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    Emailing Audiology

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    Isabel Castillo
    This document discusses pediatric audiology, including definitions of common terms, types of auditory tests, causes and effects of childhood hearing loss, and approaches to diagnosis and treatment. Objective tests like otoacoustic emissions and auditory brainstem response are used to diagnose hearing loss in children. Untreated hearing loss can delay speech development, but hearing aids, cochlear implants, and early intervention services can help rehabilitate children with hearing disorders.

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    Emailing Audiology

    Uploaded by

    Isabel Castillo
    89 views42 pages
    This document discusses pediatric audiology, including definitions of common terms, types of auditory tests, causes and effects of childhood hearing loss, and approaches to diagnosis and treatment. Objective tests like otoacoustic emissions and auditory brainstem response are used to diagnose hearing loss in children. Untreated hearing loss can delay speech development, but hearing aids, cochlear implants, and early intervention services can help rehabilitate children with hearing disorders.

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    This document discusses pediatric audiology, including definitions of common terms, types of auditory tests, causes and effects of childhood hearing loss, and approaches to diagnosis and treatment. Objective tests like otoacoustic emissions and auditory brainstem response are used to diagnose hearing loss in children. Untreated hearing loss can delay speech development, but hearing aids, cochlear implants, and early intervention services can help rehabilitate children with hearing disorders.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    89 views42 pages

    Emailing Audiology

    Uploaded by

    Isabel Castillo
    This document discusses pediatric audiology, including definitions of common terms, types of auditory tests, causes and effects of childhood hearing loss, and approaches to diagnosis and treatment. Objective tests like otoacoustic emissions and auditory brainstem response are used to diagnose hearing loss in children. Untreated hearing loss can delay speech development, but hearing aids, cochlear implants, and early intervention services can help rehabilitate children with hearing disorders.

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    The document discusses various topics related to audiology including definitions, clinical testing, causes and effects of pediatric hearing loss, and rehabilitation options.

    Some common objective hearing tests discussed include immitance measurements, auditory evoked potentials, and otoacoustic emissions.

    The different types of auditory evoked potentials mentioned include electrocochleography, auditory brainstem response, auditory middle latency response, and cortical evoked potentials.

    AUDIOLOGY

    HEARING DISORDERS IN
    CHILDREN –PEDIATRIC
    AUDIOLOGY
    JANE ZINAMPAN
    JEANELLE TORIBIO
    OBJECTIVES
    • To define common terms in audiology
    • To discuss clinical auditory testing
    • To discuss basic principles of audiometry
    • To know the different audiometric tests; the techniques and its interpretation
    • To discuss the different causes and effects of pediatric hearing loss
    • To give a background on hearing rehabilitation and auditory devices
     Acquired deafness –
    refers to a loss of the
    sense of hearing
     Congenital deafness –
    refers to the absence of
    hearing
    OBJECTIVE HEARING TESTS
    • Test without eliciting active response from the patient

    Immitance measurements • changes in the acoustic impedance in the TM via


    intra aural probe
    Auditory Evoked Potentials (AEPs) • acoustically evoked bioelectric responses of the
    cochlea, auditory nerve, auditory tract neurons, or
    cerebral cortex via surface electrodes and
    averaging techniques
    Otoacoustic Emissions (OAEs) • measure sound events in the ear canal that are
    produced by spontaneous or acoustically evoked
    active biomechanical vibrations in the cochlea via
    microphone probe
    IMMITANCE MEASUREMENTS
    • Measure of resistance that the system
    offers to the absorption of soundwaves
    • Sound absorption = compliance
    • Intra-aural probe; 220Hz

    • Tympanometry: provides graphic


    representation of impedance changes
    caused by applied air pressure
    • Stapedial reflex: produces and
    acoustically evoked change in
    impedance
    • Ipsilateral stapedial
    reflex
    • Contralateral stapedial
    reflex

    Interpretation: absence or
    increased stapedial reflex
    threshold may be caused by
    a lesion at various parts in
    the freflex pathway
    AUDITORY EVOKED POTENTIALS
    • Recorded from the scalp using
    needle or surface electrodes

