Clinical Audiology

Clinical audiology is a branch of health that focuses on the evaluation, diagnosis, and treatment of individuals with hearing and balance disorders. Audiologists are medical professionals who offer patient-centered care in the prevention, detection, diagnosis, and evidence-based treatment of hearing, balance, and other auditory impairments for individuals of all ages. 

To determine their patients' needs, audiologists employ a range of tools and cutting-edge technology coupled with communication, analytical, and problem-solving abilities. The job requires a wide range of abilities and tasks. It provides a chance for flexibility in the kind of work environment and fields of expertise. (1)

Definition and Overview

An audiologist can assess, diagnose, treat, and rehab patients with hearing and balance impairments. To prevent, identify, diagnose, and treat hearing, balance, and other auditory impairments in persons of all ages, audiologists provide patient-centered care. Hearing and balance problems are complex conditions with impacts on social interaction, mental health, physical health, learning, and employment.  

Audiologists are needed for treatment services because they have knowledge of both established and new technology, as well as the ability to communicate with patients and their families to assist them in the healing process. Audiologists offer expert, individualized therapies that lessen these illnesses' detrimental impacts, improving results and quality of life. (2)

Procedures

There are currently several tests available in the audiology field that can be administered by an audiologist based on an individual's symptoms. These tests include

• Pure tone audiometry 

This test measures a person's hearing sensitivity across different frequencies (pitches) and intensities (loudness levels). The individual wears headphones or inserts earphones and responds to tones presented at various frequencies and levels.

• Tympanometry 

The eardrum and middle ear are examined during a quick five-minute test to check for problems. The person listens to a humming sound that is being played. During this hearing test, a little pressure sensation in the ear may also be experienced.

• Speech audiometry

Speech audiometry assesses a person's ability to hear and understand speech. It involves measuring speech reception thresholds (SRT), word recognition scores (WRS), and other speech-related tests to evaluate the individual's speech perception abilities.

The word lists are also presented at different intensities.

• Auditory reflex testing

The subject basically doesn't need to provide any outside input for this test. They sit there and listen to beeping noises for nearly twenty minutes. The test's computer automatically looks for nerve signals that travel to and from the brain.

• Oto-acoustic emissions

OAEs are sounds that the inner ear produces in response to noises outside. OAE testing examines the cochlea's structure and operation, particularly the outer hair cells. It is frequently employed in newborn hearing tests and as a diagnostic instrument to evaluate cochlear function.

• Auditory brainstem response

ABR is a neurophysiological test that assesses the electrical response to sound stimulation of the brainstem and auditory nerve. It is used to evaluate the auditory system and can help identify the existence and severity of hearing loss, particularly in populations that are challenging to test, including babies or those with severe hearing loss.

• Auditory processing test

While normal human speech is one aspect of hearing sounds, they should also be able to perceive and hear non-speech sounds made in our environment. The person is listened to the sound in various ways and periods for about an hour. Then, they should report what they heard to the audiologist.

• Cortical evoked response audiometry

This longer test takes around an hour and a half to complete. Fortunately, it isn't that demanding since the person is just required to relax in a chair while reading a book and listening to beeps. When the participant hears the beeps, the test examines how well the brain's cortex is working.

• Caloric test

The test is physically painful since the subject is made to feel lightheaded. During the test, the subject will be lying down and wearing eye recording glasses. With intervals in between, warm and cool water is injected into the ear canals. The test, which examines the vestibular system's control over balance, lasts roughly an hour.

• Posturography

This test, which lasts for 20 minutes, examines a person's ability to stay balanced in a variety of conditions. On a platform, the subject will be kept as motionless as possible; as the platform moves or tilts, the subject must adjust their posture appropriately. They will be secured in seat belts to prevent them from slipping off the platform.

• Electrocochleography

This 30-minute testing measures the cochlea's or inner ear's activity. It's a balance test that requires the subject to lie down while listening to a loud noise. In order to record the results, the doctor inserts a needle with the sensor through the eardrum. (3)

Candidates 

Audiologists provide complete audiological (re)habilitation services for people and their families who are dealing with 

• hearing, 
• balance, 
• or other related disorders (such as tinnitus and auditory processing disorder) 

across the lifespan. (4)

Risk and Side Effects

Audiology procedures are noninvasive and they carry no risk. (6)

Post-Procedure and Follow-up

After the test, the audiologist will review the results with the patient. Depending on how well the patient hears the volume and tone, the doctor will advise preventive measures such as wearing earplugs in loud environments, or corrective measures the patient may need, such as wearing a hearing aid. (7)

Recovery

According to the results of the tests, for better healing, hearing aids, cochlear implants, which are devices that are surgically implanted in the ear, or surgery to solve problems in the eardrum or small bones inside the ear may be preferred.

Results

Its results can show whether the patient has hearing loss and whether the hearing loss is sensorineural or conductive. If sensorineural hearing loss is diagnosed, the results may show that the hearing loss is mild, moderate, severe, or profound.

Treatment and management procedures of sensorineural hearing loss generally depends on how serious the situation is. If conductive hearing loss is diagnosed, the healthcare provider may recommend medication or surgery, depending on the cause of the loss.