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Audiology
- Hearing Loss
- Quick Self-Hearing Test
- Degree of Hearing Loss and the Effect
on Listening
- Hearing Conversation
- Hearing Instruments/Aids
- Pediatric Audiology
- Audiology Links
Hearing Loss
Facts:
- Approximately 28 million people in the U.S. have some degree of hearing loss, and 80% of those have irreversible hearing loss
- 54% of the population over age 65 has hearing loss
- Hearing loss is the 3rd most prevalent chronic condition in the older population
- Hearing aids can help most hearing losses
There are basically three types of hearing loss:
1. Conductive Hearing Loss - A hearing loss due to damage or difficulties in the outer or middle ear. This involves a reduction in sound level or the ability to hear faint sounds. The most common causes of conductive hearing loss are wax build up in the outer ear, middle ear fluid, and eardrum perforation.
2. Sensorineural Hearing Loss – A hearing loss due to damage or difficulties in the inner ear or auditory nerve up to the point it intersects with the brainstem. This not only involves a reduction in sound level, but also affects speech understanding or the ability to hear clearly. Some common causes of sensorineural hearing loss include heredity, aging and noise exposure.
3. Mixed Hearing Loss – A hearing loss that is primarily sensorineural in nature with a conductive involvement.
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A Quick Self-Hearing Test
1. Do you often miss certain words?
2. Do you frequently ask the speaker to repeat what was said?
3. Do you hear better in one ear than you do the other?
4. Do you have any relatives who have/had a hearing loss?
5. Have family members of friends expressed a concern about you hearing?
6. Do you ever feel as though people are mumbling or not speaking clearly?
7. Do you avoid certain social situations because it is difficult to hear?
8. Do you sometimes hear, but not necessarily understand what others are saying?
9. Do you have difficulty understand speech on the telephone?
10. Do you turn up the television or radio to volume levels that are too loud for other people?
11. Do you have difficulty following conversations in noisy environments or group settings?
12. Do you experience ringing or buzzing sounds in one or both ears?
If you answered YES to one or more of these questions, then it is recommended that you have your ears examined by an ear, nose, and throat specialist and your hearing evaluated by an audiologist.
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Degrees of Hearing Loss and the Effect on Listening:
1. Normal Hearing – < 25 dB
2. Mild hearing loss – 26-40 dB
Will miss consonant sounds; can miss up to 40% of spoken message; amount of difficulty depends on noise level, distance from speaker, and configuration of hearing loss; a hearing aid will be beneficial
3. Moderate hearing loss – 41-55 dB
Can understand one-on-one conversation at a distance of 3-5 feet; may miss up to 75% of the speech message; will benefit from hearing aid
4. Moderately-severe hearing loss – 56-70 dB
May miss all of the spoken message even face-to-face; group conversation will be very difficult; will benefit amplification
5. Severe hearing loss – 71-90 dB
Will probably not hear voices unless they are very loud; without a hearing aid speech will not be understood through listening alone
6. Profound hearing loss – 91 dB or greater
Even loud sounds may not be detected without amplification; will rely on speech reading while communicating
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Hearing Conservation
Effects of noise exposure – over exposure to noise can permanently damage your hearing. When noise is too loud, hair cells in the inner ear begin to die and can no longer convert sound vibrations to electrical signals needed by the auditory nerve in order to hear. Once the damage is done, there is no way to restore it. Hearing damage risk criteria is based on the amount of time one is exposed to dangerous intensity levels. If you know you are going to be exposed to loud noises or sounds, it is extremely important and in your best interest to wear hearing protection.
Styles of hearing protection:
1. Ear Muffs – these devices usually consist of rigid molded plastic earcups that seal around the ear with foam or fluid-filled cushions. They are held in place with metal or plastic headbands or by a spring-loaded assembly attached to a hard-hat. The earcups are lined with acoustic material to absorb high frequency energy.
2. Earplugs – These devices tend to be more comfortable than earmuffs when protection must be used for extended periods. There are several different types:
a. pre-molded earplugs – manufactured from flexible materials such as vinyls and cured silicones
b. formable earplugs – manufactured from cotton or wax, spun fiberglass, silicon putty, and slow recovery foams
c. custom molded earplugs – most often manufactured from two-part curable silicon putties, although some are manufactured in vinyl. Most fill a portion of the ear canal as well as the concha (bowl) portion of the outer ear.
**These can also be used for recreational purposes such as swimming or hunting
3. Semi-Aural Devices – consist of pods or flexible tips attached to a lightweight headband. These provide a compromise between earmuffs and earplugs. The principal use for semi-aural devices is for intermittent conditions where they must be removed and replaced repeatedly.
