Hearing Assessment in Infants and Children: Recommendations Beyond Neonatal Screening

Congenital or acquired hearing loss in infants and children has been linked with lifelong deficits in speech and language acquisition, poor academic performance, personal-social maladjustments, and emotional difficulties. Identification of hearing loss through neonatal hearing screening, regular surveillance of developmental milestones, auditory skills, parental concerns, and middle-ear status and objective hearing screening of all infants and children at critical developmental stages can prevent or reduce many of these adverse consequences. This report promotes a proactive, consistent, and explicit process for the early identification of children with hearing loss in the medical home. An algorithm of the recommended approach has been developed to assist in the detection and documentation of, and intervention for, hearing loss.

from Pediatrics

Bone-anchored hearing aid A single-stage procedure in children

Conclusion
Our results show that a single-stage technique is associated with a low rate of early complications, with no reports of fixture loss due to osseointegration failure.

from the International Journal of Pediatric Otorhinolaryngology

The large Chinese family with Y-linked hearing loss revisited: Clinical investigation

Conclusion. The DFNY1 phenotypes shared many characteristics with some autosomal dominant hearing loss, in the aspects of age of onset, severity and audiometric configuration. However, the typical, outstanding feature of this trait was its remarkable pattern of inheritance. Similar traits, if ever encountered, can be most easily identified by discerning this exceptional and rare pattern of inheritance. Objectives. To analyze the audiological features in Chinese Y-linked non-syndromic hearing impairment, the extended DFNY1 family. Subjects and Methods. A nine-generation Chinese family (DFNY1) was ascertained and expanded from the year of 2000 to 2006. The audiometric evaluations included pure-tone audiometry, tympanometry, and auditory brainstem responses. Some subjects received computerized tomography scan of the temporal bone. Results. 52 out of 276 members in this family received clinical examinations. 24 live subjects had hearing impairment consisting of 23 patrilineal males and one female. In the affected lineage, 92% patrilineal males were well characterized as having hearing loss and 2 children remained to be diagnosed. Based on the audiological examinations on the male members, the degree of hearing loss was from mild (3 patients), moderate (7 patients) to severe (11 patients). The audiometry displayed 48% subjects with sloping in high frequencies, 38% flat in all frequencies, and the rest (14%) the U-shape. The age of onset ranged from 5-27 years with the average of 11.5 years.

from Acta Oto-Laryngologica

Private Practice Audiology: Coming of Age

ABSTRACT
The field of audiology has grown steadily since its inception in the 1940s. In the 1970s, the first self-employed audiologists began practicing independently of medical and academic centers. Since that time, the number of audiologists choosing to enter private practice has increased significantly. Private practitioners have made significant contributions to the field, including advocacy, involvement in professional organizations, and increased recognition of the audiologist as a well-credentialed and skilled professional. In this article, current challenges of private practice are discussed, including recognition among the medical community and the general public, business and time management, education and recruitment of new private practitioners, marketing, and continuing education. Additionally, some of the more rewarding aspects of private practice are highlighted.

from Seminars in Hearing

An assessment of parents’ decision-making regarding paediatric cochlear implants

Parents of children with severe to profound hearing loss have to make a number of fundamental decisions for their children. These decisions include communication and amplification options. In particular, the parents must decide whether and when their child will receive cochlear implants, and whether these will be implanted unilaterally or bilaterally. The objective of this study was to describe the decision-making needs of parents making the cochlear implant decision for their children. Semi-structured interviews were conducted with eight parents and eight cochlear implant team members at a Canadian cochlear implant centre to document parental and clinician recollections and opinions of the decision-making process related to a unilateral or bilateral cochlear implantation. The results demonstrated that the decision to go ahead with a cochlear implantation was consistently based on the parents’ preferences for spoken communication for their children. Parents reported satisfaction with the cochlear implant decision-making process. Two of eight parents felt that additional information on unilateral cochlear implantation risks and benefits should have been provided. Four of eight parents described how more information on the experiences of other families would have been helpful for their decision. Parental and clinical perceptions of the bilateral implantation decision were highly variable. All parents stated that additional information on bilateral cochlear implantation was needed. Based on the results of the interviews, it is concluded that there is a need for information and resources for bilateral cochlear implantation decision-making.

from the Canadian Journal of Speech-Language Pathology and Audiology

Audiology education and practice from an international perspective

from the International Journal of Audiology

This paper describes the international education and practice of audiology with the broader aim of proposing possible cost-effective and sustainable education models to address the current situation. Major audiology organizations worldwide were surveyed from February 2005 to May 2007, and organizations from 62 countries (78% of the world population) returned a completed survey. Overall, the results suggested a wide range of professionals providing hearing health care, and 86% of the respondents reported a need for more audiologists. There was also considerable variation in the scope of practice among the different hearing health care professionals, and the minimum education levels of audiologists with similar scopes of practice. The countries surveyed fell into four broad categories in terms of professional resources, and the results highlighted the urgent need for forward planning at both national and international levels. The study highlights options for addressing some of the challenges in educating audiologists and the provision of hearing health care services globally.

