97

Index

Note: Page numbers followed by f and t indicate figures and tables, respectively.

AAbbreviated Profile of Hearing Aid

Benefit (APHAB), 76, 93ABR. See auditory brainstem

response (ABR)acoustic neuroma

audiometric criteria for, 25stacked ABR findings with,

39–40, 39facoustic reflex, 27acoustic reflex decay

definition, 29negative, 29, 30fpositive, 29, 30ftesting, 29

equipment, calibration, 12, 14f

acoustic reflex threshold (ART)clinical significance, 27–28, 28fdefinition, 27interpretation, 28, 29tmeasurement, 28, 28f, 29ftesting, equipment, calibration,

12, 14fadaptation test, 50, 51fAEP. See auditory evoked

potential(s) (AEP)air-bone gap, 18, 23air-conduction (AC) testing, 14–16,

15f, 23interaural attenuation for, 17, 17fmasking for, 17, 17f

thresholds obtained via, 16alarm clock(s), amplified/vibrating,

94, 94falerting systems, 93, 94Alexander’s law, 54American National Standards

Institute (ANSI), standardsfor audiometric calibration, 12for hearing aids, 86–88for maximum permissible

ambient noise levels (MPANLs), 14, 15t

amplitude scaling, on motor control test, 48–49, 49f

ANSI. See American National Standards Institute (ANSI)

APHAB. See Abbreviated Profile of Hearing Aid Benefit (APHAB)

aphysiologic patternon motor control test, 49, 50fon sensory organization test, 45f,

46–47, 47fART. See acoustic reflex threshold

(ART)audiogram(s), 16

interpretation, 21symbols used in, 16, 16f

audiometer(s), calibration, 12, 13faudiometric equipment,

calibration, 12, 13f, 14faudiometric symbols, 16, 16f

98  Index

audiometric testing, maximum allowable noise level for, 14, 15t

auditory brainstem response (ABR), 35

clinical applications, 37interpretation, normal values in,

37tneurodiagnostic, 37–38otoneurologic, 37–38pathology-related patterns,

38–39stacked, 39–40, 39ftesting, 36–39

abnormal results, 38fnormal results, 38f

threshold, 37waveform, 36

auditory evoked potential(s) (AEP)interpretation, 34testing, 34

azimuth, 2–3, 3f

Bbackground noise, and speech

recognition, 9Baha. See hearing aid(s), bone-

anchored (Baha)benign paroxysmal positional

vertigo (BPPV), 56–57, 56fcharacteristics, by affected canal,

56–57, 57tbinaural hearing, advantages, 9–11binaural squelch, 11, 83binaural summation, 9–10, 10f, 83Bing test, 31, 32tbone-conduction (BC) testing,

14–16, 15f, 23interaural attenuation for, 18masking for, 17f, 18, 18fthresholds obtained via, 16

bone vibrator, 31BPPV. See benign paroxysmal

positional vertigo (BPPV)BTE hearing aids. See hearing aid(s),

behind-the-ear (BTE)

Ccalibration, audiometric, 12, 13f, 14f

requirements for, 12standards for, 12

caloric testingabnormal results on, 57–59methods, 57–59

canalithiasis, 57Carhart’s notched, 21CDP. See computerized dynamic

posturography (CDP)center of gravity (COG) alignment,

44f, 47center of gravity (COG) scores,

47–48CHAMP, 40, 40fCharacteristics of Amplification

Tool (COAT), 76CHL. See conductive hearing loss

(CHL)CIC hearing aids. See hearing aid(s),

completely-in-the-canal (CIC)

Client-Oriented Scale of Improvement (COSI), 76, 93

COAT. See Characteristics of Amplification Tool (COAT)

cochlear hearing loss, recruitment and, 5

cochlear hydrops analysis masking procedure. See CHAMP

cochlear pathology, ABR pattern with, 38

cocktail party effect, 11COG. See center of gravity (COG)computerized dynamic

posturography (CDP), 42clinical applications, 51limitations, 52

conductive hearing loss (CHL), 21ABR pattern with, 38audiogram for, 23, 24f

consonant(s), frequency spectrum of, 8

and speech recognition, 8, 8f

Index  99

COSI. See Client-Oriented Scale of Improvement (COSI)

