functional deafness
Introduction
Introduction to functionality Functional deafness refers to a pseudo-auditory disorder without organic disease, or non-organic deafness. Can be divided into two categories, one is mental factors or neurosis, rickets, etc. caused by mental paralysis, also known as rickets, and the other is a fake for some reason, also known as bluff. Functional sputum can also occur on the basis of the original mild organic disease, but the patient's hearing impairment exceeds the actual hearing sensitivity, and such a situation can also be called exaggerated sputum. Often caused by mental trauma. It manifests as a sudden and severe loss of unilateral or bilateral hearing, no tinnitus and dizziness. The tone and strength of the speech are unchanged, but there are many symptoms such as silence, numbness of the limbs, and excessive gaze. Repeated audiometry results vary greatly, no loudness reverberation, speech acceptance threshold and recognition rate are low. The self-tweaking curve is V-shaped, and the sacral muscle reflex and auditory brainstem evoked potential are normal. The vestibular function did not change. The patient can recover quickly by sudden self-healing or by various suggestive treatments. Hearing aids often have miraculous effects. It can recur after healing. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: blast deafness
Cause
Functional paralysis
The strong explosion of strong acoustic stimulation will cause the trauma of the cortical center, which will lead to the generation of the hearing function, the family dispute or the mistakes in the work, etc., which is full of anger. It is also possible to cause this disease, and people who are prone to rickets are prone to the disease. This disease, also known as mental deafness or rickets, is a non-organic deafness. Often caused by mental trauma.
Prevention
Functional sputum prevention
Avoid mental stimuli and focus on the patient's psychological activities.
1, a reasonable diet. Eat less sweet, too salty and thick cream, prevent arteriosclerosis and produce inner ear ischemia, leading to hearing loss.
2, quit smoking, a small amount of alcohol. Because tobacco and alcohol have a toxic effect on the auditory nerve, especially the nicotine in the smoke enters the blood, causing the small blood vessels to smash, the blood is slow, and the viscosity increases, causing insufficient blood supply to the inner ear, thereby promoting deafness.
3. Avoid noise damage. The noise makes the hearing that originally started to decline more likely to fatigue, causing the tiny blood vessels of the inner ear to be paralyzed, reducing the blood supply to the inner ear and causing hearing loss. Therefore, listening to music, watching TV and listening to music on headphones should not put the volume too large, usually around 85 decibels.
4, taboo ears, often massage. Digging ear is a bad habit. It is easy to touch the ear canal, causing infection, inflammation, and even damage to the tympanic membrane. When the ear canal is itchy, you can use a small cotton swab to dip a little glycerin or alcohol to gently wipe the ear canal. Adhere to the sputum and hearing points before and after the earlobe can increase the blood circulation of the inner ear and protect the hearing.
5, maintain a good state of mind, and participate in exercise. Excessive fatigue and mental stress can cause inner ear ischemia and affect hearing, such as anger, liver fire and so on. Usually take part in the exercise that you can do, such as outings, morning walks, tai chi, etc., can promote blood circulation, strengthen the blood supply to the inner ear, and delay organ aging.
Complication
Functional fistula complications Complications , deafness, deafness
Hearing loss generally occurs after a blast injury, and some hearing loss is completely lost in a short period of time. Then gradually recovered. However, severe blast injuries can cause permanent paralysis at one time. The degree and nature of hearing loss vary depending on the location of the injury. The middle ear injury is often a conductive sputum, and the inner ear and auditory nerve damage are mostly sensorineural hearing loss. Both of them cause mixed sputum. Severe blast injuries can cause permanent paralysis. Huge sounds can cause functional paralysis. That is, the sudden occurrence of strong noise is not caused by physical factors as an organic damage to the inner ear auditory organs, but as a psychological factor causing the central nervous system to suppress, leading to deafness. Either knocking deafness and functional deafness exist at the same time. Most of the ears were severely paralyzed, and the hearing examination was not consistent with subjective and objective hearing tests.
Symptom
Functional paralysis symptoms common symptoms deafness hearing loss mental disorder
It manifests as a sudden and severe loss of unilateral or bilateral hearing, no tinnitus and dizziness. The tone and strength of the speech are unchanged, but there are many symptoms such as silence, numbness of the limbs, and excessive gaze.
The general characteristics are as follows:
More than 1 sudden or slow onset of both ears.
2 There is a clear mental disorder.
3 The pupil cochlear pupil reflex and the cochlear eyelid reflex disappeared.
4 can be accompanied by numbness of the outer ear.
5 sleep middle ear mites continue to exist.
6 voices are not changed by deafness.
7 The answer to the question was rigid and slow.
8 vestibular function is normal.
9 can be accompanied by visual impairment.
10 The treatment effect is surprising.
Examine
Functional flaw detection
Repeated audiometry results vary greatly, no loudness reverberation, speech acceptance threshold and recognition rate are low. The self-tweaking curve is V-shaped, and the sacral muscle reflex and auditory brainstem evoked potential are normal. The vestibular function did not change.
Pure tone audiometry
The results of repeated tests in such patients are inconsistent. Normal people should repeat the pure tone audiometry results should be less than 5dB, and those with a difference of more than l0dB should be functional deafness. In addition, pure tone audiometry curves are often of a unique type, such as dish type, anti-disc type, flat type, island type, the average hearing loss is more than 80 ~ 90dB, and more common in both ears.
2. Voice recording under noise interference
In general, patients with deafness can understand the speech even if the noise exceeds the loudness of the speech by 10~15dB. Functional deafness is often unresolved because the noise is not reached or is close to the loudness of the voice. The specific method is to use the earphone or the free sound field to perform the rehearsal speech measurement while releasing and gradually enhancing the noise. Headphones are used on one side and free sound fields are used in both ears.
3. The difference between pure tone practical listening and speech hearing threshold
Normal people have little difference, while functional deafness is quite different, and speech hearing threshold is significantly lower than pure tone practical hearing.
4. Self-trace listening and listening
Normal people and general organic deafness use pulse sounds to measure the hearing threshold better than continuous sound, while mental deafness is the opposite, showing a V-shaped curve.
5. Tibial muscle reflex test and electrical response audiometry
The results are all within the normal range.
Diagnosis
Functional diagnosis
The differential diagnosis should include sudden sputum, false sputum, exaggerated sputum and so on. For patients with symptoms, it is necessary to exclude organic lesions such as epilepsy, cardiovascular disease, intracranial space-occupying lesions. Diagnosis should pay attention to the collection of a history of mental trauma. Pure tone audiometry is mostly severe or sputum in both ears, and slow-onset may be unilateral. Acoustic impedance test, otoacoustic emission, auditory brainstem response and other guest observations have no abnormal findings.
