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. 2011 Jun;108(25):433-43; quiz 444.
doi: 10.3238/arztebl.2011.0433. Epub 2011 Jun 24.

The differential diagnosis of hearing loss

Thomas Zahnert  1
Affiliations

The differential diagnosis of hearing loss

Thomas Zahnert. Dtsch Arztebl Int. 2011 Jun.

Abstract

Background: According to the World Health Organization, hearing loss is one of the six leading contributors to the global burden of disease. It is becoming an ever more important problem in society at large, not just because the population is aging, but also because young people increasingly spend their leisure time in activities that expose them to excessive noise. On the other hand, the treatment of hearing loss is improving, as the result of technical developments in otological surgery, hearing aids, and cochlear implants. For nearly every type of hearing loss, there is now some type of rehabilitative treatment. The prerequisite to effective care is timely and accurate diagnosis.

Method: Review of the pertinent literature and national guidelines.

Results and conclusion: The available epidemiological data on hearing loss in Germany are inadequate. It is roughly estimated that 13 to 14 million people in Germany are in need of treatment for hearing loss. The most common types of permanent hearing loss are those associated with old age, chronic otitis media, and acoustic trauma. Transient hearing loss is particularly common in childhood as a result of inadequate ventilation of the middle ear. The further technical development of cochlear implants has now widened their indications to include severe congenital deafness and presbycusis.

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Figures

FIGURE 1
FIGURE 1
Topographic-functional classification of hearing impairment according to the level of the lesion in the organs of hearing
FIGURE 2
FIGURE 2
a) Conductive hearing loss: testing with ear and bone loudspeakers. The cause lies in the external or middle ear. Pure-tone audiometry reveals a difference between the air conduction (x-x-x) and bone conduction (<-<-<) thresholds. b) Sensorineural hearing loss: testing with ear and bone loudspeakers. The cause lies in the cochlea. Pure-tone audiometry reveals superposable air and bone conduction curves.
Figure 3
Figure 3
FIGURE 4
FIGURE 4
The organ of Corti, with outer and inner hair cells (diagram of the human cochlea) and the attached stereocilia before and after noise-induced trauma (chinchilla).
See this image and copyright information in PMC

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