organic deafness

Functional deafness/psychogenic deafness/hysterical deafness: unilateral/bilateral sudden hearing loss, but no tinnitus or dizziness; the pitch and intensity of speech are the same as before the onset. However, they often have hysterical symptoms such as mutism, tremors/numbness of limbs, and excessive gaze; the results of repeated audiometry vary greatly and there is no loudness resurgence; the self-recorded audiometry curve is type V; there is no change in vestibular function; the patient can suddenly heal on his own/after various Implicit in treatment and prompt recovery

Congenital deafness: hereditary deafness, non-hereditary deafness

acquired deafness

Prelingual deafness: Severe congenital deafness or those who lost hearing in infancy and early childhood

Postlingual deafness: A person who loses hearing after speech is formed

hereditary deafness

Non-hereditary deafness: The mother suffers from rubella, mumps, influenza, syphilis and other diseases in early pregnancy

Bilateral symmetrical deafness that slowly progresses from high frequency to low frequency, accompanied by high-pitched persistent tinnitus; most of them have loudness resurgence, speech recognition rate and pure tone audiometry results are not proportional

Seen in: epidemic cerebrospinal meningitis, scarlet fever, diphtheria, typhoid fever, etc.

Clinical manifestations: progressive deafness with/without symptoms of vestibular involvement

Hypertension, arteriosclerosis: bilateral symmetrical high-frequency sensorineural deafness accompanied by persistent high-pitched tinnitus Diabetes: usually retrochlear deafness or cochlear deafness

Kidney disease: bilateral symmetrical high-frequency sensorineural deafness

Hypothyroidism (especially cretinism): mixed deafness in varying degrees

Common ones include aminoglycosides (such as streptomycin), NSAIDs, antimalarial drugs (such as quinine), anticancer drugs (such as vincristine), loop diuretics (such as furosemide)

Clinical manifestations: deafness (bilateral symmetrical sensorineural deafness, mostly developing from high frequency to low frequency), tinnitus, vertigo, balance disorder

Closed head trauma, transverse temporal bone fracture, caisson deafness, blast deafness

Severe sensorineural deafness that occurs suddenly within a short period of time without obvious reasons

Clinical manifestations: It is more common on one side; usually there is high-pitched tinnitus first, often accompanied by dizziness, nausea, and vomiting; the hearing damage is often more serious, and the hearing curve may be interrupted, and the loudness revitalization test is positive; but there is a tendency for self-healing.

Bilateral asymmetric, fluctuating, and progressive sensorineural deafness; often combined with other autoimmune diseases

Complications of otitis media, Meniere's disease, cochlear otosclerosis, MS, etc.

At present, while ruling out/treating the cause, drugs that can expand the inner ear blood vessels, reduce blood viscosity, and dissolve small thrombi, as well as vitamin B and energy preparations are used as early as possible. If necessary, antibiotics, antiviral drugs, and glucocorticoids can also be used.

It can be used by anyone with an average speech frequency hearing loss of 35~80dB. The best effect is achieved with a hearing loss of about 60dB.

Unilateral deafness: generally no need for hearing aids

Bilateral deafness: The degree of loss is roughly the same → wear binaural hearing aids/monaural hearing aids in turns; the degree of loss varies greatly but does not exceed 50dB → it is better to wear the ear with poor hearing; the hearing loss in one ear is >50dB → it should be given to the ear with better hearing Wear

Indications: The use of high-power hearing aids is ineffective, there are no active lesions in the ear, imaging examinations prove that the structure of the inner ear is normal, electrocochleography cannot detect it, and electrical stimulation of the promontory/cochlear fenestra can induce brainstem reactions.

Painless bleeding in the ear canal, earache, ipsilateral peripheral facial paralysis, conductive deafness, difficulty opening the mouth, and dizziness

Most of the cases have tympanic membrane perforation. Through the perforation, red granulation can be seen in the middle ear cavity, which can easily bleed when touched.

CT: There are irregular soft tissue lesions in the middle ear cavity/mastoid process, irregular large-area bone destruction on the middle ear mastoid process, irregular edges, and no edge bone sclerosis zone.

The diagnosis can be confirmed; try not to stretch the middle ear cavity granulation when collecting materials to avoid damaging the facial nerve.

Tumor located in the internal auditory canal (early symptoms): hearing loss (unilateral sensorineural hearing loss is the most common early symptom), tinnitus, vestibular dysfunction

Tumor growing into the cerebellopontine angle: severe hearing loss, balance disorder, trigeminal nerve compression (ipsilateral facial numbness, pain, and paresthesia)

Further tumor growth: brainstem compression, hydrocephalus, headache (not an early symptom), vision loss

Audiology examination: ABR is currently the most sensitive audiological method for detecting acoustic neuroma. Vestibular function examination: Abnormal electronystagmogram may be present.

Imaging: MRI is the most sensitive and effective diagnostic method for early diagnosis

Recognized as the treatment of choice

Suitable for patients with advanced age, tumors limited to the internal auditory canal, insignificant growth, and regular MRI examinations if conditions permit

It is suitable for patients with non-cystic degeneration whose systemic conditions are not suitable for surgical treatment and whose tumors are <2cm and the tumor continues to enlarge/symptoms continue to worsen.