Answers:
All of the following increase the risk of perilymphatic gusher's during stapedectomy except...
A) Meniere's Disease
B) Mondini malformation
C) Enlarged Vestibular Aqueduct Syndrome
D) Congenitally Fixed Footplate
Pts are at an increased risk of having a "perilymphatic gusher" if they have a mondini malformation, enlarged vestibular aqueduct syndrome or congenitally fixed footplate. As a "gusher" can lead to significant SNHL, these conditions are contraindications to surgery. If a "gusher" occurs intraop, a fat or muscle graft can be used to seal the leak, postop the pt should maintain head elevated
position and by placed on stool softeners.
What are three nonsurgical treatment options for otosclerosis?
Sodium Fluoride = reduces osteoclastic bone resorption and increased osteoblastic bone formation. Also thought to inhibit proteolytic enzymes that are cytotoxic to cochlea which can because SNHL.
Bisphosphonates=potent antiresorptive which inhibit osteoclastic activity.
Amplification=most pts have normal cochlear function with good speech discrimination so they are good hearing aid candidates and patients are encouraged to try hearing aids prior to surgery as risk are low.
MC Questions:
What is the most common cause of SNHL?
A) Congenital
B) Intense Noise Exposure
C) Ototoxic medications
D) Presbycusis
E) HIV related hearing loss
A) Meniere's Disease
B) Mondini malformation
C) Enlarged Vestibular Aqueduct Syndrome
D) Congenitally Fixed Footplate
Pts are at an increased risk of having a "perilymphatic gusher" if they have a mondini malformation, enlarged vestibular aqueduct syndrome or congenitally fixed footplate. As a "gusher" can lead to significant SNHL, these conditions are contraindications to surgery. If a "gusher" occurs intraop, a fat or muscle graft can be used to seal the leak, postop the pt should maintain head elevated
position and by placed on stool softeners.
What are three nonsurgical treatment options for otosclerosis?
Sodium Fluoride = reduces osteoclastic bone resorption and increased osteoblastic bone formation. Also thought to inhibit proteolytic enzymes that are cytotoxic to cochlea which can because SNHL.
Bisphosphonates=potent antiresorptive which inhibit osteoclastic activity.
Amplification=most pts have normal cochlear function with good speech discrimination so they are good hearing aid candidates and patients are encouraged to try hearing aids prior to surgery as risk are low.
MC Questions:
What is the most common cause of SNHL?
A) Congenital
B) Intense Noise Exposure
C) Ototoxic medications
D) Presbycusis
E) HIV related hearing loss
Free Response Question:
The intensity of sound is signaled to the brain by what three mechanisms?
Quick Facts:
Prevention of SNHL
Vaccination
-H. flu vaccine prevents a major cause of SNHL.
-Other vaccines (strep pneumo, MMR) also have important impact and may decrease ear infections.
Noise Avoidance
-Using earplugs and earmuffs can decrease noise damage.
-High risk activities = wood/metal working, target practice, engines, snowblowers,
chainsaws etc.
-Exposure over an 8hr period averaging 85db requires protection.
The intensity of sound is signaled to the brain by what three mechanisms?
Quick Facts:
Prevention of SNHL
Vaccination
-H. flu vaccine prevents a major cause of SNHL.
-Other vaccines (strep pneumo, MMR) also have important impact and may decrease ear infections.
Noise Avoidance
-Using earplugs and earmuffs can decrease noise damage.
-High risk activities = wood/metal working, target practice, engines, snowblowers,
chainsaws etc.
-Exposure over an 8hr period averaging 85db requires protection.
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