1. Inner Ear Disorders

2. Cochlear or Sensory hearing loss Neural or retrocochlear hearing loss
Sensorineural hearing loss - cochlea
Neural or retrocochlear hearing loss
Auditory nerve lesion
Central hearing loss
Lesion of the central auditory pathway

3. Symptoms of Inner Ear Disorder
Hearing impairement
Hearing loss or hypoacusis
Distortion of hearing or dysacusis
Tinnitus
Vestibular symptoms
Dysequilibrium
Vertigo

4. Diagnostic Evaluation
History
Noise exposure, cranial trauma, family history, history of chronic otitis media, use of ototoxic medications
Clinical Examination
Inspection, otoscopy, Weber’s test, Rinne’s test, whispered speech test
Audiometry
Imaging Studies
CT scan, MRI

5. Diagnostic Evaluation
Audiometry
Imaging Studies

6. Cochlear Hearing Loss with a Known Cause
Hereditary Sensorineural Hearing Loss
Noise-Induced Hearing Loss
Traumatic Injury to the Inner Ear
Labyrinthitis
Ototoxicity
Other Acquired Inner Ear Disorders
Immunologic Causes, Decreased Blood Flow, Metabolic Disorders, Cochlear Otosclerosis

7. Hereditary Sensorineural Hearing Loss
Syndromic
Present at birth
Autosomal recessive
Non-syndromic
Congenital form or Later-onset form
Autosomal dominant
Symmetrical
Treatment
Prevention of further acquired damage
Rehabilitation with hearing aids and other assistive devices

8. Noise-Induced Hearing Loss
Acute acoustic trauma
Blast injury
Acute noise-induced hearing loss
Chronic noise-induced hearing loss

9. Noise-Induced Hearing Loss
Acute acoustic trauma
Sudden, intense sound event of short duration
>140dB
Gunshot, airbags, firecrackers, or aerial fireworks
Blast injury
Acute noise-induced hearing loss
Chronic noise-induced hearing loss

10. Noise-Induced Hearing Loss
Acute acoustic trauma
Blast injury
Pressure wave from an explosive blast that can rupture the tympanic membrane
>140dB
Acute noise-induced hearing loss
Chronic noise-induced hearing loss

11. Noise-Induced Hearing Loss
Acute acoustic trauma
Blast injury
Acute noise-induced hearing loss
Chronic noise-induced hearing loss

12. Noise-Induced Hearing Loss
Acute acoustic trauma
Blast injury
Acute noise-induced hearing loss
Chronic noise-induced hearing loss

13. Noise-Induced Hearing Loss
Symptoms
Muffled sensation and tinnitus
Irreversible, chronic noise-induced hearing loss = sensorineural hearing loss
Loss of speech discrimination and tinnitus
Prophylaxis
Reduction of voice emissions
Hearing protection and control of noise levels
Regular screening

14. Traumatic Injury to the Inner Ear (Labyrinthine concussion and contusion; Labyrinthine trauma)
Temporal bone fracture
Barotrauma
Symptoms
Non-specific vertiginous complaints and hearing impairement that are usually obscured by symptoms of craniocerbral trauma or other injuries
Treatment
Protection from additional harmful influences

15. Labyrinthitis Tympanogenic Meningeal Hematogenous Symptoms Treatment
Cochlear hearing loss
Tinnitus
Vestibular symptoms (vertigo, dysequilibrium, nystagmus)
Treatment
Decompression with myringotomy tube
Mastoidectomy

16. Ototoxicity Symptoms Ototoxic substances
Cochlear damage accompanied by tinnitus
Symmetrical hearing loss
Vestibular symptoms (oscillopsia, dysequilibrium)
Ototoxic substances
Drugs: Aminoglycosides, Cisplatin, Loop diuretics, Quinine, Salicylates
Industrial toxins: Aminobenzenes, Lead, Mercury, Arsenic, Alcohol, Heroin, Tobacco, Cocaine

17. Ototoxicity Prophylaxis
Patient’s cochlear function should first be tested if at all possible
Special attention to dosage, renal function, adequate hydration