Download REVIEW SHEET FOR CD 420

REVIEW SHEET FOR FINAL EXAM
CD 491
Format
Multiple Choice for case studies
multiple choice for audiograms
Comprehensive Concepts Expected
 Audiometric Interpretation,
appropriate symbols
 ID CHL, Mixed, and SNHL
 interpret immitance, ABR
findings and OAE or predict
results based on case history
Topics with more emphasis
 Disorders of the Outer Ear, Middle Ear, Inner Ear, Auditory Nerve – all of them!
o Describe characteristics
o Symptoms (what patient usually experiences or reports)
o Audiometric findings
o Interventions – only for those that were discussed
 Be able to differentiate genetic vs non genetic causes hearing loss
o Example: Genetic: syndromic and non-syndromic causes of HL
 familiarity with all of them, but only focus
focus in detail on the syndromes that were on the handouts provided.
 Audiologic Assessments:
o identify the purpose of each assessment, why is this test conducted?
o how is the test conducted
o subjective vs. objective
o special tests used in pediatrics
 Critical thinking of concepts
o Can you identify the disorder/common syndrome based on characteristics?
Example: vertigo, unilateral hearing loss, tinnitus ?
Example: white forelock, profound congenital SNHL ?
Example: gradual onset of CHL, paracusis willisi
Make up flash cards for yourself and test other partners
o Can you identify what the test results should look like for each disorder?
Example: Otitis Media, Auditory Neuropathy, Ototoxicity, Rubella, Presbycusis, etc…
 PTone Air
 PT Bone
 Speech recognition
 OAE
 Tympanometry
 ABR
 Otoscopy
o Can you form an impression about these case studies in terms of
1
 hearing described?
 etiology underlying hearing loss
 general symptoms
 general treatments
Example: Pure tone air and bone responses are outside normal limits and show no air bone gap,
Tympanometry is Type A, ABR testing revealed Waves !,III and V identified at 80 dB HL with
normal inter-wave intervals. Wave V was identified down to 50 dB HL.
What would these results mean?
Example: ABR testing revealed Waves I, III and V were identified at 80 dB HL and normal interwave intervals were obtained. Wave V was identified down to 20 dB bilaterally. Morphology was
judged to be good and all waves were repeatable.
What would these results mean?
Example: Pure tone air thresholds were obtained at 35 dB HL for the frequencies ranging from 2508000 Hz bilaterally. Pure tone Bone thresholds were obtained within normal limits for 250-4000 Hz
bilaterally. Tympanograms were type B bilaterally.
What do these results mean?
Example: OAE’s were present bilaterally. ABR testing revealed Wave I at normal values, with no
other waves identified. Tympanograms were type A bilaterally.
What do these results mean?
.
CASE 1 --A 1 year old girl presented to the clinic who was found to have a severe to profound sensorineural hearing loss
that was discovered when she was 8 months old. Her observation audiometry results are shown in Audiogram
1. She was fitted with hearing aids for amplification with which she made good progress in her speech and
language development. She has no family history of hearing loss and no history of middle ear infections. Her
parents noted that she appeared clumsy and that she was even late to walk (18 months).She is personable and
outgoing and loves the UK cheerleaders. By age 3, her hearing progressed (based on conditioned play
audiometry Audiogram 2) with word recognition scores of 40% in each ear using the WIPI. Her parents are
concerned about her decrease in hearing and wonder what could have caused it.
Which ear is better in Audiogram 1? and in Audiogram 2 ?
What is the PTA in the left ear and the Right ear?
What’s the difference in procedures used in audiogram 1 and audiogram 2?
What tympanogram would you predict?
Would you expect OAEs ?
What would you observe in ABR in terms of threshold of wave V?
What are some possible etiologies of this hearing loss?
2
CASE 2
Your patient is a seven-year-old female who failed the public school hearing screenings on two occasions. The
child’s parents have had her examined by an otologist, who reported that otoscopy was WNL and could find no
explanation for the apparent high-frequency hearing loss and has referred her to you for further study. The child
denies any difficulty in hearing. Before putting the earphones on, you notice that her ears do appear to be larger
than usual, but you proceed as usual. Given the case history information and clinical findings, make your
diagnosis and substantiate it.
What would you expect for word recognition?
What type of HL is present?
What would OAEs be?
What could be causing a HF conductive HL?
3
CASE 3
Your patient is a 39-year-old female who complains of a sudden hearing loss following an automobile accident
in which her car was struck from the rear. She also claims dizziness, severe bitemporal headaches, nausea, and
“blackout spells.” She did not mention tinnitus until asked about it during the history taking. There is no
reported family history of hearing loss, ear infections, or other symptoms that the patient now claims to
experience. She requests that a written report of your findings be sent to her for her “records.” Given the case
history information and clinical findings, make your diagnosis and substantiate it.
4
Case 4
A newborn male was seen for a hearing screening in the NICU just prior to hospital discharge at 5 weeks of age.
ABRs to click stimuli were not observable in either ear and therefore he failed the hearing screening. It was
recommended that he follow up with his primary care physician about the results. Birth history includes
delivery at 35 weeks gestational age, with a birthweight of 6 .8 pounds. The infant experienced respiratory
arrest at birth and he was diagnosed with persistent pulmonary hypertension and required prolonged mechanical
ventilation (22 days), In addition he presented with hyperbilirubinemia that required 3 exchange transfusions
and phototherapy. In addition, he received medications that included gentamiacin, vancomyacin and
furosemide.
At 3 months of age he was seen for follow up testing with ABR and OAE.

What factors put this child at risk for hearing loss?

What results would you predict for ABR based on this history?

What results would you predict for OAE based on this history?
The audiological findings are as follows
5
Right Ear
Left Ear
90 dB
80 dB
0 dB


How do you interpret these results for ABR
Why is there a tracing at 0 dB?

How do you interpret these results for OAE for each ear?

What type of behavioral responses do you think you’d get for pure tones.?
6
At 1 year he began having otitis media. He had 5 episodes within 3 months. And therefore PE tubes were
recommended. His parents reported that when he had otitis media, he did not consistently respond to sound, but
when he did not have an ear infection he was responding consistently.

What type of tympanogram must have occurred when he had ROM?

When the PE tubes are in place what type of tympanogram will you observe?
7