Week # 2

This week in clinic I saw a young adult who came in for an annual hearing evaluation as part of the WVU Hearing Conservation Program. The patient informed me that he had a mastioodectomy at the age of 6. He wore an in-he-ear hearing aid in the right ear. He also mentioned that he visited his primary care physician about twice a year for check-ups and to remove debris from the middle ear space.

Immittance testing revealed a large canal volumne in the right ear which is to be expected. The left ear resulted in a normal, Type A tympanogram. Next, puretone audiometry was performed. His audiogram results were hearing withing the normal limits for the left ear. The right ear had hearing within the normal limits up to ~2000 Hz, then a sharp drop to a moderate hearing loss at 6000 Hz, and then rising again to normal at 8000 Hz. This unilateral hearing loss would have raised a red flag if the mastoidectomy had not been discussed.

This article discussing hearing loss after middle ear recontruction. The research took place over a 9 yar period of 118 ears. The average preoperative and postoperative PTA were 61.3 dB and 49.5 dB. Some ears showed no change, and others showed a deterioration in hearing loss. If a raidcal mastiodectomy was performed (the removel of all ossicles), severe hearing loss resulted.

http://web.ebscohost.com/ehost/detail?vid=8&hid=108&sid=14480891-dba2-41fb-90a8-4dea5533e3aa%40sessionmgr106