The client I observed today was a female in her late teens/early twenties. Her case history revealed noise exposure and intermittent tinnitus. Her noise exposure is from a history of playing the saxophone since the third grade. She still currently plays in a band. She notes that her tinnitus comes from both ears and is not a continuous noise. She did not report any instances of dizziness.
Otoscopy was normal for both ears. Tympanometry showed a normal type A tympanogram for both ears with all measures being within normal limits. From this point, testing was somewhat inconsistent. First speech testing was done. SRTs from the right ear first revealed 55dB. A restest also showed 55dB. The left ear was tested with a 15dB result. Puretone testing was then done. Puretone results showed a mild conductive loss in the left ear. SRTs were done again to show 5dB in the right ear and 15dB in the left ear. Discrimination was normal. The supervisor suggested that otosclerosis may be the cause. Otosclerosis in its early stages may show a conductive loss for frequencies between 250Hz and 1000Hz which was shown in this case (Hughes & Pensak, 2007) The client was referred to an ENT for an evaluation for the conductive component.
Technical problems may also have been an issue. The supervisor made this suggestion after the client had left. A thorough daily listening check may have helped assess this. Some testing did show that narrowband noise was not coming in until around 20-30dB.
The following site is a good reference for otosclerosis. The site is from the Boys Town Hospital. http://www.boystownhospital.org/Hearing/info/genetics/syndromes/otos.asp
References:
Hughes, G. B. & Pensak, M. L. (2007). Clinical otology. New York: Thieme Publishers, Inc.
Subscribe to:
Post Comments (Atom)
2 comments:
In situations where there are equipment malfunctions there should always be daily checks. If there are problems. We are service provider for the Audiology industry. www.4medtech.com
Wonderful article. The study also showed that there is little information on hearing conservation in hunter education training manuals. They also don't believe that their hearing loss comes from their hunting habits. From this experience, I believe ignorance is bliss for many. Education is the best way to reach these folks, and as an audiologist, it is our job to be the educators.
hearing aids
Post a Comment