ossicles, surgery may improve ossicular function.
• The sole surgical option for treating sensory neurological problems is cochlear implantation.
• Cochlear implantation may be a possibility for certain children, but it's crucial to understand that it is not a cure.

Reference

HealthLine. 2005. 2017 http://www.healthline.com/health/sensorineural-deafness

Lewis, Sharon Mantik, Medical  Surgical Nursing; assessment and management of clinical problem, 3rs edition

Luckmann, Joan Luckmann & Sorensen’s, Medical Surgical Nursing a Psychology Logic approach, 4th edition

Mandal, G.N. Textbook of Adult Nursing. Kathmandu: Makalu Publication House, 2013.

MedicineNet. 1996. 2017 http://www.medicinenet.com/deafness/article.htm

Medline Plus. 05 January 2017 https://medlineplus.gov/hearingdisordersanddeafness.html

NHS Choice. http://www.nhs.uk/conditions/Hearing-impairment/Pages/Introduction.aspx