Audiology
What type of accommodations might a HI student have in the classroom?
-Personal FM/DM amplification systems - allow the child to hear, listen and attend to the teacher more directly by managing background noise - Induction Loop Coupling for Personal FM/DM - the telecoil circuit picks up a magnetic signal from the induction loop and transmits the signal to the hearing aid, goes with hearing aids, CI and BAHS. - Classroom audio distribution systems (CADS)-distribute sound evenly within a room, providing listeners in the room an improved signal to noise ratio by making the speaker's voice equally loud in all areas of the room.
What things should be avoided for someone with a cochlear implant?
-manufacturers recommend CI users identify themselves when passing through electronic detection systems such as the airport or security checkpoints. - electrostatic discharge can cause damage to the speech processor -CI users should consult with the medical facility prior to electrosurgery, MRIs and neurostimulation therapy
What is a ME implant?
A hearing aid but one in which the receiver or the entire hearing aid is inserted into the middle ear. For SNHL it delivers vibratory mechanical energy to the small bones (ossicles) and then sends mechanical energy to the cochlea at the round window via motion of the stapes. For conductive or mixed hearing losses that involve damaged middle ear systems, the device sends mechanical energy directly to the cochlea through bone conduction, bypassing the ossicles
What is a BTE hearing aid?
Behind the Ear device that is worn over the top of the ear with all components being housed in the casing that sits on the ear. Sound travels from the hearing aid through the ear hook, tubing and ear mold into the ear.
What is a BAHA used for (types of HL, etc.)
Bone-anchored hearing aid/bone-anchored hearing system can be worn externally or surgically implanted. are used to address conductive and mixed hearing loss and single-sided deafness
How do you decide what style of hearing aid should be recommended for someone?
CIC - Completely in Canal - mild to moderate hearing loss, custom molded, smallest and least visible type, less likely to pick up wind noise, smaller battery, harder to handle ITC - In the Canal - mild to moderate hearing loss, custom molded and fits partly in the ear canal, less visible than larger styles, includes features CIC does not have ITE - In the Ear - mild to severe hearing loss, includes features smaller hearing aids don't have such as volume control, larger battery-longer life, more visible than smaller styles, may pick up more wind noise, easier to handle BTE - Behind the Ear - any type of hearing loss, more amplification but larger than other styles, may pick up more wind noise RIC - Receive in Canal - less visible than BTE but similar, susceptible to earwax clogging Open Fit - mild to moderate hearing loss, less visible, difficult to hand due to small size
How do you do a hearing screening?
Can be performed using an audiometer. ASHA guidelines recommend a screening to be done to identify hearing loss of 20dB HL or higher in frequencies starting with 1000Hz, 2000 Hz, 3000 Hz, 4000Hz, 500Hz starting with the right ear and then moving on to the left ear. Find the threshold by going up 10db HL until the client can hear and going down by 10 db HL and up by 5db HL to confirm the threshold.
How do you troubleshoot a hearing aid, where is the best place to start?
Check to see if the hearing aid is dead - by checking the battery, remove wax, hairspray etc. with cleaning tool Check to see if the hearing aid is emitting feedback - the volume may be turned up too high or turned down too low, earmold may not be fitting correctly due to position or size, earmold has cracks or holes Check to see if signal is distorted or intermittent - earmold may have moisture or wax buildup, use listening tube to inspect signal clarity, could be a change in hearing loss
What is a CIC or IIC?
Completely in Canal/ Invisible in Canal - custom molded to fit the shape of the individual's ear however these are designed to be inserted deeper into the ear canal to be less noticeable with a thin filament to help pull it out.
Know your types of HL.
Conductive HL - hearing loss caused by an abnormality in the external or middle ear characterized by the reduction in the conduction of sound into the ear. Sensorineural HL - hearing loss in the inner ear due to damage to the cochlea and/or retrocochlear pathway, resulting in alterations of perception of sound frequency and intensity. also results in a loss of speech clarity due to damaged neural fibers in the cochlea. Mixed HL - a hearing loss that is a combo of conductive and sensorineural. bone conduction thresholds are outside of normal (sensorineural) and air conduction is even further abnormal (conductive component) - showing an air-bone gap on the audiogram.
How is CHL treated? What are appropriate referrals for CHL?
Conductive hearing loss is treated medically and sometimes with hearing aids. Normal bone conduction thresholds with abnormal air conduction thresholds.
What is a DAI and a telecoil? How are they used?
DAI - direct audio input - cords that connect directly into the hearing aid, providing a direct audio cable connection between the hearing aid and external auditory device. Allows the hearing aid to bypass the microphone and connect directly with a telephone, television, computer, etc. Telecoil - a circuitry found inside many hearing aids, but not all. It is a magnetic coil that is designed to pick up and connect wirelessly to an external magnetic signal. designed to make sounds clear to the listener over the telephone but now can be used with multiple assistive listening devices by picking up the electromagnetic signal only, compared to the microphone that just picks up sounds.
When do you need an earmold?
Earmolds are chosen with consideration given to the severity and configuration of a hearing loss. someone with a severe to profound hearing loss may need an earmold that fills the entire concha compared to a less severe hearing loss that may need a more open concha area.
What are the three types of ITE?
Full-shell ITE - fills the entire concha portion of the outer ear completely Half-shell ITE - fills only half of the concha portion of the outer ear ITC-style - smaller than the half-shell device and can only be seen in the opening of the concha
How do you decide whether someone should have a HA or a CI?
Hearing aids should be a first option, however if the individual has demonstrated limited benefit from traditional hearing aids, then they may want to consider a Cochlear implant. Hearing aids are removable devices while cochlear implants require surgery. A hearing aid magnifies certain sounds and reduces ambient noise and other unwanted sounds. A cochlear implant is surgically implanted and sends electrical impulses through the auditory nerve. The brain recognizes these impulses as sound.
