Brief review of audiology
-
Upload
derek-stiles -
Category
Health & Medicine
-
view
1.492 -
download
0
description
Transcript of Brief review of audiology
![Page 1: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/1.jpg)
Audiology Review
Objectives: Describe ear-specific type, severity and
configuration of a hearing loss.List reasons a child would refer OAE
screening.Correlate ABR thresholds to audiogram.
![Page 2: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/2.jpg)
Audiogram – Degrees of loss
Normal
Slight
Mild
Moderate
Moderately-Severe
Severe
Profound
![Page 3: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/3.jpg)
Audiogram – Types of loss
Sensorineural:Bone conduction and air conduction thresholds abnormal and within 10 dB
Conductive:Bone conduction thresholds normal, >10 dB Air-Bone Gap
Mixed:Bone conduction thresholds abnormal, >10 dB Air-Bone Gap
<
]
X ]
XO
![Page 4: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/4.jpg)
Audiogram – Configuration of loss
Configurations Flat Sloping* Rising* Notched Cookie-bite Reverse cookie-bite
*Modifiers Gently (< 20 dB difference between octaves) Steeply (20-30 dB difference between octaves) Precipitously (> 30 dB difference between octaves)
![Page 5: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/5.jpg)
Audiogram
![Page 6: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/6.jpg)
Audiogram
![Page 7: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/7.jpg)
Audiogram
![Page 8: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/8.jpg)
Audiogram
![Page 9: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/9.jpg)
Tympanogram
Type A: NormalPeak near atmospheric pressure
Type B: Abnormal
No peakNeeds medical attention
Type C: Borderline normal
Negative pressureMonitor. May need medical attention
![Page 10: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/10.jpg)
Otoacoustic emissions
Outer hair cell activity in cochlea adds energy to transduction process
OAE equipment elicits activity and records presence of additional energy
Absent OAEs
Present OAEs
![Page 11: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/11.jpg)
Cutoffs
Absent when loss is greater than 40 dB HL(Norton 1993)
![Page 12: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/12.jpg)
Pure tone thresholds most ideal
School age children should be screened at the following times: first entry into school every year, K-3rd grade 7th grade 11th grade upon entrance into special
education upon grade repetition upon entering a new
school system without evidence of having passed a previous hearing screening
Pure tone
screen
OAE screen
Sensitivity 87% 65%
Specificity 80% 91%
(Sabo et al 2000)
(ASHA)
![Page 13: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/13.jpg)
ABR threshold
Click threshold approximates (±10 dB) pure tone threshold 2 – 4 kHz
Tone burst thresholds approximate pure tone threshold within 20 dB in 93% of children within 15 dB in 80% of children
(Stapells et al 1995)
![Page 14: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/14.jpg)
Normal hearing
Bone and air conduction thresholds are normal (-10 – 15 dB HL)
Tympanogram type A (or C) Otoacoustic emissions are present Normal ABR threshold
![Page 15: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/15.jpg)
Conductive hearing loss
Outer and/or middle ear disorder Bone conduction thresholds are
normal Air conduction thresholds are elevated Usually tympanogram type B
(sometimes C, rarely A in children) Otoacoustic emissions are absent ABR thresholds are elevated
![Page 16: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/16.jpg)
Conductive pathologies
Otitis media OM w/effusion
can be asymptomatic
Bacterial OM gluey purulent
effusion greater CHL
Chronic OM can lead to
permanent hearing loss
damage to middle ear/TM
damage to basal hair cells via round window
![Page 17: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/17.jpg)
Conductive pathologies
Otitis media Cholesteatoma
epithelial cyst erodes bone retracted TM may
create pocket for epithelial cells to collect
![Page 18: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/18.jpg)
Conductive pathologies
Otitis media Cholesteatoma Occluded ear canal
cerumen foreign objects
![Page 19: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/19.jpg)
Conductive pathologies
Otitis media Cholesteatoma Occluded ear canal Craniofacial
anomalies Atresia Ossicular
malformations
![Page 20: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/20.jpg)
Sensorineural hearing loss
Inner ear or retrocochlear disorder Bone and air conduction thresholds
are elevated and similar Tympanogram type A (or C) Otoacoustic emissions are absent
(greater than mild losses) ABR thresholds are elevated
![Page 21: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/21.jpg)
Sensorineural hearing loss
Congenital Maternal Infection Syndrome Mutation
Acquired Meningitis Ototoxicity Cochlear Insult
![Page 22: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/22.jpg)
Mixed hearing loss
Outer and/or middle ear disorder AND Inner ear or retrocochlear disorder Bone conduction thresholds are
elevated and air conduction thresholds are elevated more
Tympanogram type B or C Otoacoustic emissions are absent ABR thresholds are elevated
![Page 23: Brief review of audiology](https://reader035.fdocuments.in/reader035/viewer/2022081502/555dceb5d8b42aec698b519d/html5/thumbnails/23.jpg)
Mixed hearing loss
Separate etiologies EVA + OME Maternal CMV + Cholesteatoma
Single underlying etiology CHARGE syndrome