Clinical Audiology: An Introduction, 2nd Edition

Front Cover......Page 1
Title Page......Page 4
Copyright......Page 5
Contents......Page 6
Preface......Page 20
About the Author......Page 24
Acknowledgments......Page 26
1 THE PROFESSION OF AUDIOLOGY IN THE UNITED STATES......Page 30
Learning Objectives......Page 31
What Is an Audiologist?......Page 32
What Is an Audiologist's Role?......Page 33
Treatment......Page 34
Prevention......Page 36
Scope of Practice......Page 37
Where Do Audiologists Practice?......Page 39
Private Practice......Page 40
Physician's Practices......Page 42
Hospitals and Medical Centers......Page 43
Schools......Page 44
Universities......Page 45
Hearing Instrument Manufacturers......Page 46
Industry......Page 47
Otolaryngology......Page 48
Other Medical Specialties......Page 50
Speech-Language Pathology......Page 51
Other Professionals......Page 53
The Professional Heritage of Audiology......Page 54
The Clinical Heritage of Audiology......Page 57
Becoming an Audiologist......Page 62
Academic and Clinical Requirements......Page 63
Summary......Page 64
Short Answer Questions......Page 66
Resources......Page 67
2 THE NATURE OF HEARING......Page 69
Learning Objectives......Page 70
What Is Sound?......Page 71
Properties of Sound......Page 74
The Auditory System......Page 84
Outer Ear......Page 85
Middle Ear......Page 88
Inner Ear......Page 90
Auditory Nervous System......Page 100
The Vestibular System......Page 105
Anatomy......Page 106
Physiology......Page 108
Absolute Sensitivity of Hearing......Page 110
Differential Sensitivity......Page 118
Properties of Pitch and Loudness......Page 121
Measurement of Sound......Page 122
Summary......Page 125
Short Answer Questions......Page 126
Resources......Page 128
3 THE NATURE OF HEARING LOSS......Page 129
Types of Hearing Disorder......Page 130
Hearing Sensitivity Loss......Page 131
Suprathreshold Hearing Disorder......Page 139
Functional Hearing Loss......Page 145
Impact of Hearing Disorder......Page 146
Patient Factors......Page 147
Degree and Configuration of Hearing Sensitivity Loss......Page 148
Type of Hearing Loss......Page 155
Summary......Page 159
Short Answer Questions......Page 160
Discussion Questions......Page 162
Resources......Page 163
4 CAUSES OF HEARING DISORDER......Page 164
Auditory Pathology......Page 165
Congenital Outer- and Middle-Ear Anomalies......Page 167
Impacted Cerumen......Page 170
Otitis Media with Effusion......Page 172
Complications of OME......Page 176
Otosclerosis......Page 179
Other Middle-Ear Disorders......Page 180
Congenital and Inherited Sensory Hearing Disorders......Page 182
Acquired Sensory Hearing Disorders......Page 188
Neural Hearing Disorders......Page 206
Auditory Neuropathy......Page 207
VIIIth Nerve Tumors and Disorders......Page 208
Brainstem Disorders......Page 210
Other Nervous System Disorders......Page 211
Vestibular Disorders......Page 212
Benign Paroxysmal Positional Vertigo......Page 213
Vestibulotoxicity......Page 214
Summary......Page 215
Short Answer Questions......Page 217
Articles and Books......Page 220
Web Sites......Page 224
5 INTRODUCTION TO HEARING ASSESSMENT......Page 225
Learning Objectives......Page 226
Referral-Source Perspective......Page 228
Importance of the Case History......Page 230
The Audiologist's Challenges......Page 236
Evaluating Outer- and Middle-Ear Function......Page 237
Estimating Hearing Sensitivity......Page 241
Determining Type of Hearing Loss......Page 243
Measuring Speech Recognition......Page 246
Measuring Auditory Processing......Page 247
Measuring the Impact of Hearing Loss......Page 248
Screening Hearing Function......Page 250
Summary......Page 257
Short Answer Questions......Page 259
Articles and Books......Page 261
Web Sites......Page 263
6 THE AUDIOLOGIST’S ASSESSMENT TOOLS: PURE-TONE AUDIOMETRY......Page 264
The Audiometer......Page 265
Transducers......Page 267
Threshold of Hearing Sensitivity......Page 271
The Audiogram......Page 272
Modes of Testing......Page 273
Audiometric Symbols......Page 275
Audiometric Descriptions......Page 276
Establishing the Pure-Tone Audiogram......Page 281
Patient Preparation......Page 282
Audiometric Test Technique......Page 283
Bone Conduction......Page 285
Masking......Page 287
Audiometry Unplugged: Tuning Fork Tests......Page 294
Summary......Page 296
Short Answer Questions......Page 297
Resources......Page 300
7 THE AUDIOLOGIST’S ASSESSMENT TOOLS: SPEECH AUDIOMETRY AND OTHER BEHAVIORAL MEASURES......Page 302
Speech Audiometry......Page 303
Uses of Speech Audiometry......Page 304
Speech Audiometry Materials......Page 307
Clinical Applications of Speech Audiometery......Page 314
Predicting Speech Recognition......Page 329
Other Behavioral Measures......Page 331
Traditional Site-of-Lesion Measures......Page 332