COWS acronym, 58CROS. See hearing aid(s), CROS

systemcupulolithiasis, 57cVEMP. See vestibular evoked

myogenic potential (VEMP) test, from sternocleidomastoid muscle

DdB. See decibel(s) (dB)dB HL. See decibels in hearing level

(dB HL)dB IL. See decibels intensity level

(dB IL)dB SPL. See decibels in sound

pressure level (dB SPL)decibel(s) (dB), definition, 1decibels in hearing level (dB HL)

definition, 1equivalent dB SPL, 1, 1f, 12reference level for, 1, 1fwith speech awareness

threshold, 2with speech recognition

threshold, 2decibels in sound pressure level

(dB SPL)auditory threshold for, at

audiometric frequencies, 1, 1f

definition, 1equivalent to 0 dB HL, 1, 1f, 12reference level for, 1vs. dB IL, 1–2, 2t

decibels intensity level (dB IL)definition, 1reference level for, 1vs. dB SPL, 1–2, 2t

detection. See also speech awareness threshold (SAT)

definition, 2

difference limen (DL), 9, 10fdirectional microphone(s), 80–82,

81fpolar patterns, 81, 81f

directional preponderance, of nystagmus response from caloric stimulation, 59

discrimination. See also word recognition score (WRS)

definition, 2distortion product (DP) gram, 33,

34fdistortion product otoacoustic

emissions (DPOAE), 32interpretation, 33measurement, 33

Dix-Hallpike maneuver, 55–56, 56f

DPOAE. See distortion product otoacoustic emissions (DPOAE)

DR. See dynamic range (DR)DSL v5.0 prescriptive method for

hearing aid(s), 89DSVV. See dynamic subjective

visual vertical (DSVV) testdynamic range (DR), 6, 6fdynamic subjective visual vertical

(DSVV) test, 64–67, 65f

Eear canal volume (ECV)

abnormal, 26, 27fdefinition, 26normal values, 26, 26t

earmold(s), 85, 85fECochG. See electrocochleography

(ECOG, ECochG)ECOG. See electrocochleography

(ECOG, ECochG)ECV. See ear canal volume (ECV)electrocochleography (ECOG,

ECochG), 34–35, 35f, 36fEQ. See equilibrium score (EQ)equilibrium score (EQ), 43–45, 44f

composite, 45

100  Index

eye movement(s). See nystagmus; pursuit abnormalities; saccades

Ffeedback

definition, 82in hearing aids, management,

82–83feedback cancellation systems, 83fixate suppress

and nystagmus response from caloric stimulation, 59

and vestibulo-ocular reflex (VOR), 63

FM system, personal, 93fo. See fundamental frequency (fo)frequency. See also fundamental

frequency (fo)definition, 7just noticeable difference for, 9,

10ffundamental frequency (fo), 7, 7f

Ggaze nystagmus test, 55

HHAE. See hearing aid evaluation

(HAE)HAF. See hearing aid fitting (HAF)harmonics, 7, 7fHAT. See hearing assistance

technology (HAT)head shadow effect, 3headshake nystagmus, 55hearing aid(s)

amplifier for, 80, 80fANSI standards for, 86–88

S3.22–2003, 86, 88, 88fS3.42–1992, 86–88, 87f

basic sound processing in, 80, 80f

behind-the-ear (BTE), 78–79, 78fearmold styles for, 85, 85f open-fit, 78f, 79, 79f

tubing for, 85and bilateral amplification, 83bone-anchored (Baha), 84–85,

84fcandidacy for

determination, otologist/physician and, 75

evaluation for, 75completely-in-the-canal (CIC),

78, 78fcoupler measurements, 86–88CROS system, 84–85, 84f

traditional wireless, 84, 84ftranscranial, 84

directional mode, 81–82DSL v5.0 prescriptive method

for, 89electroacoustic assessment, 86,

87ffeedback, management, 82–83frequency channels, 82in-the-canal (ITC), 78, 78fin-the-ear (ITE), 78, 78fand medical clearance for

amplification, 75microphone for, 80, 80f. See also

directional microphone(s)and monaural amplification, 83NAL-NL1 prescriptive method

for, 89–90, 89f, 90fand noise reduction, 82omnidirectional mode, 81–82prescriptive targets for, 89–90real ear measurements (REMs)

for, 89, 89f–92f, 90–92receiver for, 80, 80fstyles, 78–79, 78fTransEar, 84–85, 84ffor unilateral hearing loss,