Assessment of Speech Recognition for HI and CI Patients: Things Need to Change

from the National Health Service (UK)

Abstract: Hearing aid and cochlear implant technologies have changed over the years, but the audiological assessment of speech recognition has not kept pace with the need to provide better assessment tools. This presentation will highlight some of the more recent findings and recommended procedures that provide more comprehensive assessments of speech recognition in quiet and various background noise environments.

For further information contact:

Tel : 0115 942 1985
Fax : 0115 924 9054

http://www.earfoundation.org.uk/contact/

Register at:

http://www.hearingseminars.com/jonshallop2008/event/registration.html

Where:Nottingham
When:06 Nov 2008 17:30 – 19:00

Audiologic Results of Surgery for Cholesteatoma: Short- and Long-Term Follow-Up of Influential Factors

from Otology & Neurotology

Objective: To review the audiologic results in a cohort of patients surgically treated for cholesteatoma.

Study Design: Retrospective review of patient records.

Setting: Tertiary referral center.

Patients: A retrospective study of patients operated on for acquired middle ear cholesteatoma during the period 1990 to 2002 was performed. A total of 758 patients were followed during a short-term period, and 611 patients were followed during a long-term period. The patients were divided into 3 age groups: children, adolescents, and adults. The localization of cholesteatoma was classified as attic, sinus, or tensa.

Interventions: Closed tympanoplasty was always performed as the single procedure of choice on all the children, and reoperation or conversion to open tympanoplasty was made later if needed. Adult patients were treated with single classic canal wall up, or wall down (CWD), according to the propagation of disease and condition of middle ear.

Main Outcome Measures: Preoperative and postoperative air-bone gap (ABG) and pure-tone average were compared after short-term and long-term follow-up.

Results: Average hearing improvement (reduction of ABG) amounted 20.0 dB for short-term and deteriorated to 18.0 dB during long-term analysis for all the patients. Preoperative hearing level was significantly worse for CWD than for intact canal wall technique. The ABG closure was much better in the group with attic cholesteatoma. Both preoperative and postoperative hearing levels were worse for children than for adolescents or adults. Revision operations and bilateral cholesteatoma gave worse total postoperative hearing. The long-term results of primary operations, when recurrent cholesteatoma did not occur, were stable. Damage to auditory ossicles correlated well with total preoperative and postoperative results. The most hearing improvement was verified for the frequencies between 500 and 3,000 Hz, and there was no sensorineural hearing loss.

Conclusion: The audiologic results of cholesteatoma surgery are preserved during long-term follow-up. We found that recurrent cholesteatoma was associated with diminished postoperative hearing. Poorer preoperative hearing level, CWD tympanoplasty, younger age, bilateral cholesteatoma, and ossicular damage, as well as revision surgery, were associated with reduced gains in hearing with surgical management. Surgical experience was important for ICW technique and for advanced damage of auditory ossicles. Recurrent cholesteatoma resulted in significantly worse hearing results for each analyzed parameter.

Transforming Services for Children with Hearing Difficulty and their Families: A Good Practice Guide (DH)

from Clinical Governance
Further to the publication of ‘Improving Access to Audiology Services in England’ in March 2007, this document provides good practice and evidence to help commissioners and service providers to make changes to the way that paediatric hearing services are delivered, and in particular to reduce waits for patients with the most common hearing difficulties.

10 Trends That Are Transforming Hearing Health Care

from The Hearing Review

Will technological change translate into greater customer satisfaction and market growth?

In the last 5 years, we’ve seen a lot of technological change. But will it translate into greater customer satisfaction and accelerated market growth?

Extending Candidacy for Thin-Tube Fittings by Modifying the Earmold

from The Hearing Review

Old-school acoustic plumbing principles for today’s instant-fit mini-BTEs

We can exploit the rules of earmold acoustics to our advantage, even with thin tubes. We just need to understand what is going on acoustically at the eardrum, and this knowledge is obtained through probe microphone measurements.

Auditory Steady-State Response: A Beginner’s Guide

from The Hearing Review

An orientation to ASSR based on refinements and offerings from Interacoustics.

Anatomy of an Earmold

from The Hearing Review

An ear can be as individual as a fingerprint, and for something so unique, the right—or wrong—earmold can make or break a hearing aid’s success.

Hearing Aid Selection and BTEs

from The Hearing Review

Understanding the advantages and limitations of the six types of BTEs

Transforming services for children with hearing difficulty and their families: a good practice guide

from the National Health Service (UK)

Further to the publication of ‘Improving Access to Audiology Services in England’ in March 2007, this document provides good practice and evidence to help commissioners and service providers to make changes to the way that paediatric hearing services are delivered, and in particular to reduce waits for patients with the most common hearing difficulties.