    Electrocochleography cochlea and auditory 1-3ms


    nerve
    Auditory Brainstem auditory nerve and 10ms
    Response audiometry brainstem structures
    Auditory Middle Latency thalamus and primary 10-100ms
    Response audiometry auditory complex
    Cortical Evoked 100-1000ms
    Potentials
    AUDITORY BRAINSTEM RESPONSE
    • Most commonly recorded AEP for diagnostic purposes
    • Mainly tests hearing at middle and high frequencies (>1kHz)
    • Adhesive electrodes: placed on the vertex and mastoid
    • differentiates cochlear and retrocochlear hearing loss
    • neurologic diseases
    • threshold testing in pediatric audiology
    • intraoperative monitoring of hearing
    • Interpretation: time intervals between waves and threshold for wave V
    OTOACOUSTIC EMISSIONS
    • Spontaneous or evoked
    • Screening of cochlear function in newborns to small children

    Spontaneous otoacoustic emissions no external stimulus


    Transient evoked otoacoustic consistently detected in response to a brief stimulus
    emissions
    Distortion product otoacoustic detected by stimulation with 2 continuous tones that
    emissions have different but adjacent frequencies
    Stimulus frequency otoacoustic Stimulation with a sine-wae tone evokes tonal
    emissions emission of the same frequency
    REHABILITATION AND HEARING AIDS

    • Restore or improve auditory communication


    • Surgery: conductive hearing loss
    • Hearing aids: amplifies auditory signals, BTE or ITE
    • Active middle ear implants: sound waves to mechanical vibrations
    • Cochlear implant: sound waves to electrical impulses
    • Vibrotactile aids: acoustic signals to vibrations transmitted to wrist
    • Other assisitive devices: vibrating wake-up alarms, TV headphones
    • Training: selective listening, lip-reading
    HEARING AID FITTING IN ADULTS
    Determine candidacy • Hearing loss of 30dB HL or more in the better ear
    by pure-tone audiometry, measured for at least
    one frequency in the range from 500-3000Hz
    • Speech audiometry: ≤80% correct responses for
    monosyllabic recognition at 65dB SPL
    • Willingness
    Audiologic examination • pure tone audiometry, speech audiometry, dynamic
    range
    Hearing aid trial • ear mold
    Final hearing aid selection • speech audiometric testing, subjective auditory
    impression, in situ measurements
    Follow-up care
    COCHLEAR IMPLANTS IN ADULTS

    Indication • Acquired, bilateral predominantly cochlear deafness


    (postlingual deafness) with a functional auditory nerve
    and intact central auditory pathway
    • Congenital or early acquired (prelingual deafness)
    • Lack of benefit from binaural hearing aid despite
    optimum adjustment
    • Willingness
    ✓ Partially functional auditory nerve
    ✓ Promontory test
    Follow-up care • Technical check of the implant function
    • Checking & adjusting speech processor
    • Auditory training
    PEDIATRIC AUDIOLOGY
    CAUSES OF PEDIATRIC HEARING DISORDERS
    • Hereditary genetic causes • Acquired causes
    • Congenital • in utero
    • Postnatal or later • perinatal
    • Monosymptomatic Genetic • postnatal
    hearing loss
    • Hearing loss in genetic syndromes • Rubella syndrome
    • Hyperbilirubinemia syndrome
    • Congenital syphylis
    EFFECTS OF HEARING LOSS

    • Newborns: earliest sign: delayed


    speech development
    • kernicterus
    • hypoxia
    • Infants & small children: MC type
    is the acquired temporary hearing
    loss 2' to otitis media
    Screening Diagnostic methods
    • Risk screening: • Objective methods:
    • ICU for 48h • Otoacoustic emissions
    • Family history • Auditory evoked potentials
    • Craniofacial anomalies • Immitance measurements
    • Universal screening: 2-3 days • Behavioral audiometric
    after birth methods:
    • Reflex audiometry
    • Newborn hearing screening: • Response audiometry
    • OAEs & ABR • Distraction test
    • older children: with • Visual reinforcement
    behavioral tests audiometry
    • Play audiometry
    • Pediatric speech audiometry
    TREATMENT
    • General consensus: children with bilateral, moderate, permanent
    hearing loss should be treated in order to prevent significant
    impairment of speech and language development
    • Hearing aids: moderate to severe hearing loss
    • Cochlear implant: profound hearing loss
    • Auditory devices:
    • Hearing aids: children are generally fitted with 2 BTE hearing aids
    • FM transmitters, vibrators
    • Cochlear implants: indicated to patients with cochlear damage but with
    responisve auditory nerve
    • Congenital deafness
    • Bilateral acquired deafness
    • Education services

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