Say What?! A discussion on hearing loss, hearing aids and implant - PDF document

6/10/2016 Say What?! A discussion on hearing loss, hearing aids and implant options Why Talk About Hearing? • Hearing loss is the 3rd most prevalent disabling condition with advanced age (#1 Arthritis, #2 Hypertension) • About 20% of adults in the U.S. (48 million) report some degree of hearing loss • 60% of the people with hearing loss are either in the workforce or in educational settings • In older people, a hearing loss is often confused with, or complicates, conditions such as dementia. • About 2-3 out of every 1,000 children are hard of hearing or deaf • Some hearing loss can be PREVENTED. Available from Internet on January 21: http://www.hearingloss.org Why Talk About Hearing? “Blindness separates us from things, but hearing loss separates us from people” – Helen Keller 1

6/10/2016 Overview 1. How the ear works 2. Hearing evaluation process 3. Interpretation of the hearing evaluation 4. Current hearing aid technology 5. Communication strategies 6. Community resources HOW THE EAR WORKS Two Systems Peripheral System consists of: – The Outer Ear – The Middle Ear – The Inner Ear The Central System – Brainstem – Auditory Cortex (Temporal Lobe) 2

6/10/2016 Three Parts of the Peripheral System Available from Internet on January 21: http://enriquem12bio.wikispaces.com/5.+THE+STRUCTURE+AND+FUNCTION+OF+THE+HUMAN+EAR Peripheral Auditory System Available from Internet on January 21: http://enriquem12bio.wikispaces.com/5.+THE+STRUCTURE+AND+FUNCTION+OF+THE+HUMAN+EAR Systems of the Inner Ear Available from internet on January 21: http://hyperphysics.phy-astr.gsu.edu/hbase/sound/eari.html 3

6/10/2016 Normal & Abnormal Outer Hair Cells Available from internet on January 21: http://www.pnas.org/content/97/13/6939/F1.expansion.html. Primary Auditory Cortex Available from internet on January 21: http://dspace.jorum.ac.uk/xmlui/bitstream/handle/123456789/965/Items/SD329_1_section17.html Available from internet on January 21: http://en.wikipedia.org/wiki/File:Primary_auditory_cortex.PNG HEARING EVALUATION 4

6/10/2016 Warning Signs of Hearing Loss • Asking for repetition • Turning up the TV • Tinnitus that is constant or occasional • Slight muffling of sound • Speech is difficulty to hear in noisy social environments Complete Hearing Evaluation Tests often included: – Collection of case history – Otoscopy – Immittance testing – Pure tone testing – Speech testing Immittance Testing • Used to test the status of the middle ear system • This is NOT a hearing test! • Three measurements: – Tympanometry – Acoustic reflex – Acoustic reflex decay 5

6/10/2016 Pure Tone & Speech Testing • Conducted in the sound booth • Air Conduction vs. Bone Conduction • Several beeps will be presented at varying pitches and volume levels • Goal: find the softest level that you can hear at each pitch • Speech Testing • Repeat a list of words for each ear • Goal: understand the difficulties experienced by the patient when understanding speech Classification of Hearing Loss Types of Hearing Loss Three types of loss – Sensorineural • Cause of loss is located in the inner ear or 8 th nerve – Conductive • Cause of the loss is located in the outer or middle ear – Mixed • Cause of the loss is both a conductive and sensorineural 6

6/10/2016 Causes of Conductive Hearing Loss • Fluid in the middle ear from colds • Allergies • Impacted earwax • Foreign body in the ear canal • Otosclerosis Causes of Sensorineural Hearing Loss • Noise (exposure to loud noise) • Aging (presbycusis) • Genetic hearing loss • Head trauma • Virus or disease • Combination of causes Degree of Hearing Loss Normal Hearing 0-25 dB Mild Hearing Loss 26-40 dB Moderate Loss 41-55 dB Moderately Severe 56-70 dB Severe 71-90 dB Profound > 90 dB 7

6/10/2016 Configurations of Hearing Loss • Shape of the hearing loss • Types of configurations http://hubpages.com/hub/The-Best-Hearing-Loss-Simulations-Understanding-Audiograms-and-the-Impact-of-the-Speech-Banana 8

6/10/2016 Current Hearing Aid Technology Hearing Aid Styles Behind the Ear Receiver in the Ear Lyric Full Shell ITE Half Shell ITE Completely in Canal Available from internet on May 20: http://www.phonak.com/ Different Levels of Technology Economy Basic Advanced Premium 9

6/10/2016 Current Implant Technology Types of Implants • Middle Ear Implants • Moderate to severe sensorineural hearing loss • Auditory Brainstem Implant • Typically used for patients with neurofibromatosis 2 (NF2) • Bone Anchored Hearing Aids (BAHA) • Adults or children with conductive hearing loss • Cochlear Implants • Adults or children with severe to profound sensorineural hearing loss Available from internet on May 20: www.hearlifeclinic.ae 10

6/10/2016 Available from internet on May 20: speech-language-pathology-audiology.advanceweb.com & sciteech.com Available from internet on May 20: umm.edu, ais.southampton.ac.uk, www.midwesthearingconsultants.com, www.audiologyonline.com Available from internet on May 20: mommyspeechtherapy.com, gigaom.com 11

6/10/2016 Community Resources Utilize Community Resources Places that offer Assistive Listening Devices: • Movie theaters • Churches • Century Link Center • Orpheum Theater Available from internet on May 20: https://marcustheatres.com/Movie/Captions/ Other Assistive Technology • Alarm Clocks • Fire/CO Alarms • Weather Alert • Television • TV Ears, Closed Captioning, Amplifiers • Telephones/Cell Phones • Amplified ringers, visual alerts, vibrating alerts, amplified phones, Bluetooth connections Available from internet on January 21: http://www.harriscomm.com/equipment.html 12

6/10/2016 Community Organizations Other Resources: • Nebraska Commission for the Deaf and Hard of Hearing (NCDHH) • Nebraska Department of Education Vocational Rehabilitation (VR) • Assistive Technology Partnership • Local Hearing Aid Banks • Sertoma, Lion’s Club, HearU Questions? Ashton Lampe, Au.D. Phone: (402) 559-5208 Email: alampe@nebraskamed.com 13