Hearing Loss, Fourth Edition

726 Pages·2005·24.5 MB·English

by  Joseph Sataloff

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Robert T. Sataloff
Jefferson Medical College, Thomas Jefferson University,
Philadelphia, Pennsylvania, U.S.A.
Graduate Hospital, Philadelphia, Pennsylvania, U.S.A.
Joseph Sataloff
Jefferson Medical College, Thomas Jefferson University,
Philadelphia, Pennsylvania, U.S.A.
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Preface
As noted in the prefaces to the first (1966), second (1980), and third (1993) editions of
Hearing Loss, this work is written for a broad audience. It includes introductory and
more advanced reference materials of value to otolaryngologists, general practitioners,
pediatricians, residents, medical students, audiologists, nurses, audiometric technicians,
attorneys, and other professionals with an interest in the ear and hearing. Although it
includes a great deal of information, an effort has been made to continue the tradition
of the first three editions by keeping the language “readable” not only for physicians,
butalsoforthosewithoutanextensivemedicalvocabulary.Therehavebeenmanyexcit-
ing new developments in the decade since the third edition was published. This revised
edition includes new material on cochlear biology, “new” causes of hearing loss such
as autoimmune inner ear disease, advances in audiometry and aural rehabilitation, and
many other areas. In addition, it contains expanded chapters on tinnitus, vertigo, and
facial paralysis, as well as new chapters on otoacoustic emissions, sudden hearing loss,
hearing protection devices, temporal bone tumors, neutraceutical research and hearing
in dogs. The book is extensively augmented with case reports that illustrate important
principles.
Chapter 1 provides a brief, succinct overview of hearing loss, emphasizing both
medical and societal considerations. Chapter 2 is an accessible review of aspects of the
physics of sound pertinent to clinical measurement of hearing and noise. It provides the
reader with an understanding of the decibel, hertz, weighting networks, and techniques
for calculating the effect of multiple noise sources. Chapter 3 introduces the anatomy
and physiology of hearing, and a basic classification of hearing loss. The following
chapter provides a comprehensive introduction to the history and physical examination
for patients with otologic complaints, including a list of questions to be asked when
taking a history.
Chapter 5 reviews the principles of and techniques for measuring hearing and it
includes a discussion of who should do audiometry. It also includes suggested subjects
tobecoveredintrainingprogramsforaudiometrictechniciansandhearingconservation-
ists.Inaddition,itprovidesinformationoncomputerizedaudiometry.Chapter6explains
the audiogram and its interpretation, including basic information about masking. This is
followed by a discussion of special hearing tests, which includes updated material from
the third edition. Chapter 8 is a new chapter on auditory evoked emissions, explaining
the nature of this phenomenon and its clinical applications. Chapter 9 offers an in-depth
overview of causes of conductive hearing loss and their management. Before providing
a similar overview for sensorineural hearing loss, Chapter 10 includes an updated
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iv Preface
summary ofthe latest, basic concepts incochlear biology helpful for understandingsen-
sorineuralhearingloss.Chapter11isanewchapterthatdiscussesthecomplexproblemof
sudden sensorineural hearing loss and controversies in its management. Chapter 12 pre-
sents the problems of mixed, central, and functional hearing loss, including information
on auditory processing disorders.
Chapter 13 provides updates to the unique chapter on systemic causes of hearing
loss. This chapter summarizes not only the most common and important hereditary
causes of hearing impairment, but also many of the non-syndromic systemic causes of
sensorineural hearing and syndromic loss, including hypertension, diabetes, syphilis,
andmanyotherconditions.Chapter14reviewsthedifficultiesandcomplexitiesassociated
withestablishinganaccuratediagnosisofoccupationalhearingloss.Itsummarizesperti-
nentliteratureonthissubjectandincludesareviewofthecriteriarecentlyestablishedby
theAmericanOccupationalMedicineAssociation.Chapter15discussesmanyimportant
common causes of hearing problems in children, the special consequences of hearing
impairment inpediatric patients, and important treatment considerations.
Chapter16hasbeenrevisedsubstantially,particularlyregardinghearingaids.Infor-
mation about the latest concepts in amplification has been added, as well as information
about cochlear implants. Chapter 17 is a new chapter that reviews practical information
about hearing protection devices, a topic of concern to many patients. Chapter 18
reviewsthe problems oftinnitus, aconditionoftenassociated with hearing loss.Chapter
19 provides an expanded review of the problems associated with balance disorders and
moderntechniquesofevaluation,includingposturography.Chapter20hasbeenexpanded
tocoverdiagnosisandmanagementoffacialparalysisinconsiderablygreaterdetailthan
was provided in the third edition. This condition may be associated with hearing loss,
especially following trauma or tumor. The next five chapters are all new to this edition.
Chapters 21 and 22 provide in-depth overviews of malignancies of the temporal bone,
includingsquamouscellcarcinomaandsarcomas.Chapter23discussesresearchonneutra-
ceutical modulation of Glutathione, which affects the Cytokine system (among other
things),andwhichmayplayaroleinfuturehearingresearch.Chapter24isabriefbutfas-
cinatingdiscussionofhearingindogs,atopicaboutwhichevenmanyhearingexpertshave
misconceptions.Thefinalchapteriscomposedoftablessummarizingthedifferentialdiag-
nosisofhearingconditions.Itisespeciallyvaluableforquickreview.Thisbookalsocon-
tainsfourappendices,allofwhicharenewtothisedition.Theyprovideoutlinesummaries
ofmoredetailedinformationaboutanatomyoftheear;pathologyoftheear;otosclerosis,
Paget’sdiseaseandosteogenesisimperfecta;andneurofibromatosis.Theyareintendedto
provide in “easy reference” fashion, more detailed information on these subjects than
wasconsideredappropriateforthebodyofthetext.Wehopethattheywillproveparticu-
larlyusefulforstudentsandresidents.
WearedeeplyindebtedtoMaryHawkshaw,R.N., B.S.N.,CORLN,ourindefatig-
ablecolleagueandeditorialassistant;CarenSokolowandTracyVirag,twoofouraudiol-
ogists whose contributions to this book have been extremely helpful; and Helen Caputo
and Beth Luby for their expertandtireless efforts inpreparation ofthe manuscript.
RobertT. Sataloff
JosephSataloff
Contents
Preface .. . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . iii
Contributors . . . .. . . .. . . .. . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . ix
1. Hearing Loss: An Overview . . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 1
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2. ThePhysicsof Sound . .. . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 3
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3. TheNature ofHearingLoss . . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 19
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4. TheOtologic Historyand Physical Examination . .. . .. . . .. . . .. . . .. . .. . 29
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5. Classification and Measurement ofHearingLoss .. . .. . . .. . . .. . . .. . .. . 47
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6. TheAudiogram . . .. . . .. . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 71
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7. Special HearingTests . .. . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 91
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8. Auditory-Evoked Phenomena:Theory and
Clinical Applications . . .. . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 119
Mark T. Agrama, Robert T. Sataloffand Thomas O.Willcox
9. Conductive Hearing Loss . .. . . .. . . .. . . .. . . .. . .. . . .. . . .. . . .. . .. . 129
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10. SensorineuralHearing Loss: DiagnosticCriteria . .. . .. . . .. . . .. . . .. . .. . 195
Robert T. Sataloffand Joseph Sataloff
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