Audiology Assoicates Inc.
Clinical Services
Meet Our Audiologists
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Audiologists serve as the managers
of a patient's hearing health care. They are uniquely trained to diagnose and counsel
patients concerning their most appropriate treatment options. Our practice provides the
most comprehensive audiologic care that is performed anywhere in the United States. Our
services include both diagnostic and rehabilitative
including the fitting of hearing aids.
Diagnostic Services
Audiologists perform measurements
of the entire auditory system from the ear canal to the cortex (brain) to provide a
comprehensive assessment of a patent's auditory or balance system. In this manner the
appropriate diagnosis and treatment plan can be initiated in order to resolve a patient's
concerns. The following procedures are included in the audiologists scope of practice;
- Complete Diagnostic Audiology -
Evaluates the status of the auditory system, revealing the degree and type of hearing
loss. This procedure is the introductory test that guides the audiologist in determining
the need for other protocols. It also provides information as to whether or not a patient
has a medical problem causing the loss of hearing or if the person has a non-medical
etiology. This procedure requires a one hour time period which allows for counseling and
discussion of the findings.
- Acoustic Impedance Measurements
- Determines the mobility of the eardrum and associated middle ear bones. Many
children develop fluid behind the eardrum due to upper respiratory infections. This
procedure can make a direct measurement of the middle ear system to rule out the
possiblity of a middle ear problem. Other disorders are also assocated with middle ear
dysfunction. This procedure requires a five minute period.
- Auditory Brainstem Response (ABR)
- Measures the integrity of the neurologic system leading from the inner ear
(cochlea) to the central auditory mechanism. This procedure is used to assist in ruling
out a lesion affecting the central auditory nervous system. It is also used in determining
the hearing levels of children. This procedure requires a one hour period.
- Otoacoustic Emissions (OAE)
- Measures the performance of the outer hair cells of the inner ear. This procedure is
extremely useful when evaluating the hearing of young children. Pitch specific information
can be obtained in a very short period of time. The first clinical application of
Otoacoustic Emissions began in the United States only within the past several years. This
procedure requires an actual test time of 5-30 seconds per ear.
- Electronystagmography (ENG)
- Determines the status of the vestibular (balance) system. This procedure is the primary
method of documenting a patient's dizziness. Ten percent of complaints to an internal
medicine doctor relates to a concern about dizziness or vertigo. Many patients who have
dizziness experience problems when they rotate their heads in different postions. This
type of dizziness may be caused by what is termed "postional vertigo" that can
be treated and cured by the audiologist with one or two visits. The ENG procedure requires
one hour and 15 minutes.
- Electrocochleography (ECOG)
- Measures the role of the inner ear for suspected cases of Meniere's disease. This
procedure can also track the progress of other disorders that affect the organ of corti.
The Ecog procedure requires one hour.
- Loudness Mapping -
Determines the growth of loudness to various pitches. All patients with a hearing loss due
to a problem of the inner ear (most common, 96%) have an abnormal loudness perception.
This measurement needs to be taken into account when determining the appropriate type of
hearing aid system for a patient. This procedure requires 20 minutes.
- Tinnitus Evaluation -
Measures the pitch and loudness of "ringing in the ears". Many patients with and
without hearing loss experience "ringing in the ears". This evaluation
determines the extent of the subjective sensation and allows the audiologist to recommend
a treatment plan. This procedure requires 15 minutes.
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Rehabilitative
Services
Following the inital evaluation,
should the audiologist determine that a patient has a non-medical problem with their
hearing, then a treatment option of using hearing aids may be recommended. Just as with
the case of all electronics, hearing aids are "not what they used to be". Many
manufacturers produce devices that utilize computer capabilities to enhance the processing
of speech, making soft sounds audible and loud sounds comfortable. No adjustment of volume
needs to be made by the patient. In addition, many patients with this advanced technology
report much better understanding in the presence of noise. This includes noisy restautants
and other social situations. In order to "prove" these enhancements in hearing,
patients are provided with a minimum of a three month trial period with amplification to
allow them to experience the difference. Improved communication skills leads to a better
and more complete lifestyle. In this day and age of technology no patient with a hearing
problem should experience life in a confused "sound" world. The following
services are available to the patient who wants to try a hearing aid:
- Real-ear Measurements -
Measures the performance of the hearing aid while the patient is wearing the device. Since
1984, in the United States, this measurement has been available to objectively assess a
patient's performance with a hearing aid. The real-ear measurement system presents a broad
range of pitches to a patient and then displays a pitch response of the amplification
device. This is then compared to a projected "target" reflecting the idealized
acoustic response. The hearing aid can then be adjusted in order to maximize a patient's
auditory capabilities.
