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'cochlear implant evaluation'
Pediatric Hearing Evaluation is one of the challenging task for every audiologist. Detailed case history, selection of appropriate physiological electrophysiological and behavioural testing is a key. Established hearing thresholds helps us select proper hearing aid and auditory training/ auditory verbal therapy approach. Child need to be evaluated subsequently to measure the benefit of amplification device and therapy. If no significant benefit is obtained by hearing aid further, child should be subjected to cochlear implant evaluation. Aided Audiogram, radiological study and therapists feedback helps team to consider the child for cochlear implant. Cochlear implant has really changed the world of children with hearing impairment. The goal of team is to integrate the child in mainstream and should get every opportunity as any other child with normal hearing. #brainstem evoked response #otoacoustic emission #Digital Hearing Aid #Aided audiogram #auditory Verbal therapy
Auditory neuropathy/auditory dyssynchrony (AN/AD) is a condition that affects the neural processing of auditory stimuli. Patients with AD/AN are able to respond to sounds accurately but their ability to decode speech and language is affected. AN/AD has only recently been described. In the late 1970s, clinical investigators began to describe groups of patients with normal or slightly elevated audiogram pure tone thresholds accompanied with absent or severely abnormal auditory brainstem responses (ABRs). With the advent of the otoacoustic emissions (OAEs) in the mid 1980s, these groups of patients were found to have normal cochlear function. The finding of normal cochlear function accompanied with abnormal brainstem responses was defined in 1996 as auditory neuropathy (AN). Whether this represents a true auditory nerve neuropathy is debatable. Further investigations led to the conclusion that AN may truly represent a dyssynchronous auditory nerve rather than a neuropathy. This finding gave rise to the newer term of auditory dyssynchrony (AD). [1] For the purposes of this summary, AN and AD are considered synonymous (ie, AN/AD). Now a days this condition commonly known as Auditory Neuropathy Spectrum Disorder (ANSD). Rather than just considering a condition some of researchers have labeled as syndrome. Treatment for ANSD is varies case to case and needs lot of trial and error method. Hearing aids have been effective of some of the cases where as cochlear implant is also being recommended strongly and found to be effective. Very short number of cases donot really benefits from above two option those advised to use communication strategies to be able to understand speech.
Voice Disorders Voice disorders are medical conditions involving abnormal pitch, loudness or quality of the sound produced by the larynx and thereby affecting speech production. Disorders are categorized in organic, psychogenic, functional and neurological. organic are vocal cord nodules, cysts, polys etc functional meaning voice box is normal but mechanism is being used improperly or inefficiently. psychogenic means due to some reason patient is unable to produce the voice in spite of normal laryngoscopy findings neurological disorders involves palsy, paresis, spasmodic dysphonia, Parkinson disease, other neurological diseases #Voice Therapy # ENT evaluation # Voice Evaluation
Ototoxicity (oto-means ear and toxic means side effect) Ototoxicity means certain drugs used to treat certain medical conditions in the body has a side effect on hearing or balancing organ situated in the inner ear. The effects of ototoxicity can be reversible and temporary, or irreversible and permanent. Hearing loss caused by this kind of medication tends to develop quickly. The first symptoms usually are ringing in the ears (tinnitus) and vertigo. Hearing usually returns to normal after you stop taking the medicine. But some medicines can cause permanent damage to the inner ear. Early intervention plays a key role in improving speech understanding. hearing loss will be treated either by bilateral Digital Hearing Aid fitting or cochlear implants. Hearing aid benefit depends on the site of damage in the inner ear or nerve.
Speech Banana The speech banana is a area in which all the speech sounds of the language fall on an audiogram. An audiogram is a graphical representation of a person's hearing sensitivity at a range of frequencies and loudness levels, and it is generally presented with frequencies (in Hertz on the x-axis and decibel level (dB) on the y-axis. When the sounds of speech or phonemes of all known human languages are plotted on an audiogram, they cluster in a banana-shaped region known as the speech banana. People with normal hearing sensitivity can also hear sounds outside of the speech banana. These sounds include ambient natural sounds such as a rustling of leaves in the wind or birds chirping. Artificial sounds outside of the speech banana can include music and mechanical noises (e.g., automobiles, lawn mowers). Audiologists are primarily concerned with hearing loss that occurs within the speech banana because it can slow the development of a child’s language and speech abilities, and this in turn can profoundly interfere with learning. Hearing loss within the speech banana can also hinder communication capabilities in adults, as in elderly people with age-related hearing loss. Benefit of the hearing aid also showed with the help of speech banana. If all the aided (speech and tone) fall with the banana then we consider as significant benefit from the device. If not child or adults will be evaluated for other hearing devices options like, Cochlear implant.