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Disorders of the CAP
Audiology Exam 4
| Question | Answer |
|---|---|
| Acoustic Neuroma | Slow growing benign tumor located on 8th cranial nerve (auditory nerve) |
| Acoustic Neuroma incidents | 2/100,000 |
| Acoustic Neuroma is also called | Vestibular schwannoma |
| Acoustic Neuroma tumor is composed of? | Schwann cells |
| Acoustic Neuroma damage arises from what three things? | Compressions, Atrophy, Invasion |
| Internal Auditory Canal (IAC) | A small bony canal that allows the auditory nerve to travel in cranial cavity and synapse into brainstem |
| Small Acoustic Neuroma | <1.5mm |
| Medium Acoustic Neuroma | 1.5-2.5mm |
| Large Acoustic Neuroma | >2.5mm |
| Acoustic Neuromas are located someplace on the _________, but different locations can have greater or less severe implications | Auditory nerve |
| Does not necessarily have to be “____________” to grow in these locations – any tumor that causes compression to __________ can affect hearing | Acoustic Neuroma, auditory pathway |
| Cerebellar Pontine Angle | Neuroma location is at the site where auditory nerve branches into brainstem nuclei (Cochlear Nucleus) |
| Brainstem functions critical for? | Autonomic life supporting functions |
| Internal Auditory Canal | Neuroma can be smaller but have greater impact on neural function due to the limited space within bony channel |
| Acoustic Neuroma usually presents between the ages of? | 30-60 years old |
| Acoustic Neuroma usually presents between the ages of 30-60 years old. _______% are _______ (except for _______) | 95%, unilateral, NF2 |
| What are the symptoms of an Acoustic Neuroma | • Unilateral Hearing Loss • Tinnitus • Aural Fullness • Chronic balance issues |
| Increased tumor size of Acoustic Neuroma worsens symptoms: | • Dysphagia • Dysarthria • Headaches • Other Facial Nerves |
| What are the audiologic tests in acoustic neuroma? | • Audiogram • Speech Testing • Tympanometry • Acoustic Reflexes • ABR • Caloric |
| Audiologic Tests in Acoustic Neuroma: Audiogram | Unilateral SNHL |
| Audiologic Tests in Acoustic Neuroma: Speech Testing | Poorer than expected for degree of pure tone thresholds |
| Audiologic Tests in Acoustic Neuroma: Tympanometry | Normal – Type A |
| Audiologic Tests in Acoustic Neuroma: Acoustic Reflex | Elevated or absent to ipsilateral stimulation on affected side or contralateral stimulation |
| Audiologic Tests in Acoustic Neuroma: ABR | Abnormal peak latencies in affected side |
| Audiologic Tests in Acoustic Neuroma: Caloric | Weak nystagmus response on affected side |
| Acoustic Neuroma diagnosis can only be made through ________ typically performed by an __________ or ___________ | Imaging testing, otolaryngologist, neurologist |
| Acoustic Neuroma treatments: | • Monitor • Surgical Intervention • Gamma Knife |
| Neurofibromatosis | Genetic disorder that causes tumors to grow on nervous tissue |
| Neurofibromatosis _____% chance parents pass on condition to child | 50% |
| When is Neurofibromatosis typically discovered? | At birth or during early childhood |
| Neurofibromatosis symptoms | • SNHL • Tinnitus • Balance problems |
| Two different types of Neurofibromatosis: | • NF1 • NF2 |
| NF1 is characterized by: | • Multiple cutaneous tumors • Many birthmark-like brown spots on skin • Neuromas that grow on peripheral and spinal nervous tissue • Rarely Acoustic Neuromas |
| NF2 is characterized by: | BILATERAL acoustic neuromas |
| NF2 patients have very different signs of ________ | Retro cochlea pathology |
| NF2 hearing loss is _______ and ________ | Bilateral, more progressive |
| Brainstem Disorders | •Infarcts •Gliomas •Multiple sclerosis |
| Infarcts | Localized areas of ischemia |
| Ischemia | Shortage of blood flow due to blockage |
| Two Syndromes related to Brainstem infarcts: | • Inferior Pontine syndrome • Lateral inferior pontine syndrome |
| Brainstem infarcts oftentimes affect multiple ________ | Cranial nerves (including 8th nerve) |
