Audiology Case Study

Allison Scott
Independent Study Mentorship- Spring 2018
Mrs. Click
Some of the information in my PowerPoint is
from outside sources, so my research is
cited at the end of the presentation.
Mentor Introduction
• Mentor(s): Dr. Louise McLaughlin and Dr. Toni Jennings
• Career of Study: Audiology
• Education: AuD (doctorate in audiology)
and state license
Mentorship Site

UTMB Ear, Nose, and Throat (1600 W League City Pkwy, League
City)
Independent Study Mentorship
• Advanced Academic course is designed for students wishing to mentor
an adult professional in a chosen career. This course is ideal for the
self-motivated student with a passion for a particular area of study.
Students in this course must perform at a collegiate or professional level.
This Photo by
Unknown Author is
licensed under CC
• Complete an in-depth mentorship/study in an area of interest BY-SA

• Document a minimum of 3 hours of mentorship each week (Mentorship

Activity Log)
• Complete a Journal Entry each week documenting mentorship
experiences (ISM Journal)
• Complete an ISM Professional Portfolio (online format/Weebly)
showcasing assignments completed during the course and the final
project
• Develop a final product and presentation at the collegiate/professional
level that is presented to a panel of graders at the conclusion of the
semester
Why I chose this project topic
I am very interested in the different ways audiologists are now able
to test and treat patients for hearing loss and problems with the
ear, nose, throat.
Key Points/ Topic

• Adult patient’s types of hearing loss

• Adult tests preformed
• Adult management procedures
• Pediatric patient’s type of hearing loss
• Pediatric tests preformed
This Photo by Unknown Author is licensed under CC BY-SA

• Pediatric management procedures

Adult Patient: Normal Hearing
Background Information:
• 47 year old female
• Referred for concern of hearing loss
• Patient reported ear pain (“shooting through jaw”)
• “Sensitivity to sound and wind” in right ear
• Reported having swimmer’s ear in July 2017
• Hearing in left is better than right
• Father had hearing loss in later life
• Denied: otalgia, otorrhea, swallowing concerns, balance issues, and
changes in medical history
 Adult Testing: Normal Hearing

• Otoscopy: clear canal with TM visible in both ears

• Immittance: normal ear canal volume, TM mobility and

middle ear pressure in both ears, present acoustic reflexes

• Audio: pure tone audiometry revealed hearing within normal

middle ear function, word recognition excellent at normal
conversation level
 Adult Management: Normal Hearing

Repeat audio per

otologic plan of
care or sooner if
change in hearing is
noted
 Adult Patient: Asymmetrical Hearing Loss
Background Information:
• 60 year old female
• Referred because of hearing loss in right ear
• January 2017, went on cruise and began experiencing vertigo,
aural fullness, tinnitus, intermit, and hearing loss in right ear
• Reported vertigo for 8 days with nausea
• Taken to urgent care and given steroids and decongestants,
resolved symptoms
• Reports continued right ear aural fullness and tinnitus, constant
“roaring”
• Denied: otalgia, otorrhea, swallowing concerns, balance
issues, and changes in medical history
• Medical conditions: various autoimmune issues including
Hashimoto’s and autoimmune anaphylaxis, osteoarthritis, and
nodules on thyroid and vocal chord
 Adult Testing: Asymmetrical Hearing Loss
• Otoscopy: clear canal with visual TM visual in both

• Immittance: normal ear canal volume, TM mobility, and middle

ear pressure in both. Acoustic reflexes present in left
ipsilateral and contralateral conditions, normal function and
hearing in left ear, acoustic reflexes absent in right ipsilateral
and contralateral conditions

• Audio: pure tone audiometry revealed normal hearing in left

ear with excellent word recognition at soft speech level, right
ear testing revealed profound SNHL. Word recognition not
tested due to severity of hearing loss
Adult Management: Asymmetrical Hearing Loss

Implications:
• Due to unilateral hearing loss, patient will have difficulty
locating sound source
• Benefit from having speech directed to left ear
• May have difficulty understanding speech in less than
ideal environments (e.g. distance, background noise)
• May benefit from raised speaking voices and increased
visual cues in these situations
• Patient may benefit from hearing aid evaluation
appointment to discuss amplification options
 Adult Management: Asymmetrical Hearing
Loss Continued

