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Mr. Andi, 50 y.o. Railway Guard SpecSens PBL Trigger 2 Jashan Kumar -…
Mr. Andi, 50 y.o. Railway Guard
SpecSens PBL Trigger 2
Jashan Kumar - 2406369186
PBL Group E
Standard Condition
Anatomy of the Ear
Outer ear
Funnels
sound
Pinna
External
auditory
canal
Tympanic
membrane
Barrier
Vibrates
Ossicles
Incus
Impedance
match
Stapes
Malleus
Cochlea
Organ of Corti
Hair
cells
Mechanoelectrical
transductions
Normal Physiology
of the Ear
Sound Path
Pinna
Tympanic membrane
Ossicles
Oval window
Cochlea
Cochlear
Transduction
Basillar membrane
movement
Hair cell
stereocilia deflection
K+ influx
Depolarization
Cranial Nerve VII
Eustachian
tube
Ventilates
middle ear
Equalizes
pressure
Tonotopy
Base
cochlea
High frequency
Apex
Low frequency
Chronic Suppurative
Otitis Media
Differential
Diagnosis
Cholesteatoma
Otitis media
w/effusion
Adhesive
otitis media
Otosclerosis
Tympanosclerosis
Examinations
Tuning
fork tests
Rinne negative
Weber lateralizes
to affected ear
Pure tone
audiometry
Air-bone gap
Conductive pattern
Otoscopy
Central TM
perforation
Active discharge or
dry perforation
Tympanometry
Type B or large
ear canal volume
History
Chronic discharge
Hearing difficulty
Risk Factors
Recurrent
childhood AOM
URTIs
Allergic Rhinitis
Poor hygiene
Immunologic
factors
Low socieconomic
status
Treatment
and
Management
Dry ear precautions
Active
infection
Aural toilet
Topical
floroquionolone drops
Avoid aminoglycosides
if perforated TM
Definitive
Tympanoplasty
Ossiculoplasty
if needed
Mastoiedctomy if
unsafe disease
Hearing rehabilitation if
residual loss
Pathophysiology
Bacterial
Colonization
Biofilm
formation
Intermittent
otorrhea
TM
peforation
Reduced vibratory
surface
Conductive
hearing loss
Eustachian Tube
Dysfunction
Poor middle ear
ventilation
Chronic
inflammation
Persistent TM
perforation
Noise-Induced
Hearing Loss
Pathophysiology
Metabolic stress
ROS formation
Outer hair cell death
Basal cochlea
damage
3 to 6 kHz notch
High-frequency
hearing loss
Chronic noise
exposure >85dB
Mechanical stereocilia
damage
Tip-link disruption
Deafferentiation
Central gain
increase
Tinnitus
Risk Factors
Occupational noise
(railway environment)
Long duration
exposure
Impulse noise
Smoking
Aging
Genetic susceptibility
Differential Diagnosis
Presbycusis
Sudden sensorineural
hearing loss
Otoxicity
Meniere disease
(if vertigo present)
Examinations
Tuning fork
tests
Rinne positive
Weber to better ear
Pure tone
audiometry
3 to 6 kHz notch
Bilateral symmetric SNHL
Otoscopy
Usually normal TM
Otoacoustic
Emission
Reduced outer hair
cell function
History
Gradual hearing decline
Tinnitus
Occupational nois
Treatment and Management
Primary prevention
Hearing
protection
devices
Occupational
health
program
Noise
control
Early acoustic
trauma
Consider
short-course
steroids
Chronic NIHL
Tinnitus
counseling
Sound
therapy
Hearing
aids
