STUDY - Technical - New Dacian's Medicine
Hearing
disorders
(3)
Translation Draft
I will complete (for now) posts about hearing disorders.
Tens (perhaps hundreds) of millions of people experience noise-induced hearing loss, much of which is exposed to harmful noises at work. Noise-induced hypoacusis results from both recreational and occupational activities and begins in adolescence, especially among boys, as they begin to engage in high-risk activities (from the point of view of exposure to noise), such as wood and metal processing with electrical equipment, target shooting and hunting with small firearms etc.
The use of all internal and electric combustion engines, including snow and leaf cleaners, electric sleds, outdoor motor boats and chain saws, requires user protection with protective devices such as earplugs or fluid-filled ear sleeves. Theoretically, all noise-induced hearing-induced hearings can be prevented by education, which must be started before adolescence.
Programs to protect hearing in industry are necessary if the 8-hour exposure is on average 85 dB on scale A. Workers in these noisy environments can be protected by performing an audiological examination before hiring, mandatory use of hearing production equipment and annual audiological examinations.
From the point of view of the clinical evaluation of hearing loss, for the evaluation of patients with hearing loss, the associated symptoms of tinnitus, vertigo, difficulties in balance, otorea and the feeling of otitic fullness should be carefully considered together with the history of the evolution of the hearing deficit. The sudden onset of unilateral hearing-a-like hearing leave, with or without tinnitus, may signal a viral infection in the inner ear.
Gradual progression of a hearing deficit is common in otosclerosis, noise-induced hearing loss, vestibular schwannom or Meniere's disease. In the latter case, tinnitus and intermittent vertigo are commonly encountered. Hypoacusis can occur in demyelinated lesions of the brain stem.
The genetic basis of hearing deficit is evident in families where hearing deficit occurs in several generations. Hearing deficit is also genetically predetermined in cases where there are obvious environmental factors. For example, in some Asian families sensitivity to ototoxicity of aminoglycosides is transmitted through a mitochondrial mutation.
Variations in individual and familial susceptibility to noise-induced hearing-induced hearing and to presbiacusia are probably also genetically determined. One in 1,000 infants is born with severe hearing impairment and at least 50% of congenital deafness has a genetic basis. A large number of individuals develop hereditary hearing deficit in childhood and later in life. Between 70 and 80% of hereditary hearing deficits are transmitted autosomal recessively and 15 - 20% autosomal dominant. Less than 5% are transmitted X-bound.
Hereditary hearing deficits also occur in syndromes in which other organs are affected. Due to the ease with which the hereditary basis of hearing deficit can be determined, special progress has been made in identifying the genes responsible for hereditary deafness syndromes.
The genes responsible for Waardenburg syndrome (lack of migration of melanocytes from the neural crest, with deafness and pigmentation and intrategumentary changes) were located at chromosome 2 (type 1) and 3 (type 2), and the genes responsible for Uscher syndrome (deafness, vestibular deficiency and cetitis by pigment retinitis) were located at chromosome 1 (type 2) and chromosome 2 (type 1).
Genes responsible for one of the forms of Alport syndrome (deafness and glomerulonephritis leading to renal failure), genes involved in albinism and neurofibromatosis type 2 (bilateral acoustic neurinomas) have also been identified. The first gene that causes isolated deafness was detected on the long arm of chromosome 5 (where there is dominant autosomal deficiency). Several genes responsible for hereditary recessive hearing deficits isolated in isolated, insantous families have been identified.
Between 30 and 35% of individuals over 65 years of age have hearing loss sufficiently important to require hearing aids. Presbytery is characterized by loss of discrimination of phonemes, sound hardening (abnormal increase in intensity) and particular difficulty in understanding spoken language in noisy environments.
Tinnitus is defined as the perception of a non-existent sound. It can be similar to a hum, hissing or ringing and can be pulsating (synchronous with heartbeat). Tinnitus is usually associated with transmission or neurosensory hearing loss. The physiology of tinnitus is not well understood.
The cause of tinnitus can usually be determined by identifying the cause of the associated hearing deficit. Tinnitus may be the first symptom of a severe condition such as vestibular schwannoma. Pulsatil tinnitus requires the evaluation of the vascular system in order to exclude vascular tumors such as the jugular glomus, aneurysms and stenotic lesions.
