Download Fitting amplification on Conductive Hearing loss

FITTING AMPLIFICATION ON
CONDUCTIVE HEARING LOSS
CASE PRESENTATION
KATHLEEN HAUSBECK-MILLER AU.D
PATIENT “O”
• Referred originally by The Newborn Hearing Screening Program at her local
hospital.
• Parent reported she consulted the pediatrician who told her “not to worry”,
“nothing is wrong” No rescreen was recommended
• Parent began to be concerned regarding child’s lack of response to her voice
• Also concerns regarding speech/language were noted
• I saw patient “O” for an evaluation when she was 18 months old.
• Results via VRA in the soundfield were consistent with a moderately-severe
rising to mild hearing loss for at least the better ear
• Ear specific testing was attempted with Insert earphones but patient would not
tolerate
• SDT was noted at 45 dB HL
• Tympanograms were Type B bilaterally suggestive of middle ear effusion
• OAE’s were absent bilaterally
• Referral was made for medical management
• Patient returned 6 weeks later
• Tympanograms continued to indicate middle ear effusion for each ear
• Hearing levels improved 10-15 dB
• Referred to ENT
• PE tubes inserted at age 21 months
• Post op audiogram indicated responses in the soundfield between 20-25 for at least
the better ear
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We put patient on 6 month routine monitoring schedule
Patient continued to have chronic otitis media bilaterally
By age 2 ½ the PE tubes again extruded and left bilateral TM perforations
Audiogram indicated a mild conductive hearing loss for the left ear and a mild to
moderate conductive hearing loss for the right ear
• ENT recommended a 6 months wait to see if perforations would heal
• Child began speech/language therapy due to articulation errors
• The perforations did not heal and amplification was recommended
• Fit child at age 3 with binaural amplification
• Aided responses were excellent
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Tympanoplasty performed at age 4 years
An evaluation 6 weeks post-op indicated mild conductive hearing loss bilaterally
Tympanograms were consistent with continued TM perforations
Tympanoplasty was unsuccessful 
Hearing and hearing aids were monitored every 3-6 months
At age 5, the left TM perforation healed on its own, but mild hearing loss in that ear
persisted
• At age 7, the left ear perforated again
Today, the patient is 11 years old and the TM
perforations persist, with a moderate rising to
mild conductive hearing loss for the left ear and
a moderately-severe rising to mild conductive
hearing loss for the right ear.