Hearing Loss Cochlear Implants and Surgical Treatments Test 2 — Questions and Answers
Question 1: Which surgical procedure is used to treat otosclerosis that has fixed the stapes bone?
- Tympanoplasty
- Stapedectomy or stapedotomy (Correct answer)
- Myringotomy
- Cochleostomy
Correct answer: Stapedectomy or stapedotomy
Stapedectomy (removing the stapes) or stapedotomy (creating a small hole in the stapes footplate) replaces the fixed stapes with a prosthesis, restoring sound conduction and improving conductive hearing loss.
Question 2: Tympanoplasty is a surgical procedure that repairs which structure?
- The cochlea
- The auditory nerve
- The eardrum (tympanic membrane) and/or ossicular chain (Correct answer)
- The Eustachian tube
Correct answer: The eardrum (tympanic membrane) and/or ossicular chain
Tympanoplasty repairs perforations in the tympanic membrane and may also include reconstruction of the ossicular chain (ossiculoplasty) to restore hearing.
Question 3: Myringotomy with tympanostomy tube placement is a common surgical treatment for:
- Otosclerosis
- Recurrent or chronic otitis media with effusion (glue ear) (Correct answer)
- Acoustic neuroma
- Cochlear ossification
Correct answer: Recurrent or chronic otitis media with effusion (glue ear)
Pressure equalization (PE) tubes are surgically inserted through a small myringotomy incision to ventilate the middle ear and drain fluid in children with recurrent or persistent otitis media with effusion.
Question 4: Acoustic neuroma (vestibular schwannoma) is a benign tumor that grows on which nerve?
- The facial nerve
- The trigeminal nerve
- The vestibulocochlear nerve (cranial nerve VIII) (Correct answer)
- The glossopharyngeal nerve
Correct answer: The vestibulocochlear nerve (cranial nerve VIII)
Acoustic neuromas (vestibular schwannomas) grow on the vestibulocochlear nerve (CN VIII), typically on the vestibular branch, causing progressive unilateral sensorineural hearing loss, tinnitus, and balance problems.
Question 5: Cochlear ossification following bacterial meningitis creates a surgical urgency for cochlear implantation because:
- Infection spreads to the brain
- New bone formation in the cochlea can block the electrode array from being inserted (Correct answer)
- The auditory nerve degenerates rapidly
- Insurance coverage expires quickly
Correct answer: New bone formation in the cochlea can block the electrode array from being inserted
Following meningitis, labyrinthitis ossificans (cochlear ossification) can cause new bone to fill the cochlea, potentially blocking full electrode insertion and compromising cochlear implant outcomes.
Question 6: What is the primary goal of auditory brainstem implants (ABIs)?
- To amplify residual hearing
- To provide hearing sensation to patients without a functional cochlear nerve by stimulating the brainstem (Correct answer)
- To treat middle ear disorders
- To replace damaged eardrums
Correct answer: To provide hearing sensation to patients without a functional cochlear nerve by stimulating the brainstem
ABIs bypass both the cochlea and auditory nerve, electrically stimulating the cochlear nucleus in the brainstem, providing hearing sensation to patients who are not cochlear implant candidates due to absent or non-functional auditory nerves.
Hearing Loss Cochlear Implants and Surgical Treatments Test 2
Which surgical procedure is used to treat otosclerosis that has fixed the stapes bone?