External ear
Wax (one of the commonest cause), fungus, otitis externa, foreign bodies, polyps, meningitis, stenosis, atresia, tumors.
Middle ear
- Congenital defects of the ear drum and ossicles.
- Traumatic: Barotrauma, rupture of the ear drum, haemotympanum, ossicular discontinuity, fracture of the base of sully.
- Inflammation: Acute otitis media, chronic otitis media, serous otits media,adhesive media.
- Tuberculosis and syphilitic otitis media re uncommon.
- Neoplasms are rare.
- Miscellaneous Otosclerosis.
- Eustachian catarrh (very common)
- Eustachian tube dysfunction due to diseases of the nose, paranasal sinuses and pharynx.
- Barotrauma.
- Sensori–neural Deafness
- Vascular: Spasm, thrombosis, embolism, hemorrhage.
- Trauma: Head injury, acoustic trauma, rupture of round window membrane.
- Infection: Viral labyrinthitis, mumps.
- Meniere’s disease.
- Ototoxicity.
- Central nervous system: Meningitis, encephalitis, vascular lesions, trauma.
- Functional.
Deafness can be mild, moderate, severe or the person may be stone deaf.
Diagnosis of early deafness
Severe deafness is easily detected by the patient or his relatives, but it may be difficult to detect mild hearing loss. A patient with very mild deafness or unilateral deafness may not be detected at all, but one should suspect deafness if:
- One has to request others to repeat their sentences often.
- There is difficulty in distinguishing words like ‘Twenty’ or ‘Thirty’.
- Ringing of telephone is missed often, while other person can hear it.
- The person is considered to be inattentive, or dose not answer if called from an adjoining room.
- A bright child tents to lag behind in studies, Hearing and vision of all children who are backward in studies, should be tested.
- Test of hearing: Voice test, watch test, tuning fork test, eudiometry.
- Caloric test.
- VDRL.
- Blood sugar.
- Serum cholesterol.
- Radiograph of skull for internal auditory meatus (Towne’s view).
- Check of blood pressure.
- Neurological examination and investigations.