• Repeat audio per

otologic plan
• Patient counseled
with communication
tips
• Recommended
hearing evaluation
pending medical
clearance
 Adult Patient: Sensorineural Hearing Loss
Background information:
• 72 year old woman
• Referred by audiologic evaluation by audiology due to progressive
hearing loss
• Previous audio (10/6/16) revealed moderate-severe SNHL with poor
word recognition bilaterally
• Decrease in hearing resulted from noise trauma 9/9/16
• Currently wears Siemens Pure RITE hearing aids fit at an outside
facility, hearing aid check/adjustment at UTMB on 1/30/18
• Denied changes in medical status or any new symptoms
• Continues to experience intermittent tinnitus/buzzing
• Denied: ear infections, ear pain, ear drainage, or dizziness
• Current medicine taken for osteoporosis
Adult Testing: Sensorineural Hearing Loss

• Otoscopy: TM visible bilaterally

• Audio: pure tone audiometry revealed overall

moderately-severe SNHL with fair word recognition

• Tympanometry: revealed normal middle ear

pressure and TM compliance consistent with normal
middle ear function for both ears
 Adult Management: Sensorineural Hearing Loss

• Continued use of
amplification and hearing
aid checks as needed
• Repeat audio as medically
indicated if change in
hearing or otologic status
• A copy of today’s results
were mailed to patient
• Authorization to receive
medical information was
obtained
Adult Patient: Normal Hearing (difficulty blind
noise)
Background information:
• 40 year old man
• Referred because of tinnitus and difficulty hearing
• Reported bilateral, constant tinnitus for the past 2-3 years
• Reported difficulty hearing in the presence of competing
noise
• Denied: otalgia, otorrhea, swallowing concerns, balance
issues, and changes in medical history
• Experienced noise exposure with constant use of hearing
protection while serving in the military
• Mother had hearing loss, suspected genetic hearing loss
• Not on an medications
 Adult Testing: Normal Hearing (difficulty in
blind noise)
• Otoscopy: TM visible in both ears

• Audio: pure tone audio revealed hearing and word

recognition was excellent

• Tympanometry: middle ear pressure and acoustic reflexes

normal

• Quicksin: revealed normal

 Adult Management: Normal Hearing (difficulty
in blind noise)

• Repeat audio as
medically indicated I
change in hearing or
otologic status
• A copy of todays
results were mailed
to the patient
 Pediatric Patient: Behavioral With Normal
Hearing

Background information:
• 2 year old male
• Referred because of middle ear effusion
• 1/2/18 audio revealed better ear responses at normal
hearing level in response to speech and mild hearing
loss in response to warbled tones at 500 and 2000
Hertz
• Mother denied: otalgia, otorrhea, swallowing concerns,
balance issues, and changes in medical history
• Currently receiving speech therapy
Pediatric Testing: Behavioral With Normal
Hearing
• Otoscopy: TM and tubes visible in both ears

• Immittance: large ear canal volume, reflexes not tested

due to tubes

• Otoacoustic Emission: response at 3k, 2k, and 4k Hertz,

normal hearing in outer hair cells, left ear response not
obtained due to noise and screaming

• Audio: visual reinforcement revealed normal hearing

response to speech and warbled tones only at 2000 Hertz,
no additional responses due to inattentiveness, talking
during the test, and inability to remain seated in chair
Pediatric Management: Behavioral With
Normal Hearing
• Comparison with
previous test results:
improvement
• Better responses at
2000 Hertz
• Repeat audio in 4
months or in
conjunction with next
ENT appointment
• Continue with speech
therapy
Pediatric Patient: Speech Delay With Normal
Hearing
Background information:
• 2 year old male
• Referred for speech delay
• Parents say babbles but doesn’t talk
• Parents reported said “mama” and “dada” at 6 months, but no
longer says them or any other words
• Denied: hearing development concerns, otalgia, otorrhea,
swallowing concerns, balance issues, and changes in medical
history
• Passed new born hearing screening and was born full term with no
complications
• No medication currently and no additional health concerns
Pediatric Testing: Speech Delay With Normal
Hearing
• Otoscopy: clear canal, TM visible in both ears

