* Incidence in the general population is unknown

* Does not inherit

• Diagnosis

  • Routine otoscopy

  • Small perforation -> otomicroscopy

  • Hearing status -> middle ear impedance testing
    

• Before repair/treatment attempts, perform audiometry

• Treatment

  • Most perforations can heal by itself within weeks

    • May prescribe antibiotic drops

    • Avoid eardrops that may bring ototoxicity risk

    • Avoid water and excessive pressure (blowing nose hard)

  • Surgical -> applying a paper patch

    • May perform repeatedly before full heal

  • Surgical -> tympanoplasty

    • Grafts a bit of your own tissue to patch and close the hole in your eardrum

• Prognosis

  • Typically have great prognosis based on being able to self heal and recover most of the time

• Results from congestion and swelling

  • Nasal passages

  • Throat

  • Eustachian tubes

    • Swollen eustachian tube blocks and lead to mucus build up

    • Mucus can become infected

    • Impede movement of the eardrum and ossicles

• Leads to a perforation in the eardrum

  • Tympanic Membrane Perforation

• Most common amongst children (70% younger than age 6)

  • The eustachian tube are more narrow, horizontal, and floppier than adults -> difficult to drain (smaller opening), more likely to clog

  • Have larger adenoids than adults -> when swollen, easier to block the eustachian tube

  • Immature immune systems

  • Most common during Fall and Winter

  • More often among boys

• Types of Chronic Otitis Media

1. Non-infected chronic otitis media

Hole in the eardrum, no infection, keep dry, treatments only needed to improve hearing and prevent infection

2. Suppurative (filled with pus) chronic otitis media

Hole in the eardrum, infection in the middle ear, purulent fluid, treatment through antibiotics

3. Chronic otitis media with cholesteatoma

Hole in the eardrum lead to cholesteatoma (buildup of skin cells and debris)

• Inheritance pattern

  • More common among Alaska Natives

  • Those with cleft palates (harder to drain eustachian tube)

  • Those with Down Syndrome are at greater risk

• Complications

  • Communication ability

  • Language learning

  • Auditory process disorders or learning disabilities

    • For young children, Chronic OM disrupts auditory input during critical language learning and auditory development periods

  • Cholesteatoma -> abnormal collection of skin cells that can lead to hearing loss and ear infections without treatment

  
  

• Diagnosis

  • Listening to the symptoms

  • Pneumatic otoscope -> check the ear and determine if there is fluid behind the eardrum or any tears

  • Other tests to determine the fluid or for bacteria and viruses

    • Tympanometry

    • Acoustic reflectometry

    • Tympanocentesis

Treatments 

• Chronic otitis media with tympanic membrane perforation

  • A chronic ear infection that results in perforation in the eardrum

    • Tympanic Membrane Perforation

    • Healing the eardrum

  • Would need the fluids out through the ear canal

  • Can be treated with antibiotics with drops as the medium

    • fluoroquinolone antibiotic solution, such as ciprofloxacin

  • Typically does not need surgery

    • Cholesteatoma requires surgery

    • Persistent eardrum perforation requires surgery

• Ear tubes

  • For infections that are consistent and recurring with thick fluids (chronic otitis media)

  • Myringotomy

    • Creates a tiny hole in the eardrum to help fluid out of middle ear into ear canal

  • Tympanostomy tube/Pressure Equalization tube

    • Tiny tube placed in the myringotomy opening or perforation (two types of tubes)

    • Help ventilate middle ear into the ear canal and prevent more fluid build ups

    • Stays for typically six months (four to 18 months) and fall out itself

    • Even longer stays will be surgically removed

    • Risk of building up wax and potentially begin new infection

Prognosis

• With treatment, prognosis typically are great

• Infections usually goes away after therapy

• Depending on the damage from the ear infection and how well the ear heals can affect the degree of hearing skills

presbycusis

• age-related hearing loss

• affects the ability to hear high-frequency sounds

  • ex: voiceless consonants

causes (has external and internal factors)

• changes or loss of functions in the inner ear (typical) or middle ear

• most common factor is age

• genetic -> found specifically in mitochondrial DNA related to oxidative stress

• built up extreme noise exposure throughout the years (noise-induced cochlear damage); can also damage and lead to the loss of spiral ganglion neurons

