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Audiometry Test 2
| Question | Answer |
|---|---|
| Speech Reception Threshold (SRT): Purpose | -validate puretone thresholds at 500, 1000, and 2000 Hz (called the pure tone average/PTA) -baseline for speech discrimination test -hearing aid evaluation for gain prescription |
| SRT definition | -lowest level an individual can identify spondees 50% of the time or three repeated responses |
| SRT speech material | CID W-1 (two syllabic words/spondees with equal stress) |
| SRT procedure starting intensity level | 30 dB above the pure tone average for each ear |
| SRT threshold procedure | down 10 dB (until no response then up 5 dB) |
| SRT procedure presentation mode | live voice |
| What do you say | "Say the word _____" |
| SRT for puretone validation | PTA and SRT should be within +/-10 dB |
| If not, suspect: | test procedure, test equipment and calibration, functional hearing loss |
| Speech Discrimination Test purpose | determine extend of SD ability, site of ear pathology, candidacy for hearing aid amplification, and prognosis for aural rehab |
| SD testing procedure, initial intensity level | 30 dB above SRT in each ear |
| SD testing procedure, number of words | 25 |
| SD testing procedure, open word lists | CID W-22 or NU-6 (adults) |
| SD % = | N (correct) x 4 |
| 99% of the time SDT is not done live but through.... | a pre-recorded CD |
| SD 90-100% | excellent -normal/conditional hearing loss |
| SD 60-89% | moderate to fair -sensorineural (cochlear) |
| SD 00-59% | very poor -sensorineural (neural/8th nerve) |
| SD at higher intensities | stress test |
| SD in noise | SPIN test (speech perception in noise) |
| SD using synthetic sentences | SSI synthetic sentence identification |
| SD using high-frequency stimuli | CCT california consonant test |
| PI | performance intensity |
| PB | phonetically balanced |
| PI-PB | simply measuring performance (SD) at different intensity levels using PB words (CID W-22 or NU-6) |
| 3 intensities are normally used | -30 dB above SRT (30 dB SL*) -45 dB above SRT (45 dB SL) -60 dB above SRT (60 dB SL) |
| SL | sensation level, refers to a level of sound above threshold |
| PI-PB Roll Over Ratio | ROR (%) = PB (max) - PB (min)/PB (max) |
| 0.4 or less | is consistent with normal/conductive/sensorineural cochlear lesion |
| greater than 0.4 | is consistent with neural lesion |
| Immittance audiometry purpose (directly) | -evaluate middle ear status via tympanometry and stapedial reflex threshold |
| Immittance audiometry purpose (indirectly) | -evaluate inner ear status via stapedial reflex threshold and stapedial reflex decay |
| Immittance audiometry advantages | -objective test...replicable, less patient cooperation, determine cause for conductive hearing loss, determine functional integrity of the inner ear |
| IA: probe ear (test ear): probe tone frequency | 220 Hz or 660 Hz (must with newborn babies to get reliable tymps) |
| IA: probe ear (test ear): probe tone intensity | 85 dB SPL in the ear canal |
| IA: phone ear | -ear with the earphone -placed to present sounds to elicit contralateral stapedial reflex |
| Tympanogram Normal | Type A |
| Tymp Abnormal Type As | stiffness |
| Tymp Abnormal Type Ad | flaccidity |
| Tymp Abnormal Type B | fluid |
| Tymp Abnormal Type C | eustachian tube malfunction |
| Type A | normal peak compliance around "0 to -100 mm air pressure |
| Type As | limited peak compliance around "0 to -100 mm air pressure -consistent with otosclerosis |
| Type Ad | abnormally "high" compliance around 0 to -100 mm air pressure -consistent with eardrum flaccidity and ossicular disarticulation |
| Type C | normal peak compliance beyond -100 mm air pressure -consistent with eustachian tube malfunction (plugged up) |
| Type B | abnormally low compliance, peak compliance is absent, consistent with middle ear fluid build up |
| Normative Values (absolute): Ear canal volume | 0.2 to 2.0 mL |
| Normative Values (absolute): Peak compliance | 0.3 to 1.8 mL |
| Normative Values (absolute): Middle ear pressure | 0 to +50 mm 0 to -100 mm |
| Immittance Audiometry: Tympanogram | graphical plot showing eardrum compliance at different values of air pressure (0 to +/-200) |
| The relationship between SRT and SDT is usually | SRT 10 dB higher (poorer) than SDT |
| Word-recognition scores are most commonly determined by using | PB word lists |
| SRTs are usually measured with | spondaic words |
| The PI function for spondees is usually | steeper than for PBs |
| The last word of the carrier phrase in word-recognition testing with PB word lists should | strike zero on the volume units (VU) meter |
| In audiograms showing sharply falling (in the higher frequencies) sensorineural hearing loss, the SRT is best predicted by the average of the thresholds at | 500 and 1000 Hz |
| The word-recognition score expected of a patient with a mild cochlear hearing loss is | 80% |
| The word-recognition score expected of a patient with moderate conductive hearing loss is | 100% |
| RCL(DR) is determined by the difference (in dB) between | UCL and SRT |
| The slope of the normal PI-PB function averages | 2.5% per dB |
| PB MAX - PB MIN/PB MAX is the formula for | rollover ratio |
| SRT can be used to... | validate PTA |
| 2 frequency average is an average of best a/c thresholds at any two frequencies between... | 500, 1000, and 2000 Hz |
| use this when... | you have a selective high frequency loss |
| The speech reception threshold is... | the lowest level an individual can identify spondees 50% of the time or three repeated responses |
| For SRT assessment, live voice presentation of spondees is.... | clinically acceptable |
| PTA and SRT should be within... | +/-10 dB |
| If PTA and SRT are not within +/-10 dB, there may be a problem with... | the test procedure, a problem with the test equipment and calibration, or a functional hearing loss |
| Speech discrimination testing determines... | extent of SD ability, site of ear pathology, candidacy for hearing aid amplification, and prognosis for aural rehabilitation |
| The conversational speech discrimination testing... | using the CID W-22 should begin at 30 dB above the SRT |
| Assuming your patient missed 10 words out of 25 words, the SD score is... | 60% |
| SD score of 60-89% is consistent with.. | a sensorineural (cochlear) hearing loss |
| CCT is appropriate for... | patients with a selective HF sensorineural hearing loss |
| PI-PB rollover is significant in... | patients with 8th nerve lesion |
| PI-PB rollover ratio = 0.4 or less is consistent with... | patients with a cochlear lesion |
| To directly evaluate the middle ear... | obtain the stapedial reflex threshold and perform tympanometry |
| Normal peak compliance ranges from... | 0.3-1.8 mL |
| Type As | consistent with otosclerosis, means stiffness/shallow |
| Type B | consistent with otitis media |
| Normal middle ear pressure ranges from | 0 to +50 and 0 to -100 |
| In a patient with a conductive hearing loss, you can expect... | normal b/c, abnormal a/c, abnormal/absent OAEs, and abnormal tymps |
| Normal ear canal volume ranges... | from 0.2 to 2.0 mL |
| Compliance is indirectly related to... | stiffness |
| You can expect higher than normal ear canal volume in patients with... | perforated eardrum or pressure equalization (PE) tubes |
Created by:
copage