• Immittance: normal ear canal volume, TM mobility, and

middle ear pressure in both ears, acoustic not tested due
to crying

• Audio: visual reinforcement audiometry, sound field

revealed normal hearing in at least the better ear in
response to speech and warbled tones from 500-4000
Hertz, word recognition not tested due to patient’s age

• Otoacoustic Emission: tested not completed due to

patient’s opposition to anything being put into ears
Pediatric Management: Speech Delay With
Normal Hearing
Implications:
• Patient’s hearing does
appear adequate in better
ear to support speech and
language development and
communication

• Repeat audio in 6 months

to attempt obtaining ear
specific information
• Continue with speech
evaluation as planned
 Current Event
• “The Kansas City Chiefs nabbed the honor of
having the loudest stadium in the world, in
September of 2014... during a Monday night
game, fans clocked a 142.2 decibel (dB) reading
on the sound level meter. In case you’re
wondering, the generally accepted safe level of
sound is 85 dB. Anything above that has the
potential to permanently damage your hearing”
(Plotnick 4).
• The fans at home also have a risk of getting
hearing loss because of people
cheering/screaming for their team, or the TV
volume being louder than normal.
• The author suggests that the host of the party
turn the volume down so that not only the TV
volume is lower, but the people watching have
to talk quieter to hear the game.
• Even though there is a risk of hearing loss for
watching the game, there are still things we can
do to prepare and prevent this from happening.
Product

Audiograms
Conclusion
From this mentorship, I have learned more about audiology as a
profession and what audiologist do, which has prepared me for classes I
will take later in high school and college.
Weebly Page

allisonscottspringsism.weebly.com
Thank You

Thank you Dr. McLaughlin and Dr. Jennings for

allowing me to shadow you in your profession and
giving me the opportunity to experience what an
audiologist gets to do. Also, thank you to my
evaluators for coming to watch my presentation
and Mrs. Click for giving me the opportunity to be
in this class.
Works Cited Websites
• “Adult Hearing Tests | Audiology.” Camino ENT, Bass Medical Group,
caminoent.com/audiology/hearing-tests/adult-hearing-tests/.
• Mayo Clinic staff. “Hearing Loss: Diagnosis Ans Treatment.” Hearing
Loss, HONcode, www.mayoclinic.org/diseases-conditions/hearing-
loss/diagnosis-treatment/drc-20373077.
• Plotnick Brande MS. “The Super Bowl and Hearing Loss.” Healthy
Hearing, Your Hearing Network, 23 Jan. 2018,
www.healthyhearing.com/report/52374-The-super-bowl-and-hearing-
loss.
• Thompson, Spencer. “Audiologist.” Sokanu, Sokanu,
www.sokanu.com/careers/audiologist/.
Works Cited Pictures (in the order they
appear)
• “UTMB Health Ear, Nose and Throat - League City.” UTMB Health
Ear, Nose and Throat - League City - League City, TX - AARP,
local.aarp.org/local-services/utmb-health-ear-nose-and-throat---
league-city-1600-w-league-city-pkwy-league-city.html.
• “Audiology.” Pinterest, www.pinterest.com/mag1179/audiology/.
• “Audiology Stuff.” Pinterest,
www.pinterest.com/pinklemonadeandribbons/audiology-stuff/.
• “What Did You Say?” Blog: Hearing Aids and Tinnitus Solutions,
Pearls of Wisdom,
www.greathillsent.com/blog/tag/Audiologist.html.
Works Cited Pictures Continued

• “American Football NFL (USA) 2018 Playoffs - Magazin.” Sport.de,

www.sport.de/american-football/usa-nfl/magazin/.
• Trapp, Dave. “Sensing Our World: Touching and Hearing.” B2:
Touch & Hearing, 13 Apr. 2008,
d1068036.site.myhosting.com/eChem.f/labB2.html.