Audiology answers for otolaryngologists

121 Pages·2011·12.04 MB·English

Audiology Answers for
Otolaryngologists

Audiology Answers for
Otolaryngologists
Michael Valente, PhD
Director, Division of Audiology
Department of Otolaryngology–Head and Neck Surgery
Washington University School of Medicine
Saint Louis, Missouri
Elizabeth Fernandez, AuD
Clinical Audiologist, BJC Medical Group
Ballas ENT Consultants
Saint Louis, Missouri
Heather Monroe, AuD
Clinical Audiologist, Dizziness and Balance Center
Department of Otolaryngology–Head and Neck Surgery
Washington University School of Medicine
Saint Louis, Missouri
Thieme
New York ● Stuttgart
Thieme Medical Publishers, Inc.
333 Seventh Avenue
New York, NY 10001
Acquisitions Editor: Beth Campbell and Emily Ekle
Managing Editor: Dominik Pucek
Editorial Director: Michael Wachinger
Production Editor: Marcy Ross, MPS Content Services
International Production Director: Andreas Schabert
Compositor: MPS Content Services, A Macmillan Company
Printer: Sheridan Press
Library of Congress Cataloging-in-Publication Data
Valente, Michael.
Audiology answers for otolaryngologists / Michael Valente, Elizabeth Fernandez, Heather Monroe.
p. ; cm.
Includes bibliographical references and index.
Summary: “Audiology Answers is designed to supplement and reinforce the audiology compo-
nent of the otolaryngology/ENT resident training program. In addition, this book will be useful for
medical students doing otolaryngology clerkships, physicians of all specialties who see patients for
ear problems, and students enrolled in undergraduate communication sciences and graduate-level
speech-language pathology programs. Audiology students will also appreciate this quick-reference
source early in their training. The book will be written in Q/A format and generously illustrated.
The most commonly performed diagnostic tests will be covered, with emphasis given to those top-
ics that may be encountered in daily practice and that are most likely to appear on the otolaryngol-
ogy board exam”—Provided by publisher.
ISBN 978-1-60406-357-8 (alk. paper)
1. Audiology—Examinations, questions, etc. 2. Otolaryngology—Examinations, questions, etc.
I. Fernandez, Elizabeth, 1983- II. Monroe, Heather. III. Title.
[DNLM: 1. Hearing Disorders—Handbooks. 2. Audiology—methods—Handbooks. 3. Hear-
ing Impaired Persons—rehabilitation—Handbooks. 4. Hearing Tests—Handbooks. WV 39 V154a
2011]
RF291.3.V35 2011
617.80076—dc22
Copyright © 2011 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is le-
gally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits
set by copyright legislation without the publisher’s consent is illegal and liable to prosecution.
This applies in particular to photostat reproduction, copying, mimeographing or duplication of any
kind, translating, preparation of microfilms, and electronic data processing and storage.
Important note: Medical knowledge is ever-changing. As new research and clinical experience
broaden our knowledge, changes in treatment and drug therapy may be required. The authors and
editors of the material herein have consulted sources believed to be reliable in their efforts to pro-
vide information that is complete and in accord with the standards accepted at the time of publica-
tion. However, in view of the possibility of human error by the authors, editors, or publisher of the
work herein or changes in medical knowledge, neither the authors, editors, nor publisher, nor any
other party who has been involved in the preparation of this work, warrants that the information
contained herein is in every respect accurate or complete, and they are not responsible for any er-
rors or omissions or for the results obtained from use of such information. Readers are encouraged
to confirm the information contained herein with other sources. For example, readers are advised
to check the product information sheet included in the package of each drug they plan to admin-
ister to be certain that the information contained in this publication is accurate and that changes
have not been made in the recommended dose or in the contraindications for administration. This
recommendation is of particular importance in connection with new or infrequently used drugs.
Some of the product names, patents, and registered designs referred to in this book are in fact reg-
istered trademarks or proprietary names even though specific reference to this fact is not always
made in the text. Therefore, the appearance of a name without designation as proprietary is not to
be construed as a representation by the publisher that it is in the public domain.
Printed in the United States of America
5 4 3 2 1
ISBN 978-1-60406-357-8
Contents
Foreword by Joel Goebel and Timothy E. Hullar ............. vii
Foreword by J. Gail Neely .................................. ix
Preface .................................................. xi
Acknowledgments ...................................... xiii
1 Psychoacoustics ........................................ 1
2 Audiometric Testing ................................... 12
3 Vestibular Evaluation .................................. 42
4 Amplification .......................................... 75
Index .................................................... 97


