case presentation-otology
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8/7/2019 case presentation-OTOLOGY
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OTOLOGYOTOLOGYGTA 206/2GTA 206/2
CASE PRESENTATIONCASE PRESENTATION
Name : Khadijah binti Kamarudin
Course : AudiologyMatric No : 106014
I/C No : 900322115358
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Name : MAS
Age : 4 years old
D.O.B : 28th
August 2007Sex : Male
Race : Malay
Registration No : B 344138Date of clerking : 18th March 2011
PATIENT DETAILS..PATIENT DETAILS..
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Child came for hearing assessment as
referred by ORL doctor due to anotia with
atresia in the left ear and GoldenharSyndrome.
According to mother, child responded to
sound at home.
PRESENT SITUATION..PRESENT SITUATION..
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Antenatal
� No problem noted during antenatal
Birth
� Fullterm pregnancy
� Patient was born via EMLSCS due to maternal PEand DM on diet control.
� Big baby-birth weight 4.42kg
� No other complications
Postnatal
� Admitted 3 days in ward due to GoldenharSyndrome.
Birth Medical HistoryBirth Medical History
PATIENTS HISTORY..PATIENTS HISTORY..
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Physical
Have normal physicaldevelopment
Speech
During age of 2 years,
mother noted childsspeech progress is at 1word stage limitedvocab
4 yrs old, increase
vocabulary andincompletepronouncation (pelat).
Good understanding(simple instruction)
Developmental HistoryDevelopmental History
Hearing
Showed good response to
sound at home
Able to response correctly
toward simple instruction
But, at the moment hesusing gestures to indicate his
need
Able to imitate speech
soundSocial
Able to develop social play
skill with others
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Youngest out of 6 siblings
Both parents are consanguineous marriage
Family history of birth defect cousin
His father have mild facial dysmorphism
His mother having diabetes - history of big babies
about 3 times (3rd, 4th, and 5th )
While his older brother have colour blind
Family HistoryFamily History
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Tympanometry and OAE cant be done on left ear due tocomplete atresia.
For right ear, OAE - clear EAC and intact TM,tympanometry - persistent type B suggest of abnormalmiddle ear function.
DPOAE refer on the right ear
ABR (click stimulus) - wave V detected down to 40dBnHLfor R ear, suggest of conductive HL. Wave V detecteddown to 65dBnHL for L ear.
Play audiometry mild to moderate for R ear andmoderate to severe for L ear
Speech vocab increase, receptive-good and expressive-talk a lot but pelat.
ASSESSMENT DONE..ASSESSMENT DONE..
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Discussion with parents regarding childs
condition.
Parents were advised to monitor childs speech
& hearing development at home. Child referred to ENT clinic for ENT
management.
M ANAGEM ENT..M ANAGEM ENT..
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Right ear mild HL, suggestive of conductive
problem
Left ear suggestive hearing level at moderate
HL, due to anotia
IM PRESSION..IM PRESSION..
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Repeat Tympanometry test to monitor middle
ear status.
KIV for hearing aid.
RECOMMENDATION..
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Anotia is the complete absence of theauricle (external ear, also called the
pinna) and auditory canal.
This occurs when the tissues that form
the auricle fail to develop during thefirst few weeks of pregnancy - 80% of
the cases of anotia are unilateral
Atresia- absent of opening of the
external auditory meatus and causesignificant conductive hearing loss
which can be as great as 60dB.
DISCUSSION DISCUSSION ....
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Jerry L. Northern & Marion P. Downs. (2001).
Hearing in Children. Sydney : Lippincott Williams
& Wilkins.
http://www.in.gov/isdh/files/anotia.pdf http://www.faces-cranio.org/Disord/Golden.htm
REFERENCES..REFERENCES..
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