- Adjustment Period With
Amplificaiton - All patients receive a three month adjustment period with
amplification to insure satisfactory benefit. Even with the advances in circuit design of
hearing aids, it is vital that the patient perceives an improvement in their lifestyle
with hearing aid use. Some amplification devices provided by Audiology Associates, Inc.
are provided with an exclusive one-year satisfaction guarantee.
- Comprehensive Follow-up Care - Receiving
the correct circuit and obtaining the appropriate acousitics from the hearing aid is the
inital first step in maximizing a patient's benefit from amplification. However, obtaining
the proper acoustics is just the beginning. The treatment program for the hearing aid
patient must include through follow-up and monitoring of benefit. Patients are seen at a
minimum of three visits in the first three months of inital use. Patients that are fit
with computerized hearing aids are seen more frequently for adjustments
and counseling. The hearing aid is just part of the treatment plan for the patient with
communication difficulties.
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Current Hearing Aid Technology
Audiology Associates, Inc.
utilities a broad range of hearing aid manufactures in order to best maximize a patient's
benefit from amplification. The circuits that are discussed below are available in a
variety of formats that will enhance the patient's benefit depending upon individual
needs. It is useful to review the different levels of technologies that are available to
the audiologist.
Linear
Amplification
Linear circuits were
incorporated in the first type of electronic hearing aid technology. They amplify sounds
in a one-to-one relationship. As the intensity of the sound increases going into the aid,
the exact same proportion of the sound exits from the aid. This increase loudness
continues until the maximum capability of the aid is reached. This type of signal
processing may be adequate for some patients until loud sounds are introduced such as
background noises. When other noises are present, this type of technology requires the
patient to turn the hearing aid down with the volume control (just like one uses a volume
control for television). This type of technology is still available, however, Audiology
Associates, Inc. rarely finds that this type of circuit is appropriate in today's world.
Non-linear
Amplification
This type of
technology is available in many electronic designs. The overall goal is to allow the
hearing aid to regulate the growth in loudness of sounds exiting from the aid. Therefore,
as sound increases going into the aid, there is not the same proportional increase of
sound coming out of the aid. Thus, the aid curtails the loudness of the aid in a manner
that never becomes too loud to the patient. The aid stays within a comfortable loudness
range whether the person is in a quiet environment or in a noisy restaurant.
These type of circuits are
available in two basic configurations. One is a non-programmable device, a device that
contains a preselected circuit and the other is termed a programmable hearing aid. As you
may infer, the programmable device can be altered by the audiologist in the office to best
maximize a patient's benefit from amplification. Programmable technology represents the
state-of-the art in signal processing and provides patients with unmatched performance in
a variety of listening situations. This technology has been evolving since 1988 and at
this time offers the patient the best opportunity to maximize their communicative
abilities. One needs to experience the difference themselves in order to fully appreciate
the benefit. Audiology Associates, Inc. offers their patients the opportunity to visit one
of our offices for a free demonstration of programmable technology.
For more information concerning
computerized programmable technology, please visit the following sample hearing
aid manufacturer sites. Keep in mind that there are over 30 manufacturers
that produce advance technology devices.
GN ReSound
North America
Interton
Phonak
Hearing Instruments
Micro-Tech
Hearing Instruments
Rexton
Hearing Instruments
Siemens
Hearing Instruments
Unitron
Hearing Instruments
If you have questions concerning your hearing health, we would be happy to be of
service.
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