Audiology Flashcards
6 services of an audiologist
- diagnostic hearing eval
- infant hearing screening
- vestibular assessment and treatment
- tinnitus evaluvation & management
- amplification
- custom ear molds
what age group has seen the biggest increase in hearing loss recently?
teenagers
what percentage of hearing loss can be corrected medically or surgically?
10% (why prevention is so important!)
men or women more likely to have hearing loss?
men
hearing loss: how long do people wait on average before seeking help?
7 years
what does it mean to be deaf?
no measurable hearing (peripherally)
what is tinnitus?
any perceived sound for which there is no stimulus
*7 signs of hearing loss
- difficulty hearing/ understanding speech
- increased dependence on visual cues
- asking people to repeat
- complaining that others mumble
- television loud
- difficulty localizing sound (asymm. loss)
- tire or stressed after convos.
5 parts of routine audio exam
- case history
- otoscope inspection
- tympanometry
- speech audiometry
- pure tone air and bone conduction audio
Type A tymp.
normal, middle peak
-normal ear aeration and mobility
0 +/- 100daPa is normal range
Type B tymp
flat line
no mobility of TM
middle ear fluid w/ normal volume
if high volume = TM perforation or patent tubes
Type C tymp
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
Type As tymp
short shallow middle peak
“s”= shallow or stiff
suggests soft middle ear system (ossicular fixation)
thickened/scarred TM (“otosclerosis” )
Type Ad tymp
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)
a hearing test NOT done in a sound treated booth is considered a…
screening
parameters on audiogram graph:
top –> bottom
left –> right
what does a line on the upper portion mean versus the lower portion?
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.
audiogram: what do these signify?
O—-O or red
X—-X or blue
< or >
O—O red, right ear
X—X blue, left ear
< or > unmasked bone conduction
5 types of hearing loss
- SNHL (sensorineural) - most common for hearing aid wearers
- conductive
- mixed
- central
- pseudohypacusis (fake)
what is SNHL?
damage/ defect in inner ear (cochlea) or nerve (CN 8)
what is auditory neuropathy? (not on ppt but discussed in lecture)
type of SNHL
8th CN, rare
inner ear works but nerve doesn’t - can’t get message to the brain.
8 causes of SNHL
- congenital/genetic
- prebycusis (decrease w/ age)
- bacterial/viral infection
- meds/ototoxicity (aminoglycosides- permanent HL)
- acoustic nerve tumor (vest. schwannoma)
- menier’s
- sudden: autoimmune, vasc. perilymph fistula, etc.
- acoustic trauma/ noise
what is the most common occupational injury?
noise induced hearing loss
what does an audiogram of noise-induced hearing loss have?
noise notch: a dip in the chart at about 4000Hz
4 types of Txt of SNHL
- prevention
- amplification
- Meds (sudden, autoimmune, menier’s)
- surgery: cochlear/brain stem implant
downside/danger of cochlear implant?
destroy cilia, but transmit sound b/c elec. pulses stimulate ganglia
(must have very bad hearing loss to get this)
what does conductive hearing loss entail?
cochlea works (inner ear) but sound can’t conduct through external OR middle ear
8 causes of conductive HL?
- cerumen impaction
- FB (occludes entire canal)
- external ear infection
- middle ear fluid/ infection
- TM perforation
- otosclerosis (stapes fixation)
- tumors/ growths of external or middle ear
- congenital anomalies
4 types of txt for conductive HL?
- cerumen management
- surgery
- meds (Abx, decongestants)
- amplification
what is central hearing loss?
disorder of brain/brainstem
- peripherally : external, middle and even middle ear all function fine
auditory brainstem response (aka ABR, AER, BAER)
quick, non-invasive screening tool for newborns
-high sens & spec
- provides hearing threshold estimation
-test of neural conduction and retrocochlear system
(CN 8 & brainstem
what is helpful in evaluating hearing of malingers (fakers) and other difficult to test populations?
ABR
tumors of the internal auditory canal, cerebellopontine angle, demyelination of 8th CN… can all do what?
slow neural conduction time
what is an OAE (otoacoustic emission) ?
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 )
videostagmography (VNG)
- a vestibular assesment
-determines peripheral vs central vestibular involvement
-dix-hallpike maneuver for BPPV
(not expanded on in lecture )
acoustic reflex test
measure of stapedial reflex and TM in response to loud sound
(not expanded on in lecture)
