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1、CliniCalConsultationSymptom:UnilateralHearingLossByHamidR.Djalilian,MD6-year-oldpatienthashadhearinglossononeside1252505001K2K4K8Ksincebirth,failingnewbornhearingscreeningon–107501.5K3K6Ktherightsideandpassingontheleft,thepatient’s0Amothersaid.Thechildhadnoissuesinspeechand10langua
2、gedevelopment,sothemotherdidnotfollowupfur-20ther.30Thepatientnowistostartschool,however,andarecent40hearingscreeningrevealedanearmaximumconductive50hearinglossontherightside,withnormalhearingonthe60left.70Theexaminationofthechildshowsaverynarrowearcanalimpactedwithcerumen.Thecanal
3、appearsasaslitfilledwith80debris.90100HearingLeveldB-ANSIS3.6-2004Whatisyourdiagnosis?Seep.16.110120Frequency–Hzaudstudent.comDr.DjalilianisdirectorofneurotologyandskullbasesurgeryandassociateprofessorofotolaryngologyandbiomedicalengineeringattheUniversityThisistheaudiogramforour6-
4、year-oldpatient,whohasofCalifornia,Irvine.hadunilateralhearinglosssincebirth.4/23/1511:05PM14TheHearingJournalJune2015CliniCalConsultationDiagnosis:CongenitalStenosisoftheExternalAuditoryCanalByHamidR.Djalilian,MDContinuedfromp.14nachild,unilateralhearinglosscancausedifficultiesins
5、choolperformance.Theconditionleadstoproblemswithspeechunderstandinginnoisyenvironments,suchIasclassroomdiscussions,aswellaslocalizationofsound.Consequently,theidentificationandmanagementofpatientswithunilateralhearinglossisofsignificantimpor-tance.Mostcommonly,unilateralconductiveh
6、earinglossinchil-drenisduetomiddleeareffusionafteranupperrespiratorytractinfectionoracuteotitismedia.However,significantcon-ductivehearingloss(greaterthana30-dbair-bonegapinthepure-toneaverage)wouldberarefromjustmiddleeareffu-sion.Therefore,inthepresenceofsignificantconductiveheari
7、ngloss,furtherfollow-upisnecessarytoevaluatehear-ingafterresolutionofthemiddleeareffusion.Largeconductivehearinglossisseeninchildrenwithos-sicularfixation,densecerumenimpaction,tympanicmem-ThisaxialCTofthetemporalbonesshowsaverynarrowbraneperforation,congenitalatresiaoftheearcanal,
8、andearcanalfilledwithdebri
