Otolaryngology: connect hearing, balance and the upper airway
Otolaryngology is often called ear, nose and throat medicine, or ENT. The specialty brings together nearby structures with several distinct functions. Hearing, balance, breathing, voice and swallowing should be understood separately before their anatomical connections are considered.
Sound is transferred and then converted into signals
When sound waves enter the ear canal they make the tympanic membrane (eardrum) vibrate. These vibrations are transmitted toward the fluid-filled cochlea via small bones in the middle ear. When this motion reaches the sensory hair cells within the cochlea, it is transformed into electrical signals. Electrical signals are then sent to the brain via the auditory nerve for processing and recognition of sound.
Follow the sequence above and indicate where mechanical energy is converted into sensory signaling. Identifying this conversion will help to clarify why some types of hearing difficulties affect different areas of the pathway. Muffled sounds are examples of a symptom that indicates a hearing problem but does not specifically identify the area of the ear that is affected. It is necessary to perform a complete history, examination and appropriate hearing assessments to confirm if there truly is a problem with hearing.
Balance involves several sources of information
Balance is determined by multiple sources of input; however, one major source of input regarding movement and position is the inner ear. Dizziness describes an experience that can have several possible explanations. Based upon this concept, a problem with balance does not automatically mean that it is an ear-related issue and the results from hearing and balance testing are not interchangeable terms describing the same function.
In an example scenario, describe exactly what "dizzy" meant when the patient said it prior to labeling what occurred. Was it spinning or unsteady, or something else? Separate your description from identifying a specific reason. Your evaluation may include additional professionals and tests selected based upon your questions. A brief comparative study cannot provide the cause for an actual episode.
The larynx has a role in both airflow and voice
Voice is produced through vibration of the vocal folds in the larynx. Voice production is assisted by the coordination of the throat, mouth and nasal cavities to shape the resulting sound. Although breathing, voice and swallowing utilize similar anatomically connected structures, each utilizes different coordinative processes. As a result, changes in voice can have numerous reasons therefore voice quality does not exclusively determine which tissue or process is responsible for voice alterations.
Describe how sound is created versus how that sound is shaped into spoken language. While creating sound and shaping that sound into spoken language are related they are not synonymous. In addition, during your revisions consider linking each structure to its respective function and do not assume all communication issues arise due to vocal cord malfunction. If you suffer from persistent or concerning symptoms seek proper medical attention from an acceptable health care provider prior to attributing those symptoms solely to over use without adequate supporting evidence.
The test should fit the function being investigated
Hearing tests, ear and throat examinations and selected investigations provide different kinds of evidence. The symptoms, onset and effect on daily life help frame the clinical question. Audiology assessment and an ENT examination can provide complementary information. Neither is a universal test that resolves every ear, nose or throat complaint.
If you suddenly lose hearing, immediate medical consultation is required instead of awaiting results of a routine hearing check or an online exercise designed to preclude a medical problem. Long term care may require treatments for an identified cause, hearing support or other rehabilitation. In developing a teaching plan, clearly outline the rationale behind each step of the process and detail how progress will be evaluated relative to the individual's circumstances.
Check your understanding
A short quiz, with an explanation after each answer.
Which structure is involved in converting vibration into hearing signals?
Repeat the hardest part you were struggling with and explain why this was an example without looking at the original text. Then verify your response after repeating the quiz later. Understanding how to articulate your thought process is far more valuable than memorizing where you placed a correct response.