84–85, 84fvalidation, 93venting, 85–86, 86fverification, 93

hearing aid evaluation (HAE), 75–76

hearing aid fitting (HAF), 75, 76

Index  101

verification, 76, 93hearing assistance technology

(HAT), 93–94, 94fhearing loss

asymmetrical, 30conductive. See conductive

hearing loss (CHL)configuration, 21, 22f

flat, 21, 22ffragmentary (corner), 21, 22fhigh-frequency, 21, 22finverted trough, 21, 22fnotched, 21, 22fprecipitous, 21, 22frising, 21, 22fsloping, 21, 22f

gradual, 21precipitous, 21sharp, 21

trough, 21, 22ffunctional, differential diagnosis,

30magnitude, 21, 21tmixed, 21, 23

audiogram for, 23, 24fnoise-induced, 21, 23sensorineural. See sensorineural

hearing loss (SNHL)type, 21unilateral, 30

hearing aid options for, 84–85, 84f

and vestibular evoked myogenic potential (VEMP) test, 69

hertz (Hz), 7Hz. See hertz (Hz)

IILD. See interaural level difference

(ILD)immitance audiometer(s), 25, 25f

calibration, 12, 14finfrared listening system, 93intensity, just noticeable difference

for, 9, 10finteraural attenuation, 17, 17f

for air-conduction (AC) testing, 17, 17f

for bone-conduction (BC) testing, 18

interaural level difference (ILD), 3, 4f

interaural spectral differences, 3interaural time difference (ITD), 4,

4f, 5fITC hearing aids. See hearing aid(s),

in-the-canal (ITC)ITD. See interaural time difference

(ITD)ITE hearing aids. See hearing

aid(s), in-the-ear (ITE)

Jjnd. See just noticeable difference

(jnd)Jongkee’s formula, 58just noticeable difference (jnd)

definition, 9for frequencies, 9, 10ffor intensity, 9, 10f

Llatency, on motor control test,

48–49, 49fLDLs. See loudness discomfort

levels (LDLs)LGOB. See Loudness Growth in

Octave Bands (LGOB)loudness

rapid growth of, 5recruitment, 5–6, 5f

loudness discomfort levels (LDLs), 92

definition, 76measurement, 76–78, 77f

Loudness Growth in Octave Bands (LGOB), 5–6, 5f

loudness scale, 77, 77t

MMAA. See minimum audible angle

(MAA)

102  Index

malingering, differential diagnosis, 30

masking. See also CHAMPfor air-conduction (AC) testing,

17, 17fbackward, 9for bone-conduction (BC) testing,

17f, 18, 18fdefinition, 9downward spread of, 9for non-test ear, 17, 17ffor speech audiometry, 17for speech recognition threshold,

20upward spread of, 9for word recognition testing, 20

maximum complianceabnormal, 26–27, 27fdefinition, 26normal values, 26, 26t

maximum permissible ambient noise levels (MPANLs), for audiometric testing, 14, 15t

medical clearance for amplification, 75

Meniere’s disease, 23differential diagnosis, 35, 40headshake nystagmus in, 55

MEP. See middle ear pressure (MEP)

microphone(s). See also directional microphone(s)

hearing-aid, 80, 80fmiddle ear pressure (MEP)

abnormal, 26, 27fdefinition, 26normal values, 26, 26t

minimum audible angle (MAA), 2–3, 3f

MLV. See monitored live voice (MLV)

monitored live voice (MLV), 19motor control test, 48–49, 49f, 50f

amplitude scaling on, 48–49, 49faphysiologic pattern on, 49, 50f

latency on, 48–49, 49fweight symmetry on, 48–49, 49f

MPANLs. See maximum permissible ambient noise levels (MPANLs)

NNAL-NL1 prescriptive method for

hearing aid(s), 89–90, 89f, 90f

narrow-band noise (NBN), in masking for pure tone testing, 17

National Acoustic Laboratories (NAL), NAL-NL1 prescriptive method for hearing aids, 89–90, 89f, 90f

NBN. See narrow-band noise (NBN)noise-induced hearing loss, 8noise reduction, hearing aids and,

