Clinical Services
Audiologists serve as the managers
of a patient's hearing health care. They are uniquely trained to
diagnose and counsel patients
concerning their most appropriate treatment options. Our practice
provides the most comprehensive
audiologic care that is performed anywhere in the United
States. Our services include both diagnostic and rehabilitative
including the fitting of hearing aids.
Diagnostic
Services:
Audiologists perform measurements
of the entire auditory system from the ear canal to the cortex
(brain) to provide a comprehensive assessment of a patent's
auditory or balance system. In this manner the appropriate
diagnosis and treatment plan can be initiated in order to resolve
a patient's concerns. The following procedures are included in
the audiologists scope of practice;
- Complete Diagnostic
Audiology - Evaluates the status of the auditory
system, revealing the degree and type of hearing loss.
This procedure is the introductory test that guides the
audiologist in determining the need for other protocols.
It also provides information as to whether or not a
patient has a medical problem causing the loss of hearing
or if the person has a non-medical etiology. This
procedure requires a one hour time period which allows
for counseling and discussion of the findings.
- Acoustic Impedance
Measurements - Determines the mobility of the
eardrum and associated middle ear bones. Many children
develop fluid behind the eardrum due to upper respiratory
infections. This procedure can make a direct measurement
of the middle ear system to rule out the possiblity of a
middle ear problem. Other disorders are also assocated
with middle ear dysfunction. This procedure requires a
five minute period.
- Auditory Brainstem
Response (ABR) - Measures the integrity of
the neurologic system leading from the inner ear
(cochlea) to the central auditory mechanism. This
procedure is used to assist in ruling out a lesion
affecting the central auditory nervous system. It is also
used in determining the hearing levels of children. This
procedure requires a one hour period.
- Otoacoustic Emissions
(OAE) - Measures the performance of the outer hair cells
of the inner ear. This procedure is extremely useful when
evaluating the hearing of young children. Pitch specific
information can be obtained in a very short period of
time. The first clinical application of Otoacoustic
Emissions began in the United States only within the past
several years. This procedure requires an actual test
time of 5-30 seconds per ear.
- Electronystagmography
(ENG) - Determines the status of the vestibular (balance)
system. This procedure is the primary method of
documenting a patient's dizziness. Ten percent of
complaints to an internal medicine doctor relates to a
concern about dizziness or vertigo. Many patients who
have dizziness experience problems when they rotate their
heads in different postions. This type of dizziness may
be caused by what is termed "postional vertigo"
that can be treated and cured by the audiologist with one
or two visits. The ENG procedure requires one hour and 15
minutes.
- Electrocochleography
(ECOG) - Measures the role of the inner ear for suspected
cases of Meniere's disease. This procedure can also track
the progress of other disorders that affect the organ of
corti. The Ecog procedure requires one hour.
- Loudness Mapping -
Determines the growth of loudness to various pitches. All
patients with a hearing loss due to a problem of the
inner ear (most common, 96%) have an abnormal loudness
perception. This measurement needs to be taken into
account when determining the appropriate type of hearing
aid system for a patient. This procedure requires 20
minutes.
- Tinnitus Evaluation
- Measures the pitch and loudness of "ringing in the
ears". Many patients with and without hearing loss
experience "ringing in the ears". This
evaluation determines the extent of the subjective
sensation and allows the audiologist to recommend a
treatment plan. This procedure requires 15 minutes.
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Rehabilitative
Services:
Following the inital evaluation,
should the audiologist determine that a patient has a non-medical
problem with their hearing, then a treatment option of using
hearing aids may be recommended. Just as with the case of all
electronics, hearing aids are "not what they used to
be". Many manufacturers produce devices that utilize
computer capabilities to enhance the processing of speech, making
soft sounds audible and loud sounds comfortable. No adjustment of
volume needs to be made by the patient. In addition, many
patients with this advanced technology report much better
understanding in the presence of noise. This includes noisy
restautants and other social situations. In order to
"prove" these enhancements in hearing, patients are
provided with a minimum of a three month trial period with
amplification to allow them to experience the difference.
