Conductive hearing loss is seen in all EXCEPT:
Correct Answer: Presbycusis
Description: (Presbycusis): Ref: 38-43-D (30-33-D 4th)Conductive hearing lossSenorineural hearing lossCharacteristicsCharacteristics1. Negative Rinne test ie BC > AC1. A positive Rinne test ie air AC > BC2. Weber Lateralized to the poorer ear2. Weber lateralized to better ear3. Normal absolute bone conduction3. Bone conduction reduced in schwarbach and absolute bone conduction tests4. Low frequency affected more5. Audiometry shows bone conduction better than air conduction with air- bone gap: Greater the air bone gap, more is the conductive loss4. More often involving high frequencies5. No gap between air and bone conduction curve on audiometry6. Loss may exceed 60dB6. Loss is not more than 60dB7. Speech discrimination is poor7. Speech discrimination is good8. There is difficultly in hearing in the presence of noiseCauses - Any disease which interferes with the conduction of sound to reach cochlea causes conductive hearing loss. The lesion may lie in the external ear and tympanic membrane, middle ear or ossicles up to stapediovestibular jointCausesCongenital - anomaly of the inner ear or damage to the hearing apparatous by parenteral or perinatal factorsAcquired1. Infections of labyrinth - viral, bacterial or spirochaetal2. Trauma to labyrinth or VIII nerve eg fracture of temporal bone or concussion of labyrinth or ear surgery3. Noise induced hearing loss4. Ototoxic drugs5. Presbycusis6. Meniere's disease7. Acoustic neuroma8. Sudden hearing loss9. Familial progressive10. Systemic disorders eg DM, hypothyroidism, kidney disease, autoimmune disease, multiple sclerosis, blood dyscrasiasCongenital causes* Meatal atresia* Fixation of stapes footplate* Fixation of malleus head* Ossicular discontinuity* Congenital cholesteafoma
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