To meet demand, the number of persons entering the field will have to increase by 50% beginning immediately. In addition, the attrition rate will have to be lowered to 20%. Any combination of increased graduation rate and lowered attrition will improve the opportunities to meet demand. Additional strategies could include increasing the capacity of current practitioners or allowing internationally trained audiologists to practice in the United States.
The purpose of this prospective study was to determine the incidence and type of hearing loss occurring in children who suffered head injuries. Fifty children admitted to the neurosurgical service after sustaining head trauma were studied. Neurologic, otologic, and audiologic evaluations were performed. Diagnostic studies included skull roentgenograms and computerized tomography scans. A 32% incidence of conductive hearing loss and a 16% incidence of high-frequency sensorineural hearing loss was found in this group. All patients with temporal bone fractures had conductive hearing losses, but the presence of a skull vault fracture did not correlate with the presence, type, or degree of hearing loss. In addition, there was no correlation between either cause of injury, loss of consciousness, or Glasgow Coma Scale scores and the presence, type, or degree of hearing loss. There was a significant incidence of both sensorineural and conductive hearing loss in this series of patients, which indicates that close audiologic and otologic follow-up is necessary for all head injury patients.
Sudden hearing loss as the initial manifestation of a hematologic disorder is a rare finding. A variety of hematologic diseases are among the causes of sudden-onset deafness, and these include leukemia, multiple myeloma, 1 and Waldenstrom's macroglobulinemia. 2 Despite the rarity of this presentation, early diagnosis and treatment may result in improved hearing outcome. CASE REPORT A 65-year-old woman was hospitalized with acute-onset back pain. Additionally, the patient reported a 6-day history of tinnitus and a 1-day history of sudden-onset bilateral hearing loss. There was no report of vertigo or imbalance. Her medical history was significant for a gradual onset of multiple arthralgias at the hip, heels, and distal interphalangeal joints. These were believed to be caused by osteoarthritis with degenerative joint disease. The patient had a history of hypertension, gastroesophageal reflux, and peptic ulcer disease. She denied any history of prior hearing loss. Physical examination revealed bilateral serous middle ear
Purpose
The purpose of this manuscript is to describe the regulatory, technological, and training considerations for audiologists investigating telehealth and to offer some examples of audiology services provided through telehealth.
Method
The authors presented the regulatory components, the technology required for audiology staff and patients, and staff training for the audiology telehealth program at Cincinnati Children's Hospital Medical Center. Four case studies highlighting the successful use of telehealth in providing auditory device services to patients were also presented.
Results and Conclusion
The described regulatory, technological, and training hierarchy provides a framework for audiologists interested in starting a telehealth program. The cases presented illustrate that telehealth can be used to provide some auditory device services, such as troubleshooting, mapping, and parent consulting.
The Joint Committee on Infant Hearing 2000 position statement includes guidelines for the development of Early Hearing Detection and Intervention programs. These guidelines provide specific recommendations for the audiologic test battery for infants who fail a newborn infant hearing screening. The recommended test battery includes electrophysiologic measures such as the ABR, frequency specific electrophysiologic tests, bone-conducted ABR, OAEs, tympanometry using high frequency probe stimuli, and acoustic reflexes. In the Commonwealth of Kentucky, 42 centers are listed as providing follow-up diagnostic testing services for infants failing the newborn hearing screening. The purpose of this investigation was to determine how many of these centers were abiding by the Joint Committee guidelines. Results show that only three of 42 centers listed are providing services that meet the guidelines. Less than 50% of infants identified with hearing loss are referred for genetic evaluations by the audiologist. Only 19 of the 42 sites listed provide amplification services for infants identified with hearing loss.
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