Overview

This book bridges the gap between theory and clinical application for electro-acoustic and electro-physiologic assessment of hearing loss across the age range. Strategies and techniques for screening and diagnosis of hearing loss are presented clearly and simply. The authors incorporate findings of accumulated clinical experience and recent clinical research in a readable review of electro-acoustic measures (immittance measures and otoacoustic emissions) and electro-physiologic measures (electrocochleography, ABR and ASSR) that are essential for best practice in audiology today. This book is a one-stop resource for clinicians who are responsible for the diagnostic auditory assessment of children and adults.

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Review

• Ryan McCreery, M.S. (Boys Town National Research Hospital), Doody's Review Service, (2010):
  "The book is squarely aimed at providing students with an introduction to the clinical application of objective auditory tests. The authors succeed in providing an in-depth discussion of important concepts, while maintaining a practical focus."

Audience

Primary Subject: Audiology / Neuroaudiology
Audience Level: Professional/Textbook - 90 Days

• Chapter 1: Rationale for Objective Hearing Assessment
  • Differentiate screening versus diagnostic measures
  • Differentiate auditory dysfunction vs. hearing sensitivity vs. hearing
  • Cross-check principle revisited … test battery approach (classic quote)
  • What we need to get from a hearing assessment
    Degree of hearing loss
    Configuration
    Symmetry
    Frequency specific thresholds
    Ear specific thresholds
    Valid and reliable measures
  • Clinical limitations of behavioral audiometry
    Age
    Neurological immaturity
    Sensitivity and specificity
  • Identification (screening) of hearing loss (auditory dysfunction)
    Distinguish between auditory vs. hearing sensitivity vs. hearing (cortical function)
    Purpose of hearing loss identification
    Principles of screening
    Principles of sensitivity and specificity
    Options for screening
  • Factors influencing hearing loss identification
    Age
    State of arousal
    TABLE for all techniques
  • Estimation of hearing thresholds
    Purpose of hearing threshold estimation with electro acoustic techniques
  • Factors influencing hearing threshold estimation
    Age
    State of arousal
    TABLE for all techniques
• Chapter 2: Immittance Measurements
  • Introduction and historical perspective
  • Anatomy and physiology in a nutshell (Figures)
  • Identification of hearing loss (screening)
    Tympanometry
    Single vs. multi-component
    Low vs. high frequency probe tone
    Jerger classification
    ASHA guidelines
    Gradient
  • Wide Band Reflectance
  • Acoustic reflex thresholds for broad-band noise signals
  • Estimation of hearing loss
  • Sensitivity Prediction by Acoustic Reflex (SPAR)
  • Other acoustic reflex predictive techniques
    Acoustic reflex thresholds for broad-band noise signals
  • Clinical considerations and constraints (TABLE)
    Subject factors (list as many as possible)
  • Pathologic factors (list as many as possible)
    Summary of clinical application
• Chapter 3: Otoacoustic Emissions (OAEs)
  • Screening for hearing loss
    Transient OAEs (TEOAEs)
    Distortion product OAEs (DPOAEs)
    Automated techniques
  • Estimation of hearing loss
    Relation of OAEs to the audiogram
    Statistical attempts to estimate hearing loss with OAEs
  • Clinical considerations and constraints
    Subject factors
    Pathologic factors
    Auditory neuropathy
    Summary of clinical application
• Chapter 4: Electrocochleography (ECochG)
  • Identification of hearing loss
  • Estimation of hearing thresholds
    Electrode options
    Dynamic range for intensity
    Frequency specificity
    Clinical considerations and constraints
    Subject factors
    Pathologic factors
    Sedation and anesthesia
    Auditory neuropathy
    Summary of clinical application
• Chapter 5: Auditory Brainstem Response (ABR)
  • Screening for identification of hearing loss
    Automated ABR
    Detection algorithms and techniques
  • Estimation of hearing thresholds
    Stimulus options
    Tone-burst ABRs
    Latency-intensity functions
    Bone conduction ABRs
  • Clinical considerations and constraints
    Subject factors
    Pathologic factors
    Sedation and anesthesia
    Alternative non-sedation strategies
    Auditory neuropathy
    Summary of clinical application
• Chapter 6: Auditory Steady State Response (ASSR)
  • Background to the ASSR
  • Defining the ASSR
    Response physiology
    Neural generators
    Stimulus characteristics
    Type of stimuli
    Presentation of stimuli
    Clinical stimulus protocols
    Response measurement
    Improving the signal-to-noise ratio
    Clinical recording protocols
    Response analysis
    Spectral analysis
    Phase analysis
    Considerations in analysis
  • Estimating hearing thresholds
    General subject factors
    Hearing loss characteristics
    Bone conduction
    Sound-field measurements
    Sedation & anesthesia
    Remaining clinical questions
  • Summary of clinical application
• Chapter 7: Recommendations for Objective Identification and Estimation of Hearing Loss
  • Guidelines, recommendations, and standard of care
  • New directions for research
  • Combined OAE/ABR hearing screening technique
    Infants
    Pre-school and school-age children
    Adults
  • Test battery approach for estimation of hearing loss
    Children
    Adults
  • Once again … what we need to get from a hearing assessment
  • Advantages of electro-acoustic and electro-physiologic measures
• Chapter 8: Illustrative Case Reports and Clinical Findings
  • Normal hearing
  • Conductive hearing loss
  • Sensory hearing loss
  • Auditory neuropathy
  • Complex case
  • HIV
• REFERENCES
• APPENDICES
  • A. Clinical forms
  • B. Normative data

About The Authors

James Hall III, Ph.D.

Dr. James W. Hall III is Clinical Professor in the Department of Communicative Disorders at the University of Florida in Gainesville, where he maintains a clinical practice and is an instructor in the Doctor of Audiology on-site and distance learning programs.

Dr. Hall’s main research interests are auditory neurophysiology, auditory processing disorders, early identification of hearing loss in infants, and tinnitus/hyperacusis. Dr. Hall lectures internationally on these topics. He is the author of numerous journal articles, monographs, or book chapters, as well as the Handbook of Auditory Evoked Responses and Audiologists’ Desk Reference Volumes I and II, the Handbook of Otoacoustic Emissions and the New Handbook of Auditory Evoked Responses.

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De Wet Swanepoel, PhD

De Wet Swanepoel, PhD, is an Associate Professor and clinical research audiologist at the Department of Communication Pathology, University of Pretoria, South Africa, and Adjunct Professor at the University of Texas at Dallas, Callier Center for Communication Disorders. His research and clinical interests are in the field of early identification and diagnosis of infants with hearing loss, including electro-physiologic and electro–acoustic assessment procedures. Dr. Swanepoel also has an interest in auditory functioning in special populations such as persons infected with HIV/AIDS. He has received several awards and research grants for his work in these areas from institutions like the Medical Research Council and National Advisory Council on Innovation. He has published numerous peer-reviewed articles and regularly presents at international conferences. He is also a regional editor for the International Journal of Audiology and reviews for several international journals.

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