Audiology final

What is the biggest red flag for an audiologist?

asymmetric hearing loss

List 4 red flags for a medical referral

1. sudden hearing loss

2. sudden onset of persistent tinnitus

3. new onset of conductive hearing loss

4. ear pain or drainage

What is an acoustic neuroma and where does it develop?

a beneign tumor on either the auditory or vestibular portion of the 8th cranial nerve

What are some symptoms of an acoustic neuroma?

asymmetric SNHL, tinnitus, poor word recognition on the affected side

What are possible treatments for an acoustic neuroma?

1. observation/monitoring

2. radiation (slow growth)

3. surgical removal (in severe cases)

What will the ABR look like on a patient with an acoustic neuroma?

unaffected side: Normal

affected side: abnormal

What does CROS stand for and what hearing loss would we recommend to use this?

Contralateral Routing of Signal / unilateral hearing loss

What is otosclerosis?

abnormal bone growth on the stapes

What would the tympanometry results from a patient with osteosclerosis look like?

a reduced peak and denoted as a Type A

What is the removal of the stapes bone and replacement with a prosthesis called? What is it a solution for?

stapedectomy / osteosclerosis

Which type of provider sees a patient with a suspected acoustic neuroma or ostoscerosis and why?

ENT for additional testing and medical examination

What is the most common pathology that leads to hearing loss in children? What is the percent of kids that will experience this?

80-90% of kids will experience Otitis Media (middle ear infection) before age 5

What would be completed with the 1-3-6 rule? Give an example of what test/intervention would be given at each stage

a. 1 month: All infants should be screened for HL; OAE testing

b. 3 months: All infants that failed their hearing screening should have a diagnostic evaluation; Tympanometry, Behavioral Testing, ABR

c. 6 months: All infants diagnosed with HL should be enrolled in early intervention; Medical intervention w/ENT if needed, HA/CI fitting depending on severity, enroll in early intervention SLP services

What is the first type of audiogram that can be performed on a peds patient and what ages can this test? What behavior is the Audiologist looking for and how is it observed?

Visual Reinforcement Audiometry (VRA) / 6-24 months / head turning toward the sound and reinforced by a toy or screen in that direction

What is the second type of audiometry that can be preformed on a peds patient and what ages can this test? What behavior is the Audiologist looking for and how is it observed?

Conditioned Play Audiometry / 2-5 years / the child should follow the instructions when they hear the sound and is reinforced through praise for following the rules of the game

How can speech recognition be assessed in peds patients?

picture pointing

What are the Ling-6 sounds? definition., list, and 4 new sounds

definition: speech sounds that can be imitated by young children

list: “m, oo, ee, ah, sh, s”

new: “n, d3, z, h”

Is a hearing aid or CI used for corner audiograms and why?

CI, because hearing aids do not produce enough amplification to support speech recognition

What four parts make up the CI?

1. sound processor and microphone

2. transmitting coil

3. internal receiver

4. electrode array

What is the CI candidacy in adults?

1. moderate to profound SNHL

2. Limited benefit from amplification (≤50% speech recognition w/HA)

3. speech material used: sentences or word tests

What is the CI candidacy rate in children?

1. severe to profound SNHL

2. Limited benefit from amplification (≤30% speech recognition w/HA)

3. Speech material must be age-appropriate

What is the CI candidacy in infants and toddlers?

1. Profound SNHL in both ears

2. Limited benefit from amplification (case dependent)

3. limited opportunity for speech-based testing

What are the five criteria prior to CI implant referral?

1. surgical risks

2. family support

3. anatomical counterindications (absent cochlea, loss of 8th nerve)

4. health concerns

5. onset of HL

What are t-levels?

The lowest current requited for perception

What are m-levels?

the amount of current for loud but not uncomfortable perception

How many electrodes are in a current CI?

12-22

explain the CI implant surgery process

1. surgeon (ENT) creates an incision behind the pinna

2. surgeon drills through the mastoid bone

3. surgeon threads electrode in the cochlea via the round window

4. incision is sewed up. Recovery is 3-4 weeks