1/3. Screening and management of adult hearing loss in primary care: clinical applications.hearing loss is one of the most common chronic health conditions and has important implications for patient quality of life. However, hearing loss is substantially underdetected and undertreated. We present clinical cases to illustrate common situations in which primary care physicians may be called on to identify or to manage hearing loss. With the data reported in the companion scientific review as a guide, we present potential answers to important questions pertaining to hearing loss and suggest ways in which primary care physicians can improve the detection, evaluation, and treatment of hearing loss. The cases focus on screening for chronic hearing loss, evaluation of hearing loss, and treatment of patients with presbycusis.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/3. tinnitus in childhood.All of 1,420 children seen for clarification of a hearing disorder or to follow up for known difficulty in hearing were questioned as to whether they experienced tinnitus. The interview was carried out after a hearing test was conducted, which was based on play audiometry or normal pure-tone threshold audiometry, depending on the age of the child. When being interviewed, 102 children reported that tinnitus had appeared or was still present. Seventy-five children (73.5%) demonstrated difficulty in hearing in one or both ears, whereas 27 children (26.5%) had normal hearing in both ears. The most frequently obtained information (29.4%) was the progression of an existing hearing loss. meningitis is an important cause of hearing loss and of tinnitus and could be identified in 20% of our patients. We also considered as a cause of tinnitus skull or brain trauma, acute hearing loss, and stapes surgery. However, the mechanisms of tinnitus development were not immediately clear in a large proportion of the children studied: Problems included central sensory perception (14.7%) and emotional factors (11.8%). No additional information that might lead to an understanding of the hearing loss was available for 14.7% of the patients studied. tinnitus is a frequent symptom in childhood and, because children seldom complain about their tinnitus, such hearing problems that they report must always be taken seriously. The diagnosis should exclude metabolic disturbances, possible damage to the sensory level of the central nervous system, and circulatory disturbances. In addition, the physician should always consider emotional problems and disturbances of perception.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |
3/3. Neurofibromatosis type I--a rare case resulting in conductive hearing loss.Notwithstanding the many similarities, there are important differences between NF1 and NF2. NF1-related neurofibromas, which can number in the hundreds, can occur all over the body. Unique clinical situations, such as the case described here, can occur that test the ingenuity of the physician. Once the presenting problem has been ameliorated, genetic counseling is imperative in this common and at times devastating genetic disease.- - - - - - - - - - ranking = 0.5keywords = physician (Clic here for more details about this article) |