• hormones

incidence

• one in 3 adults over age 65 has presbycusis/hearing loss

inheritance

• those with a family history of presbycusis have a higher chance of inheriting it

six types of presbycusis

1. Sensory

   • loss of receptor hair cells

2. Neural

   • loss of cochlear nerve fibers and spiral ganglion neurons

3. Strial

   • loss of spiral ganglion neurons

4. Mechanical (cochlear conductive)

   • physical changes of the cochlear duct

5. Mixed

   • has changes or loss in more than one of the structures in the inner ear

6. Indeterminate

   • the changes or losses are not too significant

diagnosis

• normal physical examination -> use an otoscope to check the eardrum and outer ear

• hearing tests (pure tone test) to test hearing loss severity

• the different types of presbycusis can help providers understand how it will affect daily life

treatment

• not curing the disorder, but hearing aids help amplify sounds to the ear

• to prevent further hearing loss

  • wear earplugs, turn down the volume, or physically leave loud environments

  • stop smoking

  • overall health can be linked to presbycusis so keeping a healthy body is important

prognosis

• since there is no true cure to restore hearing loss, most people can get through their lives with hearing aids

• Otalgia

• Tinnitus

• Vertigo

• Aural Fullness

• Hyperacusis

Types of hearing loss

• Conductive Hearing Loss

• Sensorineural Hearing Loss

• Mixed Hearing Loss

Outer ear disorders

• microtia

• ear canal

  • Atresia: closure or absence of canal

  • Stenosis: narrowing of canal

  • Exostosis: benign growths in canal

  • Foreign bodies + impacted cerumen

  • Otitis Externa: infection and or inflammation in the skin of
    the ear canal

Middle ear disorders (conductive hearing loss)

• Perforated Tympanic Membrane

• Tympanosclerosis Eustachian Tube Dysfunction

• Glomus Tumor

• Otitis Media

• Cholesteatoma Ossicular

• Discontinuity Otosclerosis

• characteristics

  • Disorders of the outer
    and middle ear result
    in conductive hearing
    loss

  • Usually mild to
    moderate degree of
    hearing loss

  • Loss of loudness due to
    blockage in the
    conductive mechanism

  • Treatment of CHL can
    be medical or surgical

  • If medical or surgical
    intervention fail to
    restore hearing audiologic treatment (amplification)

  • Loss of loudness, not
    clarity

Inner ear cochlea disorders (sensorineural hearing loss)

• Congenital SNHL

• Inheritance of Non-
  Syndromic Hearing Loss

• Non Syndromic Congenital SNHL

  • Connexin 26

  • Enlarged Vestibular Aqueduct

  • Mondini Malformation

  • Auditory Neuropathy Spectrum Disorder (ANSD)

• syndromes associated

  • Autosomal Recessive Transmission

    • Usher Syndrome

    • Jervell and Lange-Nielsen Syndrome

    • Pendred Syndrome

  • X-linked or Autosomal
    Dominance Transmission

    • Alport’s Syndrome

    • Branchio-oto-renal (BOR) syndrome

    • Treacher Collins Syndrome

    • Waardenburg Syndrome

• Presbycusis

• Noise Induced Hearing Loss (NIHL)

• Ototoxicity

• Meningitis

• Meniere’s Disease

• Acoustic Neuroma

Interpretation:

Audiogram #1 indicates that the patient has a moderate to moderately severe bilateral conductive hearing loss, the air-conduction test are shown tested on both ears and the unmasked bone-conduction test was tested on the right ear. At 500 Hz, the significant air bone gap of the right ear is 60 dB, showing that it is a conductive hearing loss. The speech reception thresholds are 50 dB on the right ear and 50 dB on the left ear. The right ear aligns with the type and degree of the patient’s hearing loss, but the left ear has a larger gap than 5 dB. The pure tone average of 55dB is consistent with both speech reception thresholds and the flat type B tympanometry refers back to the conductive hearing loss.

Interpretation:
Autdiogram 3 indicates that the patient has a bilateral mild to severe cookie bite sensorineural hearing loss, the air-conduction test were are shown tested on both ears and the unmasked bone-conduction test was tested on the right ear. There is no air-bone gap seen, showing that it is a sensorineural hearing loss. The speech awareness thresholds (SAT) are 50 dB for the right ear and 45 dB for the left ear, comparing the SAT with the pure tone average (63.3 db for both ears), the air conduction audiometry difference are larger than 13 dB and is inconsistent. There are reflexes in the middle ear for both ears for all frequencies tested. The type A tympanograms are consistent with the type of hearing loss.

