Internal Medicine

0521779407-09 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:12

Hearing Loss Helicobacter Pylori 665

differential diagnosis

■Audiologic evaluation should establish CHL, SNHL, or mixed hearing

loss when both are present.

■CHL: external auditory canal atresia, microtia, cerumen impaction,

tympanic membrane perforation, ossicular discontinuity, otoscle-

rosis, otitis media, trauma

■SNHL: cochlear hearing loss, vestibular schwannoma, trauma, mul-

tiple sclerosis, aging, ototoxicity

management

■Amplification with hearing aids for SNHL and CHL

■Cochlear implantation when HA are inadequate

■Ventilation tube for AOM or SOM

■Stapedectomy for otosclerosis will successfully restore hearing in

95%.

■Surgery or radiation therapy for tumors of the cerebellopontine angle

(eg vestibular schwannoma)

Side Effects

■Hearing aids, while making things louder, may not help with clarity

■Surgical risks are present with cochlear implantation, placement of

ventilation tubes or resection of cerebellopontine angle tumors

specific therapy

n/a

follow-up

■Audiological evaluation every 2 to 3 years once hearing loss has been

identified

■Hearing aid checks as necessary

complications and prognosis

■CHL: medical or surgical intervention usually corrects the underly-

ing problem or provides excellent rehabilitation

■SNHL: Hearing loss usually progresses at a variable rate. Hearing aids

may provide adequate rehabilitation.

Helicobacter Pylori...................................

M. BRIAN FENNERTY, MD

history & physical

Risk Factors for Infection

■Age (cohort effect):