Let's move on to differential diagnosis! Many patients with neurosensory hearing loss should undergo evaluation of the vestibular system by electronstagmography and caloric tests. Most patients with transmission hearing loss should be examined by TC at the temporal bone. Patients with unilateral or asymmetric neurosensory hearing loss should be examined by cranial MRI with gadolinium amplification.
From a prophylactic point of view, transmission hearing loss can be prevented by prompt and correct administration of an antibiotic therapy of adequate duration for acute otitis media and by re-ventilation of the middle ear with time-tubes in the case of discharges to the middle ear, lasting six weeks or more. Vestibular function deficiency and deafness due to aminoglycoside antibiotics can be largely prevented by careful monitoring of their maximum and minimum serum concentrations.
Noise-induced hypoacusis can be prevented by avoiding exposure to loud noises or by regularly using ear plugs or fluid-filled sleeves to alleviate intense sounds. Vaccination of infants against meningitis with Haemophilus influenzae type B will prevent a major cause of acquired deafness, as has been achieved with measles, epidemic parotiditis and rubella immunisation.
Here we are at the treatment... In most patients with transmission hearing loss, reconstruction of the middle ear can be performed through procedures such as timpanoplasty after chronic otitis media and trauma and stapedectomy for otosclerosis.
Tympanoplasty tubes allow a prompt return of hearing to normal in children and adults with overflows in the middle ear. Hearing aids are effective and well tolerated in patients with transmission hearing loss. Patients with mild, moderate or severe neurosensory hearing loss are usually rehabilitated with hearing aids with varying configuration and powers.
However, in the case of hearing aids, the problem of understanding a conversation on the background of noise persists. Hearing aids have been improved to achieve greater fidelity and have been miniaturized. Accentuating high frequencies, required in many neurosensory hearing loss, was obtained mainly for ventilation of ear structures and through filters.
There was amplification of weak sounds and lack of amplification of intense sounds. Digital hearing aids can be programmed by the patient, and multiple and directional microphones in the ear help some hearing aid wearers, who still have difficulty perceiving sounds in noisy environments.
Because all hearing aids amplify both conversation and noise, the only absolute solution found so far for this problem is to place the microphone closer to the speaker than to the noise source. This is not possible in the case of aesthetically acceptable self-contained prostheses. They are uncomfortable and require a user-friendly environment.
In many situations, including conferences and theatre performances, people with hearing loss benefit from assistive devices that are based on the principle of approaching the speaker's microphone, not noise sources. Assistive devices involve infrared and FM transmission, as well as an electromagnetic loop that surrounds the room for transmission to individual hearing aids.
Telecable hearing aids can also be used in the same way with properly equipped phones.
Cochlear implants are neural prostheses that convert sound energy into electrical energy and can be used to directly stimulate the acoustic branch of nerve VIII. cochlear implants consist of electrodes that are inserted into the cochlea, speech processors that extract the acoustic elements of speech for conversion into electric currents and a means of transmitting electricity through the skin.
Most commonly, for this purpose, an induction spiral is placed over another implanted induction spiral, with magnets in each spiral. In most cases of deep auditory deficits, the auditory ciliated cells are destroyed, but the ganglion cells of the auditory branch of the VIII nerve are not damaged.
Cochlear implants are suitable for children with congenital and acquired severe hearing impairments and for adults with hearing deficits so severe that they can only understand less than 30% of conversations, even under the conditions of wearing a hearing aid and under ideal hearing conditions.
At the moment, in the world, more than 14,000 people with deafness, 2,000 of whom are children, have cochlear implants (the number is constantly increasing). They perceive sounds that help them read lips and allow the recognition of sets of words.
It is anticipated that the improvement of the design of electrodes and verbal processors will allow for further progress in understanding spoken language, the Implant also allows hearing and identifying sounds from the environment and distinguishing between male and female voices, and is also useful in shaping the voice of the wearer.
For people with both VIII nerves destroyed by bilateral trauma or vestibular schwannomas, an auditory implant has been experimentally placed in the brain stem with similar benefits to those with cochlear implants. Treatment of tinnitus is quite problematic. The frequency range and intensity of the tinnitus can often be determined using the audiometer.
The improvement of the tinnitus can be achieved by masking it through a musical background. Hearing aids are also useful in suppressing tinnitus, as are slides that mask tinnitus, by emitting a sound that is more pleasant than tinnitus. The use of a tinnitus masking device is often followed by several hours of tinnitus inhibition.
From tomorrow we move on to the respiratory signs...
I will complete (for now) posts about hearing disorders.
Tens (perhaps hundreds) of millions of people experience noise-induced hearing loss, much of which is exposed to harmful noises at work. Noise-induced hypoacusis results from both recreational and occupational activities and begins in adolescence, especially among boys, as they begin to engage in high-risk activities (from the point of view of exposure to noise), such as wood and metal processing with electrical equipment, target shooting and hunting with small firearms etc.
The use of all internal and electric combustion engines, including snow and leaf cleaners, electric sleds, outdoor motor boats and chain saws, requires user protection with protective devices such as earplugs or fluid-filled ear sleeves. Theoretically, all noise-induced hearing-induced hearings can be prevented by education, which must be started before adolescence.
Programs to protect hearing in industry are necessary if the 8-hour exposure is on average 85 dB on scale A. Workers in these noisy environments can be protected by performing an audiological examination before hiring, mandatory use of hearing production equipment and annual audiological examinations.
From the point of view of the clinical evaluation of hearing loss, for the evaluation of patients with hearing loss, the associated symptoms of tinnitus, vertigo, difficulties in balance, otorea and the feeling of otitic fullness should be carefully considered together with the history of the evolution of the hearing deficit. The sudden onset of unilateral hearing-a-like hearing leave, with or without tinnitus, may signal a viral infection in the inner ear.
Gradual progression of a hearing deficit is common in otosclerosis, noise-induced hearing loss, vestibular schwannom or Meniere's disease. In the latter case, tinnitus and intermittent vertigo are commonly encountered. Hypoacusis can occur in demyelinated lesions of the brain stem.
The genetic basis of hearing deficit is evident in families where hearing deficit occurs in several generations. Hearing deficit is also genetically predetermined in cases where there are obvious environmental factors. For example, in some Asian families sensitivity to ototoxicity of aminoglycosides is transmitted through a mitochondrial mutation.
Variations in individual and familial susceptibility to noise-induced hearing-induced hearing and to presbiacusia are probably also genetically determined. One in 1,000 infants is born with severe hearing impairment and at least 50% of congenital deafness has a genetic basis. A large number of individuals develop hereditary hearing deficit in childhood and later in life. Between 70 and 80% of hereditary hearing deficits are transmitted autosomal recessively and 15 - 20% autosomal dominant. Less than 5% are transmitted X-bound.
Hereditary hearing deficits also occur in syndromes in which other organs are affected. Due to the ease with which the hereditary basis of hearing deficit can be determined, special progress has been made in identifying the genes responsible for hereditary deafness syndromes.
The genes responsible for Waardenburg syndrome (lack of migration of melanocytes from the neural crest, with deafness and pigmentation and intrategumentary changes) were located at chromosome 2 (type 1) and 3 (type 2), and the genes responsible for Uscher syndrome (deafness, vestibular deficiency and cetitis by pigment retinitis) were located at chromosome 1 (type 2) and chromosome 2 (type 1).
Genes responsible for one of the forms of Alport syndrome (deafness and glomerulonephritis leading to renal failure), genes involved in albinism and neurofibromatosis type 2 (bilateral acoustic neurinomas) have also been identified. The first gene that causes isolated deafness was detected on the long arm of chromosome 5 (where there is dominant autosomal deficiency). Several genes responsible for hereditary recessive hearing deficits isolated in isolated, insantous families have been identified.
Between 30 and 35% of individuals over 65 years of age have hearing loss sufficiently important to require hearing aids. Presbytery is characterized by loss of discrimination of phonemes, sound hardening (abnormal increase in intensity) and particular difficulty in understanding spoken language in noisy environments.
Tinnitus is defined as the perception of a non-existent sound. It can be similar to a hum, hissing or ringing and can be pulsating (synchronous with heartbeat). Tinnitus is usually associated with transmission or neurosensory hearing loss. The physiology of tinnitus is not well understood.
The cause of tinnitus can usually be determined by identifying the cause of the associated hearing deficit. Tinnitus may be the first symptom of a severe condition such as vestibular schwannoma. Pulsatil tinnitus requires the evaluation of the vascular system in order to exclude vascular tumors such as the jugular glomus, aneurysms and stenotic lesions.
Let's move on to differential diagnosis! Many patients with neurosensory hearing loss should undergo evaluation of the vestibular system by electronstagmography and caloric tests. Most patients with transmission hearing loss should be examined by TC at the temporal bone. Patients with unilateral or asymmetric neurosensory hearing loss should be examined by cranial MRI with gadolinium amplification.
From a prophylactic point of view, transmission hearing loss can be prevented by prompt and correct administration of an antibiotic therapy of adequate duration for acute otitis media and by re-ventilation of the middle ear with time-tubes in the case of discharges to the middle ear, lasting six weeks or more. Vestibular function deficiency and deafness due to aminoglycoside antibiotics can be largely prevented by careful monitoring of their maximum and minimum serum concentrations.
Noise-induced hypoacusis can be prevented by avoiding exposure to loud noises or by regularly using ear plugs or fluid-filled sleeves to alleviate intense sounds. Vaccination of infants against meningitis with Haemophilus influenzae type B will prevent a major cause of acquired deafness, as has been achieved with measles, epidemic parotiditis and rubella immunisation.
Here we are at the treatment... In most patients with transmission hearing loss, reconstruction of the middle ear can be performed through procedures such as timpanoplasty after chronic otitis media and trauma and stapedectomy for otosclerosis.
Tympanoplasty tubes allow a prompt return of hearing to normal in children and adults with overflows in the middle ear. Hearing aids are effective and well tolerated in patients with transmission hearing loss. Patients with mild, moderate or severe neurosensory hearing loss are usually rehabilitated with hearing aids with varying configuration and powers.
However, in the case of hearing aids, the problem of understanding a conversation on the background of noise persists. Hearing aids have been improved to achieve greater fidelity and have been miniaturized. Accentuating high frequencies, required in many neurosensory hearing loss, was obtained mainly for ventilation of ear structures and through filters.
There was amplification of weak sounds and lack of amplification of intense sounds. Digital hearing aids can be programmed by the patient, and multiple and directional microphones in the ear help some hearing aid wearers, who still have difficulty perceiving sounds in noisy environments.
Because all hearing aids amplify both conversation and noise, the only absolute solution found so far for this problem is to place the microphone closer to the speaker than to the noise source. This is not possible in the case of aesthetically acceptable self-contained prostheses. They are uncomfortable and require a user-friendly environment.
In many situations, including conferences and theatre performances, people with hearing loss benefit from assistive devices that are based on the principle of approaching the speaker's microphone, not noise sources. Assistive devices involve infrared and FM transmission, as well as an electromagnetic loop that surrounds the room for transmission to individual hearing aids.
Telecable hearing aids can also be used in the same way with properly equipped phones.
Cochlear implants are neural prostheses that convert sound energy into electrical energy and can be used to directly stimulate the acoustic branch of nerve VIII. cochlear implants consist of electrodes that are inserted into the cochlea, speech processors that extract the acoustic elements of speech for conversion into electric currents and a means of transmitting electricity through the skin.
Most commonly, for this purpose, an induction spiral is placed over another implanted induction spiral, with magnets in each spiral. In most cases of deep auditory deficits, the auditory ciliated cells are destroyed, but the ganglion cells of the auditory branch of the VIII nerve are not damaged.
Cochlear implants are suitable for children with congenital and acquired severe hearing impairments and for adults with hearing deficits so severe that they can only understand less than 30% of conversations, even under the conditions of wearing a hearing aid and under ideal hearing conditions.
At the moment, in the world, more than 14,000 people with deafness, 2,000 of whom are children, have cochlear implants (the number is constantly increasing). They perceive sounds that help them read lips and allow the recognition of sets of words.
It is anticipated that the improvement of the design of electrodes and verbal processors will allow for further progress in understanding spoken language, the Implant also allows hearing and identifying sounds from the environment and distinguishing between male and female voices, and is also useful in shaping the voice of the wearer.
For people with both VIII nerves destroyed by bilateral trauma or vestibular schwannomas, an auditory implant has been experimentally placed in the brain stem with similar benefits to those with cochlear implants. Treatment of tinnitus is quite problematic. The frequency range and intensity of the tinnitus can often be determined using the audiometer.
The improvement of the tinnitus can be achieved by masking it through a musical background. Hearing aids are also useful in suppressing tinnitus, as are slides that mask tinnitus, by emitting a sound that is more pleasant than tinnitus. The use of a tinnitus masking device is often followed by several hours of tinnitus inhibition.
From tomorrow we move on to the respiratory signs...
Have a good day, everyone!
Dorin, Merticaru