82non-test ear (NTE), masking for,

17, 17fNTE. See non-test ear (NTE)nystagmus. See also optokinetic

nystagmus (OPK/OKN) testgaze-evoked, 55positional, 55positioning, 55–57post-headshake, 55response from caloric

stimulation, 58directional preponderance, 59fixate suppress and, 59

spontaneousof central origin, 54characteristics, and origin, 54classification, 54measurement, 54of peripheral origin, 54

OOAE. See otoacoustic emissions

(OAE)occlusion effect (OE), 79

Index  103

ocular counter-roll, 64, 66OE. See occlusion effect (OE)open-fit behind-the-ear (BTE)

hearing aid(s), 78f, 79, 79freceiver-in-the-aid (RITA), 79, 79freceiver-in-the-ear (RITE), 79,

79foptokinetic nystagmus (OPK/OKN)

test, 63–64, 64fotoacoustic emissions (OAE). See

also distortion product otoacoustic emissions (DPOAE); transient-evoked otoacoustic emissions (TEOAE)

clinical significance, 32definition, 32measurement, 32

otoconia, 57oVEMP. See vestibular evoked

myogenic potential (VEMP) test, from extraocular muscles

Ppitch, 7presbycusis, 8, 23pure tone audiometry, 14–16. See

also air-conduction (AC) testing; bone-conduction (BC) testing

thresholds obtained via, 16pure tone sinewave, 7, 7fpursuit abnormalities, 54, 54f

Rreal ear aided response (REAR)

measurement(s), 91–92real ear front-to-back ratio

measurement, 92, 92freal ear insertion gain (REIG)

measurement(s), 90f, 91–92

real ear measurements (REMs), for hearing aid(s), 89, 89f–92f, 90–92

real ear saturation response (RESR90), 77, 89f, 90

real ear SPL measurement(s), 89f, 91–92

real ear unaided gain (REUG) measurement(s), 91–92

REAR. See real ear aided response (REAR) measurement(s)

receiver-in-the-aid (RITA) open-fit BTE hearing aid(s), 79, 79f

receiver-in-the-ear (RITE) open-fit BTE hearing aid(s), 79, 79f

recruitmentdefinition, 5sensorineural hearing loss and,

5–6, 5fREIG. See real ear insertion gain

(REIG) measurement(s)REMs. See real ear measurements

(REMs)RESR90. See real ear saturation

response (RESR90)retrocochlear pathology

ABR findings with, 38–39, 38fand acoustic reflex decay, 29audiometric findings with, 25

REUG. See real ear unaided gain (REUG) measurement(s)

Rinne test, 31, 32tRITA. See receiver-in-the-aid (RITA)

open-fit BTE hearing aid(s)

RITE. See receiver-in-the-ear (RITE) open-fit BTE hearing aid(s)

rotational chair test, 60, 61f. See also step velocity test

clinical applications, 66limitations, 66–67and vestibulo-ocular reflex (VOR)

assessment, 60–62, 61f

Ssaccades, abnormalities, 53, 53fsaccadic pursuit, 54, 54f

104  Index

SAT. See speech awareness threshold (SAT)

Schwabach test, 31sensorineural hearing loss

dynamic range for, 6, 6fand loudness recruitment, 5–6,

5fsensorineural hearing loss (SNHL),

21audiogram for, 23, 24fsudden, 23

sensory organization test (SOT), 42–47

aphysiologic pattern, 45f, 46–47, 47f

and center of gravity (COG) scores, 47–48

equilibrium score (EQ) calculated from, 43–45, 44f

inter-trial variability on, 47, 47fpathology-related patterns on,

45–47, 46fsensory analysis graph, 44f, 48six conditions for, 42–43, 43fstrategy analysis, 44f, 48support surface dependence

pattern, 45f, 46sway patterns on, 47, 47fvestibular dysfunction pattern,

45–46, 45fvestibular loss pattern, 45f, 46,

46fvision preference pattern, 45f, 46visual dependence pattern, 45f,

46signal-to-noise ratio (SNR)

definition, 11directional microphones and, 81improvement, needed by

hearing-impaired listener to equal normal hearing, 11, 11f

monaural listening and, 11single-sided deafness (SSD). See

hearing loss, unilateral

SLM. See sound level meter (SLM)smooth pursuit test, 54, 54fSNHL. See sensorineural hearing