Who would benefit from a hybrid cochlear implant?
Hybrid Cochlear Implants are designed for people with severe, high-frequency hearing loss who still have the ability to hear lower frequencies (pitches). These cochlear implants use acoustic amplification to preserve low frequency hearing that is still available at the same time as using traditional cochlear implant technology to allow access to mid and high frequency sounds that are missing.
What is an ITE?
In the Ear Hearing Aid - a device that is custom molded to fit the shape of the person's ear. A one piece amplification device with all components housed in a hard shell shaped to the contours of the individual's ear.
How are batteries inserted ?
Open the battery drawer on your device and remove the old battery. Insert the new battery into the drawer. Be sure that the "+" is facing upward. If you have installed the batteries correctly, closing the door of the drawer will be easy
What are the main parts of a hearing aid?
Power Source Options - button style batteries-smaller the battery the less power it will have. Large batteries: #675 & #13 Small batteries: #310 & #10 On/Off Switches - controlled by opening the battery door in many devices Volume Controls Push-button controls Direct audio input circuitry Telecoil circuitry
What is a RITE or RIC?
Receiver in the Ear / Receiver in Canal - this removes the receiver component of the hearing aid from the enclosed casing and places it at the end of thin tubing. a dome is placed over the receiver, which sits inside the entrance to the ear canal.
How is SNHL treated?
Sensorineural hearing loss is a Permanent hearing loss that can be treated with hearing aids or cochlear implants.
What is the difference between misophonia and hyperacusis?
The big difference between the two, is the way you react to noise. With misophonia, noise triggers rage. ... With hyperacusis, however, noise leads to pain. Hyperacusis usually starts because of overexposure to noise.
Be able to identify tympanograms.
The five Liden-Jerger-type tympanograms are A, As, Ad, B and C. The first type, A, usually has a normal range for pressure- +50 daPa-100 daPa, compliance - .25mmho-1.05 mmho for children/.3 mmho-1.7 mmho for adults and ear canal volume (ECV) 3mL - 1.0mL in children and .65mL-1.75mL in adults. While a patient may have a type A tympanogram, they may still suffer from a hearing loss but it does not stem from the middle ear canal. These hearing losses are typically sensorineural because "this type of loss arises from a problem in either the inner ear or the auditory nerve, not the outer or middle ear." (Welling, D. R., & Ukstins, C. A. (2017) The second type of tympanogram is As. This type usually has a normal range for pressure and ECV but a significantly low value for compliance, often referred to as "shallow" which is reflected in the low peak on the y-axis. Some etiologies that might be associated with this type are otosclerosis- unusual bone growth around the ossicles, middle ear effusion - scarred or thick eardrum, and plaque on the eardrum. The third type, Ad, is typically classified by normal pressure and ECV but an excessive value for compliance, referred to as "deep" which is reflected in the high peak on y-axis. Common etiologies associated with As are disconnected ossicles in the middle ear, minimal scar tissue and a thin eardrum. As you can see in both As and Ad, the nicknames "shallow" and "deep" are reflected in the second letter in the name of the tympanogram. The fourth type, B, reflects a flat line on the graph because there is no eardrum movement. This tells us there is essentially no compliance or pressure. Finding the ECV in these cases will be vital for a proper interpretation. The ECV can be normal, low or high in this type. A low ECV could indicate wax or a foreign object in the ear. A high ECV could indicate a "hole or perforation in the eardrum itself." (Welling, D. R., & Ukstins, C. A. (2017) Type B can be associated with both conductive and mixed hearing loss. Finally, Type C tympanogram is identified by a normal range for compliance and ECV but the pressure measures in the abnormally negative range. Common etiologies associated with Type C are blocked Eustachian tubes, allergies and ear infections.
What does bimodal mean?
The term bimodal refers to using two different types of hearing assistance technology between the ears.
What are appropriate referrals for MHL?
When neither bone or air conduction thresholds are within normal limits but they do not match each other also.
Know whether losses are symmetric or asymmetric.
asymmetrical hearing loss - when a person's hearing sensitivity is significantly different in one ear versus the other. can be minimal to profound. unilateral - one ear bilateral - both ears Symmetrical hearing loss means that the degree and configuration of hearing loss are the same in each ear. An asymmetrical hearing loss is one in which the degree and/or configuration of the loss is different for each ear.
How do cochlear implants work? Who are they good for?
cochlear implant - a surgically implanted device that can enhance hearing and speech abilities for individuals with severe to profound hearing loss can help those who do not really benefit from traditional hearing aids. can help those with auditory neuropathy syndrome disorder
Know your HL extents.
db HL ----------- Degree Category -10 to 15 Normal 16 to 25 Slight 26 to 40 Mild 41 to 55 Moderate 56 to 70 Moderately Severe 71 to 90 Severe 91 and above Profound
What are the CI parts ?
he parts: external speech processor - looks like a conventional BTE style hearing aid, rests on top of and behind the pinna; picks up sound from the environment via microphone and sends signal to internal transmitter via the coil transmitting coil and wire - magnetically attaches itself to the internal receiver; receives signals from the speech processor and converts them into electric impulses and sends them to the electrode array. internal receiver (magnetic) /stimulator - receiver surgically implanted into the temporal bone above the mastoid process and the stimulator (electrode array) is surgically inserted into the cochlea. Collects the electric impulses and sends the message along to the central auditory pathway. Rechargeable battery pack - replaceable #675 button-type batteries
What is an Open Fit BTE?
replaces the earhook and traditional tubing to earmold with a thin open tube incorporating a dome on the end.
What is the pure-tone average?
• Average of the threshold levels in dB HL at 500, 1000, and 2000 Hz