Improved communication skills leads to a better and more complete
lifestyle. In this day and age of technology no patient with a
hearing problem should experience life in a confused
"sound" world. The following services are available to
the patient who wants to try a hearing aid:
- Real-ear Measurements
- Measures the performance of the hearing aid while the
patient is wearing the device. Since 1984, in the United
States, this measurement has been available to
objectively assess a patient's performance with a hearing
aid. The real-ear measurement system presents a broad
range of pitches to a patient and then displays a pitch
response of the amplification device. This is then
compared to a projected "target" reflecting the
idealized acoustic response. The hearing aid can then be
adjusted in order to maximize a patient's auditory
capabilities.
- Trial Period With
Amplificaiton - All patients receive a three month
trial period with amplification to insure satisfactory
benefit. Even with the advances in circuit design of
hearing aids, it is vital that the patient perceives an
improvement in their lifestyle with hearing aid use. Some
amplification devices provided by Audiology Associates,
Inc. are provided with an exclusive one-year satisfaction
guarantee. Patients with Hear For Life products have the
option of returning the device up to one year following
the inital fitting.
- Comprehensive Follow-up
Care - Receiving the correct circuit and obtaining
the appropriate acousitics from the hearing aid is the
inital first step in maximizing a patient's benefit from
amplification. However, obtaining the proper acoustics is
just the beginning. The treatment program for the hearing
aid patient must include through follow-up and monitoring
of benefit. Patients are seen at a minimum of three
visits in the first three months of inital use. Patients
that are fit with computerized hearing aids are seen more frequently for
adjustments and counseling. The hearing aid is just part
of the treatment plan for the patient with communication
difficulties.
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Current Hearing
Aid Technology
Audiology Associates, Inc.
utililizes a broad range of hearing aid manufactures in order to
best maximize a patient's benefit from amplification. The
circuits that are discussed below are available in a variety of
formats that will enhance the patient's benefit depending upon
indiviudual needs. It is useful to review the different levels of
technologies that are available to the audiologist.
Linear
Amplification
Linear circuits were
incorporated in the first type of electronic hearing aid
technology. They amplify sounds in a one-to-one relationship. As
the intensity of the sound increases going into the aid, the
exact same proportion of the sound exits from the aid. This
increase loudness continues until the maximum capability of the
aid is reached. This type of signal processing may be adequate
for some patients until loud sounds are introduced such as
background noises. When other noises are present, this type of
technology requires the patient to turn the hearing aid down with
the volume control (just like one uses a volume control for
television). This type of technology is still available, however,
Audiology Associates, Inc. rarely finds that this type of circuit
is appropriate in today's world.
Non-linear
Amplification
This type of
technology is available in many electronic designs. The overall
goal is to allow the hearing aid to regulate the growth in
loudness of sounds exiting from the aid. Therefore, as sound
increases going into the aid, there is not the same proportional
increase of sound coming out of the aid. Thus, the aid curtails
the loudness of the aid in a manner that never becomes too loud
to the patient. The aid stays within a comfortable loudness range
whether the person is in a quiet environment or in a noisy
restaurant.
These type of
circuits are available in two basic configurations. One is a
non-programmable device, a device that contains a preselected
circuit and the other is termed a programmable hearing aid. As
you may infer, the programmable device can be altered by the
audiologist in the office to best maximize a patient's benefit
from amplification. Programmable technology represents the
state-of-the art in signal processing and provides patients with
unmatched performance in a variety of listening situations. This
technology has been evolving since 1988 and at this time offers
the patient the best opportunity to maximize their communicative
abilities. One needs to experience the difference themselves in
order to fully appreciate the benefit. Audiology Associates, Inc.
offers their patients the opportunity to visit one of our offices
for a free demonstration of programmable technology.
For more information
concerning computerized programmable technology, please visit the
Resound Corporation's site or complete our information
request form.
If you have communicative
questions, we would be
happy to be of service.
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Copyright © 1997. All rights reserved.
