AudiologyOnline Phone: 800-753-2160


Sonic Radiant - January 2021

Decreased Discrimination Following Trauma to the Head

Brian Perry, MD

November 11, 2002

Share:

Question

I saw a patient who was hit by a baseball on the left temple three months ago. Since the injury she has noticed difficulty hearing in background noise. There was no loss of consciousness at the time of the incident. Her doctor told her she just had superficial bruising and did not feel there was a concussion or skull fracture. No radiographic images were obtained. Pure tone, speech and immittance testing were all normal. OAEs were not as robust as I would have expected for the hearing (no threshold was worse than 10 dB) and emissions were 50% present in the right ear and 80% present in the left. Any suggestions for the cause of this and what further testing and management approaches to recommend?

Answer

Trauma to the head can cause a concussive injury to the labyrinth. Important questions to ask after such an injury probably should have included associated symptoms such as; tinnitus, fullness, pressure, fluctuations of hearing and dizziness. At this time, audiometric testing might include LDL's, HINT in noise, ABR and ECoG. These tests may reveal abnormalities which might help explain the current signs and symptoms the patient is experiencing.

It is quite likely this patient is experiencing a mild hydrops secondary to possible concussional injury and the patient might benefit from diuretic therapy.

Other key issues that should be addressed include the motivation of the patient. For example, as this was an injury, is she/he looking for compensation? It's unfortunately a good rule of thumb, to always be on the lookout for secondary gain when clinical signs, symptoms and history don't quite add up.

Bio.
Brian Perry, MD
Ear Medical Group, San Antonio Texas.
(210)-614-6070

Dr. Perry completed his residency in Otorhinolaryngology at Duke University, and a fellowship in Otology, Neurotology and Skull Base Surgery at The University of Iowa. He is currently in private practice in San Antonio, where he continues to publish on a variety of otologic topics.


Brian Perry, MD


Related Courses

Sudden Sensorineural Hearing Loss: Diagnosis and Treatment
Presented by Daniel Zeitler, MD, FACS
Recorded Webinar
AudiologyOnline

Presenter

Daniel Zeitler, MD, FACS
Course: #32026Level: Advanced1 Hour
  'Information was relevant'   Read Reviews
This course will review the background and epidemiology of sudden sensorineural hearing loss (SSNHL). Identifiable causes, evaluation, and medical treatment options will also be discussed during this one-hour course.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

20Q: Auditory Biotechnologies - Finding Their Way to the Clinic
Presented by Rebecca M. Lewis, AuD, PhD
Text/Transcript
AudiologyOnline

Presenter

Rebecca M. Lewis, AuD, PhD
Course: #38717Level: Intermediate1 Hour
  'engaged personal thoughts about potential options of regenerative therapies versus cochlear implant as I age and same thought for my clients too'   Read Reviews
This article details the latest developments in the field of auditory biotechnologies that aim to medically treat hearing loss using a series of different approaches. The biotechnologies described in this interview include both restorative and protective treatments, and some of the molecular and cellular mechanisms behind these treatments are described along with the most likely patient populations for early clinical trials. Finally, the current state of offerings for auditory biotechnologies is also reviewed, and readers are pointed to appropriate information to connect their patients to upcoming clinical trials.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Grand Rounds: Cases in Medical Audiology, presented in partnership with The Ohio State University
Presented by Gail Whitelaw, PhD, Abigail Smiles, AuD, Breanna Langenek, BA, Devan Lander, BS, Hailey Long, BA, Theodora Bowman, BA
Recorded Webinar
AudiologyOnline

Presenters

Gail Whitelaw, PhDAbigail Smiles, AuDBreanna Langenek, BADevan Lander, BSHailey Long, BATheodora Bowman, BA
Course: #38797Level: Advanced1.5 Hours
  'Enjoyable course'   Read Reviews
This course focuses on cases that incorporate aspects of medical audiology and considerations for audiologists providing patient care in this population.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Promoting the Audiology-Based Medical Management of Chronic Diseases
Presented by Kathy Dowd, AuD, Brian Taylor, AuD
Audio
Signia

Presenters

Kathy Dowd, AuDBrian Taylor, AuD
Course: #38113Level: Intermediate0.5 Hours
  'good info in easy format'   Read Reviews
Chronic diseases are medical conditions of long duration and slow progression. Chronic diseases are caused by a combination of genetic, physiological, environmental, and behavioral factors. They often result in significant activity limitations and participation restrictions and require ongoing medical attention. Although most chronic diseases are not curable, the impact of these chronic diseases can be reduced by medications and personal lifestyle improvement.

In this podcast, Kathy Dowd, AuD, of The Audiology Project, discusses the co-morbidities associated with hearing loss of adults onset and the importance of early identification.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Implementation of Cochlear Implants: Enhanced Candidacy Criteria and Technology Advances
Presented by J. Thomas Roland, MD Jr.
Recorded Webinar
AudiologyOnline

Presenter

J. Thomas Roland, MD Jr.
Course: #37377Level: Intermediate1 Hour
  'Although we do not do ABI at our clinic, this was extremely interesting to learn about'   Read Reviews
The participant in this course will understand the extended candidacy criteria with cochlear implantation and expectations. The course will cover implanting under age one, hybrid hearing with cochlear implantation, CI under local anesthesia, single-sided deafness, cochlear implantation, and auditory brainstem implantation.

View this Course for FREE.
Need CEUs? Become a AudiologyOnline member to get unlimited CEUs.

Only $129/yr

Learn More

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.