Chapter 23: Auditory Problems: Assessment & Management

Students learn to distinguish between conductive hearing loss resulting from mechanical obstruction or damage, sensorineural hearing loss caused by inner ear or neural pathway dysfunction, mixed hearing loss combining both types, and central auditory processing disorders. The chapter emphasizes presbycusis as the predominant age-related hearing impairment affecting older adults. Assessment methodologies include comprehensive subjective evaluation covering infection history, trauma exposure, ototoxic medication use, family predisposition, and occupational noise hazards, complemented by objective examination techniques such as otoscopic inspection, Weber and Rinne tuning fork tests, audiometric testing, tympanometry, and electronystagmography. Clinical conditions addressed encompass external otitis management through topical antimicrobial therapy, cerumen impaction removal procedures, otitis media treatment approaches including myringotomy and tympanoplasty techniques, otosclerosis intervention through stapedectomy surgery, Ménière disease management involving dietary sodium restriction and vestibular rehabilitation, benign paroxysmal positional vertigo treatment using canalith repositioning maneuvers, and acoustic neuroma surgical resection. Therapeutic interventions span hearing aid selection and fitting, cochlear implant candidacy evaluation, assistive listening device implementation, communication enhancement strategies, and health promotion activities focused on noise exposure prevention and ototoxic substance monitoring to preserve auditory function across diverse patient populations.