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'pure tone audiogram'
Pure tone Audiometery Pure-tone audiometry is a behavioral test used to measure hearing sensitivity. This measure involves the peripheral and central auditory systems. Pure-tone thresholds (PTAs) indicate the softest sound audible to an individual atleast more than 50% of the time. Hearing sensitivity is plotted on an audiogram, which is a graph displaying intensity as a function of frequency. Degrees of hearing loss Normal hearing (0-15 dB): At this level, hearing is within normal limits. Types of Hearing loss Conductive Sensorineural Mixed modalities of tone presentation are air and bone conduction. PTA is gold standard test in diagnostic audiology. Advantages of PTA - Medico-legal Purpose - Qualitative and Quantitative analysis - Pre and post operative comparison
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.
#Otitis Media It is an inflammation in the middle ear (the area behind the tympanic membrane) that is usually associated with the fluid accumulation Fluctuating hearing loss nearly always occurs with all types of otitis media. In fact it is the most common cause of hearing loss in young children If this hearing loss is untreated repetitively will have difficulty in auditory processing please consult ENT/Audiologist for more details #Pure tone Audiogram
Cleft and Hearing Loss The hearing loss in a cleft patient is a well known documented, but generally gets ignored. These children continue to have recurrent otitis media with effusion that affects the hearing abilities. Unfortunatley the middle ear function may not improve with palatoplasty. Cleft palate teams need to follow up all such children beginning at birth and going into adulthood, decades after a ‘successful’ palate repair. These patients should have careful otological and audiological surveillance with appropriate interventions whenever required. untreated and fluctuating hearing loss has impact on speech, language, social an academic progress. # pure tone audiogram, impedance testing, brainstem evoked response
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.