귀질환 DISEASES OF EAR

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귀질환 DISEASES OF EAR에 대한 보고서 자료입니다.

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cochlear and stapes
- deafness(conductive ) tinnitus paracusis willi
- schwartze sign in TM and carhart notch in audiogram
- stapes surgery for hearing impariment
5 REHABILITATION of DEAFNESS 난청의 재활
- early diagnosis of deafness is the key to successful auditory rehabilitation
- with early intensive auditory training most children develop the ability to communicate orally
- lip reading is adjunct to oral communication. sign language
- hearing aids
* limitation of HA
a) interfere with speech intelligibility in background noise
b) difficult or impossible in recruitment phenomenon patient
* recently, better signal processing( peak clipping, automatic volume control )
- more selectivity in the amplification and permit a better match - HL and HA
- cochlear implants
FACIAL NERVE PARALYSIS 안면신경마비
* Etiology of facial nerve paralysis
A) supranuclear and nuclear
- cerebral vascular lesions
- poliomyelitis
- cerebral tumor
B) infranuclear
- bell's palsy(idiopathic FNP) 40%
- traumatic(birth injury, temporal bone Fx) 20%
- tumor 12%
- suppuration(AOM, COM) 5%
- Ramsay-hunt syndrome ect.
* Diagnosis
- topographic region and degree of paralyis is important.
- Degree of paralysis
* House-Brackmann classicification of facial nerve dysfunction
* Classification of nerve injury
* Sunderlands classification in nerve fiber injury
* Test for topographic diagnosis
a) lacrimation test(schwimmers test)
b) stapedial reflex test
c) salivation test
d) taste of tongue
* Test for degree of nerve paralysis
a) maximal nerve excitability test(NTE)
b) electroneurography (ENoG)
C) electromyography
1) Bell's Palsy (Idiopathic Facial Paralyis) Bell's 마비
- edema of nerve in its vertical course, proximal to the stylomastoid foramen
- unknown etiology
Tx;
a) prednisolone orally or parenteral
b) corneal protection - eye oint or tarsorrhaphy
c) surgical - decompression
* Algorithm for evaluation and treatment of Bell's palsy
2) Temporal Bone Fracture 측두골 골절
- longitudial (about 80%), transverse (about 20%) and mixed fracture
- Sx of longitudinal fracture
a) hemotympanum
b) tearing of the TM
c) bleeding from the external ear canal
d) conductive hearing loss
e) facial paralysis in about 20% of pts
f) occasionally CSF leakage
g) Schueler's view
- Sx of transverse fracture
a) intact external ear canal
b) intact TM
c) SNHL or mixed type
d) vertigo and nystagmus to health
e) facial paralysis in about 50%
f) CSF leakage
g) Stenver's view
- easily diagnosed by checking temporal bone CT
- halo sign and beta-transferin test - checking of csf leakage
3) Paraganglioma(Glomus Tumor) 사구종
- most common tumor of the middle ear and second most common in temporal bone
- clear predilection to arise in female and present after 5ths decade of life
* Sx is variable depending on the site of origin and extent
a) unilaterl tinnitus synchronous with the pulse
b) unilteral hearing loss and feeling of pressure in the ear
c) disorder of balance
d) sign of low cranial nerve involved
- Treatment is surgery

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