Audiology

Question 1

6 services of an audiologist

Answer 1

1. diagnostic hearing eval
2. infant hearing screening
3. vestibular assessment and treatment
4. tinnitus evaluvation & management
5. amplification
6. custom ear molds

Question 2

what age group has seen the biggest increase in hearing loss recently?

Answer 2

teenagers

Question 3

what percentage of hearing loss can be corrected medically or surgically?

Answer 3

10% (why prevention is so important!)

Question 4

men or women more likely to have hearing loss?

Answer 4

men

Question 5

hearing loss: how long do people wait on average before seeking help?

Answer 5

7 years

Question 6

what does it mean to be deaf?

Answer 6

no measurable hearing (peripherally)

Question 7

what is tinnitus?

Answer 7

any perceived sound for which there is no stimulus

Question 8

*7 signs of hearing loss

Answer 8

1. difficulty hearing/ understanding speech
2. increased dependence on visual cues
3. asking people to repeat
4. complaining that others mumble
5. television loud
6. difficulty localizing sound (asymm. loss)
7. tire or stressed after convos.

Question 9

5 parts of routine audio exam

Answer 9

1. case history
2. otoscope inspection
3. tympanometry
4. speech audiometry
5. pure tone air and bone conduction audio

Question 10

Type A tymp.

Answer 10

normal, middle peak
-normal ear aeration and mobility
0 +/- 100daPa is normal range

Question 11

Type B tymp

Answer 11

flat line
no mobility of TM
middle ear fluid w/ normal volume
if high volume = TM perforation or patent tubes

Question 12

Type C tymp

Answer 12

peak shifted LEFT

• neg. middle ear pressure (compared to room- like an airplane)/ TM retraction
• eustachian tube dysfunction
• could mean on their way to middle ear infection OR recovering from one

Question 13

Type As tymp

Answer 13

short shallow middle peak
“s”= shallow or stiff
suggests soft middle ear system (ossicular fixation)
thickened/scarred TM (“otosclerosis” )

Question 14

Type Ad tymp

Answer 14

high middle peak
“d”= deep
suggest ossicular discontinuity (ear bones out of place?)
also with monomeri, healed TMs, post PE tube or perforation (middle layer of TM didnt grow back well)

Question 15

a hearing test NOT done in a sound treated booth is considered a…

Answer 15

screening

Question 16

parameters on audiogram graph:
top –> bottom
left –> right
what does a line on the upper portion mean versus the lower portion?

Answer 16

top–> bottom : soft –> loud sound
left –> right: low –> high pitch
graph along the top portion = normal hearing, as you shift the graph down = progressively worse hearing.

Question 17

audiogram: what do these signify?
O—-O or red
X—-X or blue
< or >

Answer 17

O—O red, right ear
X—X blue, left ear
< or > unmasked bone conduction

Question 18

5 types of hearing loss

Answer 18

1. SNHL (sensorineural) - most common for hearing aid wearers
2. conductive
3. mixed
4. central
5. pseudohypacusis (fake)

Question 19

what is SNHL?

Answer 19

damage/ defect in inner ear (cochlea) or nerve (CN 8)

Question 20

what is auditory neuropathy? (not on ppt but discussed in lecture)

Answer 20

type of SNHL
8th CN, rare
inner ear works but nerve doesn’t - can’t get message to the brain.

Question 21

8 causes of SNHL

Answer 21

1. congenital/genetic
2. prebycusis (decrease w/ age)
3. bacterial/viral infection
4. meds/ototoxicity (aminoglycosides- permanent HL)
5. acoustic nerve tumor (vest. schwannoma)
6. menier’s
7. sudden: autoimmune, vasc. perilymph fistula, etc.
8. acoustic trauma/ noise

Question 22

what is the most common occupational injury?

Answer 22

noise induced hearing loss

Question 23

what does an audiogram of noise-induced hearing loss have?

Answer 23

noise notch: a dip in the chart at about 4000Hz

Question 24

4 types of Txt of SNHL

Answer 24

1. prevention
2. amplification
3. Meds (sudden, autoimmune, menier’s)
4. surgery: cochlear/brain stem implant

Question 25

downside/danger of cochlear implant?

Answer 25

destroy cilia, but transmit sound b/c elec. pulses stimulate ganglia
(must have very bad hearing loss to get this)

Question 26

what does conductive hearing loss entail?

Answer 26

cochlea works (inner ear) but sound can’t conduct through external OR middle ear

Question 27

8 causes of conductive HL?

Answer 27

1. cerumen impaction
2. FB (occludes entire canal)
3. external ear infection
4. middle ear fluid/ infection
5. TM perforation
6. otosclerosis (stapes fixation)
7. tumors/ growths of external or middle ear
8. congenital anomalies

Question 28

4 types of txt for conductive HL?

Answer 28

1. cerumen management
2. surgery
3. meds (Abx, decongestants)
4. amplification

Question 29

what is central hearing loss?

Answer 29

disorder of brain/brainstem

- peripherally : external, middle and even middle ear all function fine

Question 30

auditory brainstem response (aka ABR, AER, BAER)

Answer 30

quick, non-invasive screening tool for newborns
-high sens & spec
- provides hearing threshold estimation
-test of neural conduction and retrocochlear system
(CN 8 & brainstem

Question 31

what is helpful in evaluating hearing of malingers (fakers) and other difficult to test populations?

Answer 31

ABR

Question 32

tumors of the internal auditory canal, cerebellopontine angle, demyelination of 8th CN… can all do what?

Answer 32

slow neural conduction time

Question 33

what is an OAE (otoacoustic emission) ?

Answer 33

test of cochlear hair integrity
no behavioral response required (good for babies!)
quick and non-invasive
helpful in Ddx (cochlear vs CN 8 dysynchrony)
(looks like fancier tympanometer )

Question 34

videostagmography (VNG)

Answer 34

• a vestibular assesment
  -determines peripheral vs central vestibular involvement
  -dix-hallpike maneuver for BPPV
  (not expanded on in lecture )

Question 35

acoustic reflex test

Answer 35

measure of stapedial reflex and TM in response to loud sound
(not expanded on in lecture)