Lecture 6: Hearing Loss COPY Flashcards
What are the 4 goals of evaluating potential hearing loss?
- Nature of impairment
- Severity of impairment
- Anatomy of impairment
- Etiology
What are the two main types of hearing loss?
- Conductive
- Sensorineural
When is hearing loss typically screened for?
- Birth
- Kindergarten
- Pre-employment/military physicals
When is an otoacoustic emission (OAE) test performed?
At birth to check for inner ear function.
Describe an otoacoustic emission test.
- Provider places a small earphone in the ear.
- Earphone plays a sound that should echo within the ear canal.
- Ear should send back in an echo
Can be performed while baby is sleeping, very quick.
What is an auditory brainstem response test? (ABR)
- Electrodes placed on forehead, and earphone in ears.
- Sound send through earphones, while the patch monitors brain function/response.
- Can check for abnormal sensorineural development.
If an infant fails a hearing screening, what is the protocol?
Need an EENT referral if the infant cannot pass a hearing test by the age of 3 months.
What signs might suggest that a baby has hearing loss?
- Not being startled by loud sounds
- Not turning towards a sound after 6mo
- Not saying single words like mama or dada by 1 year old.
- Turns head if sees you, but not if you only call out name.
- Seems to hear some sounds but not others.
How do we treat a child that has abnormal hearing screenings?
Visual reinforcement audiometry (VRA)
Must be 6m to 2y.
What is a VRA test?
- Patient sits in a booth while distracted.
- Patient trained to look towards the sound source.
- Rewarded if they look properly.
What is a conditioned play audiometry test? (CPA)
- Child performs an activity when a sound is heard.
2-5y old
What is a pure tone audiogram?
Test to see what a person’s hearing range is.
Tests decibels a patient can hear at certain frequencies.
How do we read an audiogram?
Y axis: intensity of sound in decibels.
X axis: pitch/frequency of sound.
What kind of sounds are at the top of an audiogram? Bottom?
Top: Whispers
Bottom: Jackhammer
What are the two types of conduction an audiogram can measure?
- Air conduction hearing using headphones.
- Bone conduction hearing using mastoid stimulators.
How do you read an audiogram?
Each frequency is plotted based on what decibel the patient could hear it at. Both ears are tested, generating a graph, which is then compared to a standard.
What is normal hearing range?
250-6000 Hz
-10 to 25 decibels.
0 decibels is the softest sound an average person can hear. Hearing something like -5 decibels on an audiogram just means you have very good hearing.
How many decibels different is profound hearing loss from regular?
Nearly 100 decibels less than the average.
AKA you need a sound at 100 decibels to hear it.
What is a tympanogram?
Measures mobility/compliance of the tympanic membrane and the small bones in the middle ear.
What are the 3 types of tympanograms and what do they represent?
- Type A: normal
- Type B: Abnormal finding, no compliance
- Type C: Abnormal finding, eustachian tube dysfunction.