/a/, /i/, /u/, /sh/, /s/, /m/

• It discusses what each symbol means and what it represents in the table

• how the air-bone gap and pure tone average represent the represents the type of hearing loss

• bilateral or unilateral

• air conduction test or bone conduction test

• masked or unmasked

types

• conductive hearing loss

  • the middle and outer ear

• sensorineural hearing loss

  • inner ear - cochlea

• mixed hearing loss

  • combination of conductive and sensorineural hearing loss

• A listening hoop, stethoscope

• A battery tester

• Extra batteries

• An air blower, soft cloth, or brush

check the hearing aid:

1. Examine and check the hearing aid, tubing, and earmold if there is any damage, debris, cracks, or blockages

2. Use the battery tester to make sure battery is charged (if not, replace it with extra batteries)

3. Using the stethoscope, which attaches to the earmold or hearing aid tone hook so you can listen to the amplified sound, and check with the Ling 6 Test sounds (/a/, /i/, /u/, /sh/, /s/, /m/), additional phonemes, Spondee words, connected speech questions

4. Adjust volume control and make sure the device is responding

5. Clean the device with what you have (air blower, soft cloth, brush)

• microphone and processor

• amplifier

• power source (battery)

• telecoil (maybe)

External

• buttons and switches

• wire

• receiver or speaker

• dome (maybe)

• earmold (maybe)

• tubing

If the hearing aid is weak or dead (no sound)
• Battery or Battery Contact Problems
• Blocked Tubing (Wax)
• Blocked Tone Hook
• Microphone

Does it produce weird sounds

• Distortion, Intermittence, or Static
  • Receiver or Circuit Problems

Does it have feedback issues
• Tubing Problems
• Earmold Fit

Internal Feedback

• Check for extra wax in the ear

If the feedback is normal (the hearing aid is off the ear and cupped in hand or when the child is inserting or removing the aid without turning the aid off)

For children: earmold needs to be changed frequently since they're growing (every 4-6 months)

Tips:

• with a dry cloth or tissue, clean the device daily

• with brush and wax loop, clean the earmold

• holding the microphone ports upside down, clean it with a brush

• for every 3 months, change the mic covers

• leave the battery door open overnight

• keep the hearing aid dry and away from moisture

Oticon Intent

2. Phonak

The Belong™

3. ReSound

ReSound ENZO Q™

4. Widex

Widex BEYOND™

5. Starkey

Halo iQ™ and Halo 2™

6. Signia (Siemens)

Pure 10 Nx and Pure Charge&Go

7. Unitron

Stride M R, Moxi Fit R, and Moxi All R

Nucleus 8 Sound Processor

2. Advanced Bionics

Marvel CI

3. MED-EL

SONNET 2 audio processor

• Microphone

• Sound Processor

• Transmitter Coil

Internal:

• Receiver/Stimulator

• Electrode Array

• BAHA

  • Baha 6 Max

  • Baha 5

  • Baha 5 Power

  • Baha 5 Super Power

• Osia

2. Oticon

Medical Ponto

3. MED-EL

• Med El Bonebridge

• Med El Adhear

If the child does not respond to sounds during listening checks

• Communication as much as possible

• check the battery status

• if the unit is turned on

• try turning the processor off and then on

• check if the indicator lights or visual display on the processor is working

• is the processor on the correct program and setting

• are all cables and cords at the right place plugged into the processor (are any of them twisted, frayed, or broken)

• using the device-specific monitor earphones or listening check device, verify the mic function

• If the child is wearing bilateral processors, use the
  other cable, battery pack to troubleshoot

1. Use the Test Rod that is free from Cochlear

2. Snap processor in

3. Plug your ears as best as possible

4. Ask someone to speak

5. You can test the FM / Roger using the same procedures

• Founded in 1967 as a parent-helping-parent organization

• Provide state and local resources for Deaf children

• Provide info across age groups and resources for navigating IEP process

• Online classes to learn ASL (not free)

• Annual family conferences, July/October

• Provide free online ASL practice with a Deaf adult called SignOn with ASDC, also helps parents learn about Deaf culture

