Download Homework 4 Case 1. Your patient is a 34-month

Homework 4
Case 1.
Your patient is a 34-month-old male who is brought to you by his parents. They are not certain whether a hearing loss is
present, although the child says “huh” a good deal. The father believes that the child “does not pay attention.” The child
has been “slightly behind” his two older, normal siblings (a boy and a girl) in his language development milestones. A
pediatrician has treated the child with antibiotics for “ear infections” on a few occasions, but more often for “tonsillitis.”
No marked temperature elevations were associated with these episodes, and the child is otherwise healthy. There is no
family history of hearing loss, although his father has difficulty understanding speech in groups and has a constant highpitched tinnitus since serving two years in the artillery. The child tired quickly before all the desired hearing tests could
be completed, but given the case history information and clinical findings, make your diagnosis and substantiate it.
Test
Right Ear
Left Ear
SRT
?
?
Word Rec Score ?
?
ARTs
(ipsilateral)
Absent
Absent
Static
compliance
0.25 cc
0.20 cc
ABR
All waves prolonged;
interpeak latencies normal;
latency-intensity function
normal
All waves prolonged;
interpeak latencies normal;
latency-intensity function
normal
DPOAE
?
?
What is the likely type of HL even though BC was not performed?
What would you predict for the SRT in each ear?
What would you predict for the word recognition score in each ear?
What would you predict for the DPOAE in each ear?
What is the likely etiology?
Case 2.
Your patient is a 19-year-old female college student. Her main complaint is a hearing loss that presents more difficulty in
hearing and understanding speech than in hearing environmental sounds. She has had this difficulty as long as she can
remember and does not believe it is getting worse. There are no known family members with a hearing loss, and she has
never had any ear infections, nor has she worn hearing aids. The patient’s speech is quite intelligible but there is some
distortion in the production of her sibilant sounds, and her vocal tone is rather monotonous. She managed to get good
grades in high school, but now that she is in college, she finds school much more difficult and believes it is because of
her hearing problem. You notice that she speaks rather loudly. Given the case history information and clinical findings,
make your diagnosis and substantiate it.
What type of tympanogram would you see with this audiogram?
What would the SRT be in each ear?
What level would you present word recognition testing at in each ear?
Transfer these thresholds onto an audiogram with a speech banana? (I do not need you to turn this in)

What speech sounds would this person miss with the current unaided hearing ability?
Case 3.
Your patient is a 16-year-old male who has had a hearing loss since early childhood when he became very ill with
bacterial meningitis. He was educated in schools for deaf children using a manual approach, although he does have
some speech. Use of amplification systems such as hearing aids and FM systems have consistently been unsuccessful.
Recently, his hearing was evaluated in the office of an otolaryngologist, who diagnosed a severe mixed hearing loss and
recommended either exploratory middle-ear surgery (due to the air-bone gaps) or powerful hearing aids. Given the case
history information and clinical findings, make your diagnosis and substantiate it.
See Audiometric Data
Test
Right Ear
Left Ear
SRT
100
95
SRS
Did not test
Did not test
ARTs (ipsilateral)
Absent
Absent
Static compliance
0.60 cc
0.57 cc
ABR
?
?
DPOAE
Absent
Absent
What would you expect to for pure tone air and bone conduction? Plot the results on an audiogram (but do not turn
this in)




Describe the degree of HL would you observe in each ear?
What type of HL would you observe?
What would you expect to see on the ABR in terms of the Wave V threshold?
Would you be able to ID any waveforms?