1、Disease of inner earCategory Ototoxic deafnessInfected deafnessSudden deafnessAutoimmune inner ear diseasePresbycusisOtotoxic deafness Definition & common drug Pathomechanism Clinical manifestation TherapyOtotoxic deafnessDefinition & common drugDefinition: a deafness cause by certains drugs who dam
2、age to auditory receptor or auditory pathway, or by long-term exposure of certains chemical drugsCommon drug： Aminoglycosides： streptomycin, kanamycin, gentamicin, micronomicin, adriamycin Antimalarials ： quinine, chloroquine Antitumor drug ： vincristine, nitroimidazole, cis- diamminedichloroplatin
3、Salicylic acids Loop diuretic：Etacrynic Acid Heavy metals Thalidomide Chemical materials, alcohol，mist tobaccoOtotoxic deafnessPathomechanismRoute of intoxication： General / Local application systemic circulationinner ear /auditory pathways CSF/fenestrated membrane inner ear /auditory pathways place
4、nta foetusMechanism：aminoglycosides Drugshair cells membrane structuremembrane protein and phospholipids proteindestroy membrane permeability Na+ influx destroy mitochondrion metabolic disorder cellular degeneration and necrosisMetabolic pathway：Kidney metabolismOtotoxic deafnessClinical manifestati
5、onBilateral hearing loss damage to high frequency firstlyTinnitus, vestibular function decrease, vertigo, instability of gaitDelay onset: aminoglycoside antibioticsCompensated vestibular symptomOtotoxic deafnessTherapy Prevention：observation-early diagnosis early treatment early drug discontinuance
6、Therapeutic principle ： Neurotrophic and hair cells drug: traditional Chinese medicine？ Improve microcirculation Calcium Neurotrophic factors Cellulose Microelement Glucocorticoid Hearing aid or cochlear implant Infected deafness Definition: deafness was resulted from auditory nerve system affected
7、by pathogenic microorganism, including bacterial, virus, rickettsia, protozoan, etc. but eliminating otitis media or secondary labyrinthitis. Typing：according to infected time: congenital, acquired according to pathogenic microorganism: bacterial, virus, rickettsia according to pathogenetic conditio
8、n: varying degree of deafnessInfected deafnessRubellaSource of infection：Rubella virusIncidence：the most frequent deafness in pregnancy infection65 years oldlEtiology: Ambient noise and enviromental pollution Internal environment modification Degeneration of auditory system Cochlear mitochondrial DN
9、A modification Mechanical reason Genetic factorPresbycusisPathologylExternal earlMiddle earlInner earbasilar membrane thickening, calcification, hyaline degenerationinner and outer hair cells atrophy, supporting cell reductionspiral ligament of cochlea and stria vascularis atrophyspiral ganglion cel
10、l and cochlear nerve fibre degenerationlAcoustic centerPresbycusisClassificationlSensory presbycusislNeural presbycusislMetabolic presbycusislMechanical presbycusisAIED Clinical manifestation Insidious, progressive, lente, bilateral hearing loss Tinnitus Examination Otoscope Pure tone test Suprathre
11、shold auditory function test Otoacoustic emissions Speech audiometry Diagnosis and differential diagnosis: aged 60 years old, bilateral progressive hearing loss, eliminate noisy, ototoxic deafness, meniere disease, cochlear otosclerosis, acoustic neuroma, AIED Therapy: Hearing aids, cochlear implantThanks for your attention