Masking Level Difference......Page 335
Short Answer Questions......Page 336
Resources......Page 339
8 THE AUDIOLOGIST’S ASSESSMENT TOOLS: IMMITTANCE MEASURES......Page 342
Immittance Audiometry......Page 343
Instrumentation......Page 344
Measurement Technique......Page 346
Tympanometry......Page 347
Static Immittance......Page 354
Acoustic Reflexes......Page 356
Principles of Interpretation......Page 360
Middle-Ear Disorder......Page 362
Cochlear Disorder......Page 368
Retrocochlear Disorder......Page 374
Short Answer Questions......Page 380
Resources......Page 383
9 THE AUDIOLOGIST’S ASSESSMENT TOOLS: PHYSIOLOGIC MEASURES......Page 385
Auditory Evoked Potentials......Page 386
Measurement Techniques......Page 388
The Family of Auditory Evoked Potentials......Page 393
Clinical Applications......Page 399
Summary......Page 411
Otoacoustic Emissions......Page 412
Types of Otoacoustic Emissions......Page 413
Relation to Hearing Sensitivity......Page 417
Clinical Applications......Page 418
Summary......Page 421
Short Answer Questions......Page 422
Discussion Questions......Page 424
Resources......Page 425
10 DIFFERENT ASSESSMENT APPROACHES FOR DIFFERENT POPULATIONS......Page 427
Learning Objectives......Page 428
Outer- and Middle-Ear Disorders......Page 429
Cochlear Disorder......Page 437
Retrocochlear Disorder......Page 444
Adult Audiologic Referrals......Page 456
Younger Adults......Page 457
Older Adults......Page 460
Pediatric Audiologic Referrals......Page 466
Infant Screening......Page 467
Pediatric Evaluation......Page 473
Auditory Processing Assessment......Page 483
Functional Hearing Loss......Page 491
Indicators of Functional Hearing Loss......Page 494
Assessment of Functional Hearing Loss......Page 496
Summary......Page 504
Short Answer Questions......Page 505
Discussion Questions......Page 506
Resources......Page 507
11 COMMUNICATING AUDIOMETRIC RESULTS......Page 510
Goal of the Encounter......Page 511
Information to Convey......Page 512
Matching Patient and Provider Perspectives......Page 515
Documenting and Reporting......Page 517
Report Destination......Page 519
Nature of the Referral......Page 520
Information to Convey......Page 521
Sample Reporting Strategy......Page 538
Lines and Ethics of Referral......Page 545
When to Refer......Page 549
Summary......Page 553
Short Answer Questions......Page 554
Resources......Page 557
12 INTRODUCTION TO AUDIOLOGIC MANAGEMENT......Page 558
Learning Objectives......Page 559
The First Questions......Page 561
The Importance of Asking Why......Page 563
Assessment of Treatment Candidacy......Page 567
The Audiologist's Challenge......Page 574
Amplification—Yes or No?......Page 575
Amplification Strategies......Page 579
Approaches to Fitting Hearing Instruments......Page 583
Approaches to Defining Success......Page 585
Summary......Page 586
Short Answer Questions......Page 587
Resources......Page 589
13 THE AUDIOLOGIST’S TREATMENT TOOLS: HEARING INSTRUMENTS......Page 591
Learning Objectives......Page 592
Microphone and Other Input Technology......Page 595
Amplifier......Page 597
Controls......Page 602
Frequency Gain Characteristics......Page 606
Input-Output Characteristics......Page 608
Output Limiting......Page 613
Signal Processing......Page 614
Other Processing Features......Page 617
Hearing Instrument Systems......Page 618
Conventional Hearing Aids......Page 619
Hearing Assistive Technology......Page 629
Implantable Hearing Technology......Page 635
Summary......Page 644
Short Answer Questions......Page 645
Discussion Questions......Page 647
Resources......Page 648
14 THE AUDIOLOGIC TREATMENT PROCESS......Page 649
Hearing Aid Selection and Fitting......Page 650
The Prescription of Gain......Page 651
Hearing Instrument Selection......Page 655
Hearing Instrument Fitting and Verification......Page 656
Orientation, Counseling, and Follow-up......Page 671
Assessing Outcomes......Page 674
Auditory Training and Speechreading......Page 676
Educational Programming......Page 677
Summary......Page 678
Short Answer Questions......Page 679
Discussion Questions......Page 681
Resources......Page 682
15 DIFFERENT TREATMENT APPROACHES FOR DIFFERENT POPULATIONS......Page 684
Learning Objectives......Page 685
Adult Sensorineural Hearing Loss......Page 686
Geriatric Sensorineural Hearing Loss......Page 690
Pediatric Sensorineural Hearing Loss......Page 695
Auditory Processing Disorder......Page 702
Conductive Hearing Loss......Page 708
Severe and Profound Sensorineural Hearing Loss......Page 713
Summary......Page 722
Short Answer Questions......Page 723
Resources......Page 725
Appendix A: Scope of Practice in Audiology......Page 727
Appendix B: Audiology: Scope of Practice 2004......Page 731
Appendix C: Answers to Short Answer and Discussion Questions......Page 736
Glossary......Page 763
Index......Page 800