耳聋与耳鸣的关系要点解析.ppt

耳聋听力图分析 耳的症状学 Ear semeiology 耳痛otalgia 耳漏Otorrhea 耳痒ear itch 耳鸣tinnitus 耳聋hearing loss 眩晕vertigo 面瘫 face paralysis 耳后肿胀 tumefaction 耳聋的分类 按耳聋病发的时间分类 antenatal pre- birth hearing loss inheritance 1.先天性耳聋：出生以前的耳聋 2.后天性耳聋：出生以后的耳聋 postnatal after birth hearing loss 耳聋的分类 按病发的部位分类 Hearing loss class according to inflammation part. 1.蜗前聋：传导性耳聋，外耳、中耳病变。 Pre-cochlea hearing loss: conductive hearing loss, external ear and middle ear have inflammation. 2.蜗性聋：感应性耳聋，耳蜗本身病变。 Cochlea hearing loss: sensorineural hearing loss,the cochlea has the inflammation. 3.蜗后聋：神经性耳聋，大脑听中枢病变。 Central Hearing loss: sensorineural hearing loss, nerve center is the morbid part. 耳聋的分类 传导性耳聋 Conductive hearing loss 正常听力图 The normal audiogram 频率 Frequency on the x-axis 声强 Intensity on the y-axis Frequency range: 125 - 8000 Hz Intensity range: -10 - 120 dB (air conduction) Example of Conductive hearing loss 传导性耳聋 Conductive hearing loss 1.骨导正常 Bone condition is normal. 2.气导下降 Air condition 3.气骨导差 10 dB A-B gap is more than 10 dB. 传导性耳聋的听损程度 传导性耳聋的听损程度 1.鼓膜穿孔。 ABG 30dB左右 2.鼓膜穿孔伴听骨链中断。ABG40dB左右 3.鼓膜和听骨完全缺如。 4.鼓膜完整伴听骨链中断。 ABG60dB 5.鼓膜完整+听骨链中断+卵圆窗封闭。 6.外耳道堵塞。 传导性耳聋的常见病变 耳部畸形 Ear malformations 耵聍栓塞 Impacted earwax 外耳湿疹 Acute otitis media 外耳道炎 Inflammation of the ear canal 外耳道塌陷 Dent of the ear canal 耳道扩大 Expand of the ear canal 异物eyewinker 常见的中耳疾病 化脓性中耳炎Suppurative otitis media 分泌性中耳炎Secretory otitis media 耳硬化症Otosclerosis 听骨链固定Fixation of the ossicular chain 　听骨链中断Interruption of the ossicular chain 鼓室硬化tympana sclerosis 感音神经性耳聋 Sensorineural loss Relationship of loudness and intensity level Frequency resolving ability Sensorineural hearing loss 1.气骨导都下降。 Air conductive decline 2.气导早期以高频下降为主，晚期低频也下降。 High frequency decline at first time, then both decline. 3.气骨导差 10 dB There is no a distance show between the bone condition and air condition. 感音神经性聋病因 老年性耳聋 噪声性耳聋 突发性耳聋 迷路炎Labyrinthitis 颞骨骨折 tempo