Foreword
Patients seeking care from otolaryngologists for hearing and balance complaints
commonly present with complex problems, sometimes affecting multiple organ
systems. A team approach is often the best way to diagnose and treat these condi-
tions. Included on such a team with the otolaryngologist are audiologists, speech
and language therapists, physical therapists, nurses, social workers, and physicians
from a wide range of other specialties.
The audiologist plays a critical role in the team approach to managing these
challenging patients. Growth in our understanding of hearing and balance disor-
ders has accompanied increasing sophistication in audiology training programs,
including the recent development of the AuD doctoral degree. This expanding body
of knowledge challenges the otolaryngologist to remain current with the assess-
ment and treatment methods of our audiologic colleagues. In this light, Audiology
Answers for Otolaryngologists offers a concise reference for otolaryngologists and
other team members regarding the terminology and methodology of a variety of
auditory and vestibular assessment and rehabilitative options. The question-and-
answer format provides for easy readability and the references for each section
give the reader access to more detailed information.
Audiology Answers for Otolaryngologists builds on the rich history of audio-
logic research and teaching at Washington University and the affiliated Central
Institute for the Deaf (CID). Since 1914, CID has been a center for educating chil-
dren with deafness, researching the causes and treatments of deafness, instructing
teachers of the deaf, and training audiologists. This guidebook is an emblem of the
tradition of excellence of these two institutions individually, and of the synergy
between them.
We sincerely appreciate the work that Mike Valente, PhD, Elizabeth Fernan-
dez, AuD, and Heather Monroe, AuD, and others have put into this guidebook, and
we are confident that it will help us all deliver more effective patient care in the
future.
Joel Goebel, MD, FACS
Professor and Vice Chairman
Residency Program Director
Dizziness and Balance Center Director
Department of Otolaryngology–Head and Neck Surgery
Washington University School of Medicine
Saint Louis, Missouri
Timothy E. Hullar, MD, FACS
Assistant Professor
Department of Otolaryngology–Head and Neck Surgery
Department of Anatomy and Neurobiology
Program in Audiology and Communication Sciences
Washington University School of Medicine
Saint Louis, Missouri
ii

Foreword
Fundamental to the practice of otology and neurotology is audiology. An expert
audiologist is a crucial member of the team. Certainly, audiology and otology/neu-
rotology are uniquely different fields, audiology for the precise identification of
site of lesion and degree of lesion within the auditory system and otology/neu-
rotology for the determination of the cause of the lesion. Aural rehabilitation re-
quires special expertise from both. The idea that either field alone can deliver the
best possible care or that conflict between the two is productive is a “fatal flaw”
in the design of a best practice. A team is much more than a word; it takes mutual
respect and a working knowledge of the other’s field. Teams don’t occur by chance;
they are laboriously built. Respect for expertise is dependent upon the achieve-
ment of personal expertise and experience with some of the practices and pitfalls
inherent within the other’s field.
In this regard, those of us with the mission to train future otolaryngologists
must make the necessary resident schedule changes and facilitate exposure and
proper training in audiology. Mike Valente, PhD, Elizabeth Fernandez, AuD, and
Heather Monroe, AuD, working with our residents and otology/neurotology fac-
ulty over the last several years, have developed and field-tested Audiology Answers
for Otolaryngologists. The organization of this work in a question-and-answer for-
mat allows quick searches for germane questions and hopefully will inspire expan-
sion of this “living document.” Drs. Valente, Fernandez, and Monroe have a long
track record of providing comprehensive audiologic education to all those seeking
a better understanding of this expansive field. We are very fortunate to be able to
have them as integral members of our practice/research/education team.
J. Gail Neely, MD, FACS
Director, Otology/Neurotology/Base of Skull Surgery
Washington University School of Medicine
Saint Louis, Missouri

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