9/27/2013

9/27/2013

Answers:

A patient complains of hearing loss.  A Weber test causes lateralization to the left ear and a Rinne test shows greater air conduction than bone conduction in the right ear.  What is the patient's likely diagnosis?
A)R CHL 
B)L CHL 
C) R SNHL 
D) L SNHL

In SNHL Weber lateralizes to better ear and Rinne shows better conduction of air than bone.  In CHL weber lateralizes to affected ear and Rinne shows better bone than air conduction.

Which test can confirm CHL, Rinne or Weber?  Why?

Only the Rinne test can confirm CHL by demonstrating greater bone conduction over air conduction (AKA "flipping forks").  The Weber test can only detect a difference between two ears but cannot assess whether it is due to CHL or SNHL.

MC Questions:
The most common cause of CHL in adults is ---, but the most common cause in children is---.
A) Cerumen Impaction; Otitis Media 
B) TM Perforation; Otitis Media 
C) Otitis Media; Cerumen Impaction 
D) Otitis Media; TM Perforation 
E)Cerumen Impaction; TM Perforation

Free Response Question:
What is the greatest possible hearing loss, in terms of dB, a CHL can cause?

Quick Facts:
Otosclerosis
-ear usually appears normal 
-often a fhx 
-Rinne must be negative in order to have surgery 
-Most common treatment is stapedectomy, 90-95% success rate.