loss (SNHL)SOT. See sensory organization test

(SOT)sound(s)

high-frequency, localization, 3, 4f

low-frequency, localization, 4, 4fsound level meter (SLM), 12sound localization, 83

psychoacoustic properties affecting, 3–4, 4f, 5f

speech audiometry, masking for, 17speech awareness threshold (SAT),

2, 19speech recognition

background noise and, 9frequency spectrum of vowels

vs. consonants and, 8, 8fupward spread of masking and,

9speech recognition threshold

(SRT), 2determination, 18–19interpretation, 19, 19tmasking for, 20

SPL-O-Gram, 89f, 92spondee words, used to establish

speech recognition threshold (SRT), 18–19

SRT. See speech recognition threshold (SRT)

SSCD. See superior semicircular canal dehiscence (SSCD)

SSD (single-sided deafness). See hearing loss, unilateral

SSNHL. See sensorineural hearing loss (SNHL), sudden

stacked auditory brainstem response, 39–40, 39f

static admittance, definition, 26static compliance, 26–27, 27fStenger test

definition, 30

Index  105

interpretation, 30technique for, 30

step velocity test, decreased/prolonged time constant on, 61f, 62

subjective visual vertical (SVV), 64. See also dynamic subjective visual vertical (DSVV) test

superior semicircular canal dehiscence (SSCD), detection, 68–69, 69f

support surface dependence, on sensory organization test, 45f, 46

SVV. See subjective visual vertical (SVV)

Ttelephone, amplified, 93, 94, 94fTEOAE. See transient-evoked

otoacoustic emissions (TEOAE)

TransEar, 84–85, 84ftransient-evoked otoacoustic

emissions (TEOAE), 32interpretation, 33, 33fmeasurement, 32–33

TTY/TDD, 94tuning fork test(s)

clinical applications, 31interpretation, 32t

TV listening devices, 93, 94ftympanogram

abnormal, 26, 27fnormal, 26, 26f

tympanometrydefinition, 25equipment, 25, 25f

calibration, 12, 14fnormal values, 26, 26ttechnique for, 25–26

Uunilateral hearing loss (UHL). See

hearing loss, unilateral

utricular dysfunction, dynamic subjective visual vertical (DSVV) test for, 64–66, 65f

Vvalidation, of hearing aids, 93velocity storage, 63VEMP. See vestibular evoked

myogenic potential (VEMP) test

vent(s)/venting, for hearing aids, 85–86, 86f

verification, of hearing aids, 76, 93vertigo. See benign paroxysmal

positional vertigo (BPPV)vestibular dysfunction, on sensory

organization test, 45–46, 45f

vestibular evoked myogenic potential (VEMP) test, 67–68, 67f

air-conducted, 67–68, 70clinical applications, 70from extraocular muscles, 67, 70hearing loss and, 69limitations, 70response

amplitude, 69latency, 69threshold, 68

significant findings on, 68–69, 69ffrom sternocleidomastoid

muscle, 67–68, 67f, 68f, 70vestibular loss, on sensory

organization test, 45f, 46, 46f

vestibulocollic reflex, assessment, 67–68, 67f

vestibulo-ocular reflex (VOR), 42. See also visual vestibular ocular reflex (VVOR) test

assessment, 60, 61fasymmetry, 61f, 62failure to fixate suppress, 63gain, 61f, 62phase measures, 61f, 62

106  Index

vestibulospinal reflex (VSR), evaluation, 42

videonystagmography. See video-oculography (VOG)

video-oculography (VOG), 42, 52, 52f

clinical applications, 59limitations, 60significant findings on, 60–62

vision preference, on sensory organization test, 45f, 46

visual dependence, on sensory organization test, 45f, 46

visual vestibular ocular reflex (VVOR) test, 63

VNG (videonystagmography). See video-oculography (VOG)

VOR. See vestibulo-ocular reflex (VOR)

vowel(s), frequency spectrum of, 8

and speech recognition, 8, 8fVVOR. See visual vestibular ocular

reflex (VVOR) test

WWeber test, 31, 32tweight symmetry, on motor

control test, 48–49, 49f

word list(s), for word recognition score, 19

word recognition score (WRS), 2determination, 19–20interpretation, 20, 20ttesting, masking for, 20

WRS. See word recognition score (WRS)