Hearing Loss Diagnosis: Tonal Audiometry, Types, and Reversible Causes

The diagnosis of hearing loss is an essential process in otolaryngological clinical practice, as it allows for the identification and classification of different types of hearing loss. Tonal audiometry is a fundamental tool in this process, providing detailed information about the degree and type of hearing loss, whether sensorineural or conductive. Additionally, it is crucial to identify potentially reversible causes of hearing loss, such as an earwax plug, to offer appropriate treatment and improve the patient's quality of life.

Diving Deeper into Hearing Loss Diagnosis

Tonal audiometry is the gold standard for assessing auditory function. This test measures the patient's ability to hear sounds of different frequencies and volumes, allowing for the distinction between sensorineural and conductive hearing loss. Sensorineural hearing loss, which affects the inner ear or auditory nerve, can be caused by genetic factors, autoimmune diseases, or exposure to loud noises. On the other hand, conductive hearing loss is due to problems in the outer or middle ear, such as infections or the presence of an earwax plug.

There are various causes of hearing loss that can be reversible. For example, serous otitis media can induce hearing loss that improves with appropriate treatment, such as the placement of tympanostomy tubes and the use of antibiotics and steroids. Similarly, the use of certain medications, such as azathioprine, can cause reversible sensorineural hearing loss upon discontinuation of the drug.

Sudden sensorineural hearing loss can also be successfully treated if addressed in a timely manner, using therapies such as intratympanic steroids and prophylactic medications for migraines. Additionally, conditions like Hashimoto's thyroiditis can affect hearing, but with proper management, it is possible to mitigate its effects.

Conclusions

Accurate diagnosis of hearing loss is crucial for determining the most appropriate treatment and improving the auditory outcomes for the patient. Tonal audiometry, along with a thorough clinical evaluation, allows for the differentiation between sensorineural and conductive hearing loss and the detection of reversible causes. Identifying and treating these causes in a timely manner can prevent the progression of hearing loss and significantly enhance the quality of life for patients.

References

• [1] Pseudo-sudden deafness
• [2] Progressive, reversible sensorineural hearing loss caused by azathioprine
• [3] Treatment of Long-term Sudden Sensorineural Hearing Loss as an Otologic Migraine Phenomenon
• [4] Audiological evaluation (128-20,000Hz) in women with autoimmune thyroiditis: The role of antibodies vs. l-thyroxine deficiency

Created 6/1/2025