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Acute Hearing Loss
1、General. Hearing loss may develop over days or acutely. It may be either conductive in nature (ossicle disruption from trauma, tympanic-membrane perforation from cotton-tipped applicator or from noise, etc., cerumen in the canal, otitis media, barotrauma, etc.) or sensorineural (CVA, infectious, tumor, Ménière's disease, herpes zoster oticus (may see vesicles), syphilis, collagen-vascular disease, ototoxic drug exposure, etc). An isolated vascular event causing unilateral hearing loss is not uncommon in young adults.
2、Presentation. Decrease in auditory acuity. May document using audiologic testing or by Rinne and Weber tests. 3、Approach. Treat cause if found. If no obvious cause is found and serious illness has been ruled out by a complete history and physical (especially neurologic exam), patient may be discharged with a follow-up appointment with ENT for further, specialized evaluation.
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