Audiograms Degree, Type and Configuration Lecture 3

Degree of HL – Normal Normal Hearing Average Speech Level

Degree of HL – Mild Loss Average Speech Level

Degree of HL – Moderate Average Speech Level l

Degree of HL–Moderately Severe Average Speech Level

Degree of HL - Severe Normal Hearing Average Speech Level l

Audiogram - Profound Normal Hearing Average Speech Level

Degree of HL– Mild to Moderate Average Speech Level

Degree of HL–Moderate to Severe Average Speech Level

Degree of HL Average Speech Level

Example Audio – AC for LE and RE Degree of HL for RE and LE?

Example Audio Degree of HL for RE and LE

Type of Hearing Loss Mixed HL Conductive HL Sensorineural HL

Describing HL: TYPES Conductive Sensorineural Mixed HL resulting from damage to the inner hair cells or hearing nerve Usually permanent Results in attenuation AND distortion of sound HL resulting from disorder of the outer and/or middle ear which interferes with transmission of the sound Usually treatable Results in attenuation of sound Mixed

Conductive Hearing Loss

Diagnosing Conductive Hearing Loss AC responses are _________________ BC responses __________________ The difference between the air to bone conduction responses is > than 10 dB HL (Air Bone Gap)

Sensorineural Hearing Loss

Diagnosing Sensorineural Hearing Loss AC responses are _________________ BC responses are _______________ When compare AC and BC pure-tone thresholds, BC responses should be similar to AC BC < or equal 10 dB of AC responses

Mixed Hearing Loss

Diagnosing Mixed Hearing Loss Reduction in_______ responses Reduction in _______ responses An AC to BC difference is present Degree of HL ranges from mild to severe in degree Tympanometry responses typically abnormal Otoscopy can be abnormal or normal

Example Audios (separate audiograms) Degree of HL for LE and RE Type of HL for LE and RE

Example Audio Estimate degree and type of HL for RE and LE

What type of HL?

Configuration Shape of HL as reflected by AC thresholds Gives an overall pattern and additional clue about underlying etiology Eg. Most HL in older adults, hearing is mostly worse in the High freq than the low freq Most persons with OM have low freq HL

Configuration Descriptions used Flat Rising (Low Freq) Sloping (High Freq) Precipitous Notch Corner Cookie Bite, Saucer Symmetry Unilateral Bilateral

Unilateral vs bilateral vs symmetrical

Configuration

Explaining Audiograms Provide privacy for explanation Refer to graph Low to high frequencies soft to loud intensity Review normal range Review results for each ear Degree of HL Type of HL Configuration of HL

Count the Dots Audiogram Quantifies what is audible Used to predict speech understanding Emphasize the importance of a particular frequency relative to the contribution of understanding speech Count the number of dots below the hearing levels plotted on audiogram Bottom Line: Some frequencies more important than others for speech recognition

Count the Dot Audiogram to calculate how much of speech is audible (aka Articulation Index) (Mueller and Killion, 1990)

Updated Count the Dots

Self Assessment Questions Can I describe an audiogram form? Can I identify where speech sounds fall in relation to an audiogram? Consonants, vowels, key speech cues for low, mid and high frequencies Can I interpret an audiogram for degree, type and configuration? Can I plot an audiogram given the description of degree, type and configuration? Can I calculate an AI on a count the dot audiogram?

1 minute evaluation What can you apply when you leave this room? What was the most important thing you remember learning today? What one question would you like reviewed related to what was discussed ? What can you apply when you leave this room?