• Support groups for Latinx families, ASL classes in Spanish

• ASL Stories Directory- dozens of videos of picture books told in ASL

_{thank you Natasha Castro}

• Focused on the right for Deaf community to use ASL and to empower the interests of the community at the national level through legal advocacy

_{thank you Natasha Castro}

_{thank you Natasha Castro}

• In-person and online tour of the museum

• Explicitly lists out group activities/programs specifically for the Deaf/Hard of Hearing community

  • Many museums provide services and events but requires requests

    • Metropolitan Museum of Art

      • Pros: Programs with American Sign Language interpretation and with real-time captioning

      • Cons: does not accommodate groups; ASL interpreters must be requested at least two weeks’ notice

• Art-making events for

  • Families in the ASL community with children ages 5 – 12 

  • ASL Teen community

• Provides classes and workshops

  • All 5 boroughs

  • Offers more than 93,000 programs annually, serving everyone from toddlers to teens to seniors

• Offers programs related to science, math, literacy, social studies, specials + domains of early childhood development

  • STEAM experiments - Core content + Specials + motor skills + cognitive + language + socioemotional

  • Arts & Crafts - Specials + motor skills

• Upon request, the library provides

  • ASL interpretation and CART real-time captioning service

  • Assistive Listening Devices

  • Hearing Loops

• Deaf/ASL Events in NYC/Long Island area

  • Facebook group

  • Cinemart Cinemas

    • Free open-caption screening for movies

Live Updates on Events Supporting Deaf/Hard of Hearing

• Events updated constantly for up to three months

  • Work opportunities

  • Museum tours

  • Meet and greets with authors

  • Performances

  • Guest speaker seminar

• Includes events related to core content, specials, and the domains of early childhood development

• Accommodations front of house staff and other theatre employees can make

  • Wearing clear masks for lip reading + facial expressions

  • Open to multiple forms of communication -> writing, typing, physical gestures

• Audio described performances

• ASL Interpreted performances

  • More and more shows are including this service

• Closed-captioning devices and apps (free)

  • Still new and not all theaters have this

• Open-caption performances

• Audio Descriptive Technologies (free)

  • Rare but is advocating

• Casting-call opportunities for aspiring actors/actresses

• Other performances -> ASL poetry slam

Advocates for 

• Learning ASL

• Elevating deaf voices 

• Interpreter training, programs, deaf studies or ASL courses at HBCUs

• The important of making eye contact when having a conversation

• Not seeing deafness as a deficit 

• Inclusion of Black people in the deaf community and recognition of BASL

• Accessibility in TikTok videos and other apps 

1. Lumity platform

2. Paradise platform

3. Marvel platform

4. Lyric

5. Terra

6. Apps

7. Accessories

8. Wireless Microphones

Most of those products have links to official videos, phone compatibility checkers, and troubleshooting. I recommend troubleshooting through the website since the company has many generations of devices and products. Each product has special features and a designated troubleshooting guide.

1. Instructions For Use

2. Technical Data

3. Product Information

4. White Papers and Publications

5. Consumer Materials

6. Video instructions (that do not include audio)

Users can also find:

• How to videos

• Clinical support

  • Clinical Support: Auditory Disorders & Syndromes

• Family Support Materials

• Patient Education

• Government services

Their most current tech is:

Oticon Intent

1. Distorted sound

"What could be the cause?

1. Dirty or corroded battery contacts

2. Dirty or corroded battery

3. Hearing aid is switched to telecoil

What’s the solution?

1. Open and close the battery compartment several times

2. Clean battery surfaces with a dry cloth or replace the battery

3. Switch to an acoustic listening program, e.g., Program 1."

2. No sound

"What could be the cause?

1. Dead battery

2. Clogged sound outlet

3. Clogged microphone opening

What’s the solution?

1. Replace the battery

2. Clean the sound outlet or change the wax filter

3. Clean microphone opening"

3. Whistling or howling sound

"What could be the cause?

1. Ear wax

2. The hearing aid is not inserted properly

What’s the solution?

1. Get your ear canal checked by a doctor

2. Remove and insert your hearing aid again"

"If none of these suggested solutions solves your problem, please consult your hearing care professional." Users will have the option to find a professional around them using the website.