| Oftentimes Brainstem affects multiple cranial nerves which may cause: | • Loss of taste • Facial Paralysis • Can't maintain lateral eye gaze • Analgesia |
| Gliomas | Tumor composing of neuroglia |
| Glia Cells | Supporting cells for neurons |
| Many different forms of Gliomas include: | • Astrocytomas • Ependymomas • Glioblastomas • Medulloblastomeas |
| Gliomas can indirectly impact what and how? | Auditory pathway through compressions and atrophying neurons of central auditory pathway |
| Multiple sclerosis (MS) | Demyelinating disease caused by an autoimmune reaction |
| With Multiple sclerosis, myelin sheath increases the speech of __________ | Neural transduction |
| With Multiple sclerosis, _______ show longer than _____________ | AEPs, normal latencies |
| In Multiple sclerosis, _____________ is typically bilateral | Sensorineural hearing loss |
| In Multiple sclerosis, _________ is typically poorer than expected for these patients | WRS |
| Auditory Processing Disorder in children, most disorders do ______ stem from known ______________ | Not, neuropathological conditions |
| Children typically "_______" Auditory processing disorder in __________ | "Outgrow," adulthood |
| Auditory Processing Disorder cases are unable to ______ or ___________ - leading to poor ability to communicate | Decode, process auditory signals efficiently or effectively |
| Individuals with Auditory Processing Disorder may have difficulty with? | • Understanding speech in noise • Dichotic Listening ability • Temporal processing of sound |
| Vestibular Neuritis | Infection / inflammation of the vestibular/auditory nerve |
| Vestibular Neuritis can be cause by? | Bacterial or viral infection |
| With Vestibular Neuritis, ____% report _______ before getting sick | 30%, common cold |
| ________ resulting from Vestibular neuritis can last ________, and can have long lasting damage to __________ | Vertigo, several days, vestibular nerve |
| Why does recovery from Vestibular Neuritis take months? | Central vestibular system has remarkable ability to self-compensate for damage |
| Tinnitus | Phantom auditory sensations |
| Subjective Tinnitus | Patient perceives sound in the absence of objective sound source |
| Objective Tinnitus | Patient perceives sound that is actually generated from other bodily function that cannot be heard by anyone else |
| Hyperacusis | Intolerance to moderately loud sounds |
| Pain Hyperacusis | Moderately loud sounds evoke physical pain |
| Loudness Hyperacusis | Moderately loud are perceived as louder than the typical LDL scores > 100 dB HL |
| Currently there is no definitively known cause or cure for _________ and ________ | Tinnitus and hyperacusis |
| ________ can persist even after ablation of auditory nerve | Tinnitus |
| How can Tinnitus persist even after ablation of auditory nerve? | Generated in Central Auditory System – Not cochlea |
| _______ medications have no scientific evidence of effectiveness | OTC |
| OTC medications have no scientific evidence of effectiveness, but works well as a? | Placebo |
| Central Gain Hypothesis | Spontaneous and sound-evoked activity in central auditory system is increased in patients with tinnitus and hyperacusis |
| Increase Spontaneous Activity is an indication of? | Tinnitus |
| Increased Sound Evoked Activity is an indication of? | Hyperacusis |
| What are treatments for Tinnitus/Hyperacusis? | Sound Therapy, Amplification, Counseling |
| Sound Therapy | Use of sound to aid in the management of annoying tinnitus or re-calibrate auditory systems tolerance to loudness |
| Sound Therapy includes: | • Interesting sounds • Engaging sounds • Noise |
| Amplification | Restoring normal range of hearing through sound amplification (i.e. hearing aids) and many times reduce tinnitus perception |
| As much as ______% of the adult population experience ___________ – only ______% seek help | 20%, chronic tinnitus, 2-3% |
| What does counseling demonstrate when it comes to chronic tinnitus? | There is an emotional reaction factor associated with tinnitus perception |
Created by:
RachelJClark
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