4. In-the-ear monitors for musicians – while there are many different types, this custom made device is designed to reduce volume levels evenly to allow the musician to accurately monitor sound at reduces volumes. For more information talk to the audiologist.
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Hearing Instruments/Aids
Hearing aids today come in many shapes, sizes, colors, and styles.
Styles:
1. Behind-the-Ear (BTE) Hearing Aids – This hearing aid is worn over the ear. It connects to a custom made earmold via tubing which transmits sound into the ear canal. BTE hearing instruments can be worn by patients with mild to profound hearing losses.
2. In-the-Ear (ITE) Hearing Aids – This hearing aid fills the entire concha (bowl) of the outer ear and a portion of the ear canal. ITE hearing instruments can be worn by patients with hearing losses ranging from mild to severe.
3. In-the-Canal (ITC) Hearing Aids – This hearing aid fits in the ear canal with only a slight protrusion in the concha portion of the outer ear. Additional cost must be considered with the purchase of this aid. Power is limited due to size, but can be used by patients with mild to moderate hearing losses.
4. Completely-in-the-Canal (CIC) Hearing Aids – This hearing aid fits deeply into the ear canal and is barely noticeable in most ears. As with the ITC hearing instrument, additional cost must be considered and power is limited even further. This hearing instrument can be fit on patients with mild to moderate hearing losses.
Electronic Features of Hearing Instruments:
1. Conventional technology: This hearing aid has a volume control that allows you to either make sounds louder or make sounds softer. Sometimes you must react quickly to adjust the volume control. All sounds within the speech range are amplified. Because of this, some patients feel these provide either too little or too much sound. Although this technology is very limited in what it can do, it is very appropriate for some hearing losses.
2. Digital technology: This hearing aid processes sound similar to the digital processing found in computers, compact disc players and cellular phones. Digital hearing aids automatically adjust volume. They measure and adjust sound by analyzing it many times per second which improves sound quality.
a. Low End Digital: provides good sound quality in typical situations; soft sounds are audible and loud sounds are not uncomfortable
b. Mid Level Digital (Advanced): Excellent performance in noise with a fixed directional microphone (fixed directionality to reduce noise from behind); excellent listening comfort in noise; excellent sound quality in most situations; excellent audibility of soft speech sounds
c. High End Digital (Premium): Exceptional performance in noise with adaptive directionality to track noise and reduce its volume; exceptional listening comfort in noise; exceptional sound quality almost anywhere; exceptional audibility of the softest sounds
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Pediatric Audiology
Hearing loss in children is a silent, hidden handicap. This is because children cannot tell us they are not hearing well. If undetected and untreated, hearing loss in children can lead to delayed speech and language development, social and emotional problems, and academic difficulties.
Facts:
- 1 in every 1000 infants born in the U.S. has severe or profound hearing loss.
- Over 1 million children in the U.S. have a hearing loss
- 2 children in every 1000 will acquire deafness in early childhood.
- 1 child in 50 from intensive care nurseries will be hearing impaired.
- Ear infections are the most common infectious disease of childhood.
Risk Factors for infants age 29 months to 3 years requiring a hearing screening:
- Parent/Caregiver concern regarding hearing, speech, language, and/or developmental delay
- Family history of permanent childhood hearing loss
- Bacterial meningitis and other infections associated with sensorineural hearing loss
- Recurrent or persistent otitis media with effusion lasting for at least three months
- Head trauma with loss of consciousness or skull fracture
- Characteristics associated with a syndrome known to include sensorineural and/or conductive hearing loss
- In utero infections including cytomegalovirus, herpes, rubella, syphilis, and toxoplasmosis
- Neonatal indicators such as hyperbilirubinemia and persistent pulmonary hypertension
- Ototoxic medications and various diuretics
Normal development of speech, language and hearing includes:
Birth to 3 months:
- startles to loud sounds
- increases or decreases in sucking behavior in response to sound
- quiets or smiles when spoken to
- makes pleasure sounds as in cooing
- cries differently for different needs
4-6 months:
- moves eyes in direction of sound
- responds to changes in tone of your voice
- pays attention to music
- notices toys that make sound
- babbling sounds more speech like (“bababa”, “mamama”, “dadada”)
- vocalizes excitement and displeasure
7 months to 1 year:
- listens when spoken to
- turns and looks in direction of sound
- begins to respond to requests
- imitates different speech sounds
- uses speech sounds to get attention
1-2 years:
- can point to a few body parts
- can follow simple demands
- will listen to simple stories and songs
- can point to pictures in books when named
- vocabulary gets larger each month
- can put 2 words together
2-3 years
- can follow 2 requests
- understands differences in meaning (big-little, up-down)
- has a word for most objects
- uses 2-3 word sentences
- speech is typically understood by familiar listeners
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Audiology Links
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