Clinic - Week 11

This week in clinic I saw an older male who came in for a hearing evaluation as part of the Hearing Conservation Program. He had previously been in the Navy for four years, and then spent 30 years working as a firefighter. He said, "back then, we never even thought about our ears or wearing hearing protection." He also reported that he enjoys target shooting and hunting. He said within the past 2-3 years he has started wearing hearing protection whenever he can and has become better at remembering!

Otoscopy was performed and the tympanic membrane was visible and appeared intact bilaterally. Immittance was performed next and the results obtained were normal, Type Ad tympanograms bilaterally. Puretone thresholds were within the normal limits up to around 2000 Hz, and then sharply sloping to a moderate loss bilaterally. Bone conduction thresholds were not tested.

This patient asked to see his results from last year because he wanted to compare and make sure that his hearing had not changed. The results were explained to him and compared to last years audiogram. The transparent "speech banana" was also used in helping the client understand some of the sounds he was missing. He said that it all made sense to him now. He reported that he can hear is wife, but she sounds like she is mumbling and he cannot understand what she is saying.

Information about amplification and the Oticon Delta was then given to this patient and we explained that if he wanted to pursue amplification he could return at any time. He was impressed at how small and compact the hearings aids had become.

I found this article that investigates speech audibility of listeners with high frequency hearing loss. It was performed on 5 listeners with normal hearing and 11 listening with hearing loss. The results were that when adding audible speech to frequencies above ~2000 Hz were most hearing loss exceeded 55 dB, little or no benefit was seen. On the other hand, providing a listener with a flat, severe to profound loss with audible speech sounds in the lower frequencies did provide benefit and better speech recognition scores. This study concluded that providing amplification to frequencies above ~2000-3000 Hz with persons who had severe to profound loss does not provide benefit.
Hope you like it, check it out!!!

Turner C., & Cummings K. (1999) Speech audibility for listeners with high-frequency hearing loss, American Journal of Audiology, 8, 47 - 56.

http://aja.asha.org/cgi/reprint/8/1/47?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=speech+banana+&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT