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Audiology

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Anatomy of the Human Ear.png

Audiology is a branch of medical science that refers to the study of the structural anatomy and applications of the ear. Audiology not only deals with the ability for the ear to detect sounds, but also in the ear's ability to regulate balance and the brain's power to receive correct auditory signals from the ear. An audiologist is a person trained in the science of audiology and has the power to administer tests and prescribe antibiotics as needed to aid patients in the alleviation of their hearing and balance-related maladies.

History

An audiometer from the 1960s

Initial Need for Audiologists

In 1899, inventor Cal E. Seashore developed an instrument designed to measure a user's hearing ability. These initially little utilized audiometers, as they were called,were used chiefly by ordinary doctors to diagnose minor degradations in hearing. The device gradually grew in popularity among medical institutions, and charts describing the hearing thresholds at various sound frequencies became standard in medical journals by 1920 [1]. The need for a doctor specifically dedicated to hearing-related ailments arrived twenty years later when soldiers returning from World War II complained of hearing loss from the constant, violently loud explosions and gunfire around them while they were on the battlefield. To aid in the veterans recovery, the American Veterans Administration provided a variety of programs which supplied veterans with doctors who specialized in hearing testing, hearing aid installment, and lipreading courses, among other things. As the demand for hearing specialist grew, the department of audiology slowly introduced itself to several hospitals and clinics worldwide [2].

Modern Advances

In modern times, the equipment and duties of audiologists have seen several advances. The field of audiology used to deal only with hearing-related issues but now has spread to the diagnosis of other ailments related to the ear, including balance inabilities [3]. Advances in hearing aid technology has also occurred through the past decades. In the past, any adjustments requested for one's hearing aids necessitated the specialized tools of an audiologist. Today, hearing aids can be easily manipulated by the user and have advanced to cut down on discomfort and visibility. Modern hearing aids can even sync with household appliances to not only provide a solution to hearing loss, but also make day-to-day interactions more convenient for the user[4]. If a hearing-related problem can not be solved by a hearing aid (or if a client simply does not want a hearing aid), an audiologist must make use of a cochlear implant. A cochlear implant improves hearing by completely replacing a patient's cochlea, the fluid-filled region of the inner ear [5].

Branches of Audiology

Audiometry

A Nigerian woman participating in an audiometry test performed by an audiologist

Audiometry is the testing of an individual's ability to detect sounds. An audiometric test is administered in a soundproofed room by an audiologist. Before deciding whether the patient truly needs an audiometry test, the audiologist will perform simple tests on the patient such as cupping one ear and measuring their ability to detect whispering or the ticking of a clock. If the audiologist decides that a professional test is in order, the individual being tested is outfitted with headphones over the ears and a bone-conduction headband around the head. [6] From an outside booth, an audiologist utilizes special equipment to send sounds of varying degree and frequency. The patient responds as to whether or not they hear the sounds reverberating from the headphones. This data is recorded on a chart known as an audiogram. The entire process is relatively brief; typical audiometry tests last for as long as five to ten minutes. A more detailed test, however, has the potential to take up to an hour. Audiometry test results are used to diagnose the presence and/or severity of hearing loss. Results of audiometric tests are used to justify hearing aid prescriptions from an audiologist [7].

In babies and young children, audiometry tests must be administered with different methods than with adults. Newborns are implanted with an earpiece and sensor which measures the cochlea’s ability to reverberate sounds back toward the sensor. In a baby's audiometry test, a baby is placed in a room outfitted with a series of speakers. The movement of the baby's head is monitored whenever a different one of the many speakers in the room emits a sound, causing the baby to turn its head toward the speaker. This action is recorded to determine the baby's level of hearing loss. To ensure the baby remains entertained and cooperative throughout the test, a reward is given each time the baby's head moves toward the correct speaker. This reward usually takes the form of blinking lights on a toy. [8]

Tympanometry

Tympanometry deals specifically with measuring issues related to the middle section of the ear. In order to perform a tympanometry test, a small device is placed within the patient's middle ear. The device affects the pressure within the ear, causing the eardrum to oscillate. These oscillations are recorded by a computer in order to diagnose the presence of fluid in the ear, tumors in the ear, torn ear drum, and a number of other detrimental conditions. [9]

Otology

The study of otology relates to the pathological structure of the ear. Otological tests are imposed in order to illuminate issues with balance, such as vertigo and ear infections. Otology is closely related to neurology, as typically the nerves connecting the ear to the brain are included within the range of otology's relevancy. Surgeries are available that are designed to repair or reconnect damaged ear nerves to the brain. [10]

Common Disorders Requiring the Aid of an Audiologist

Hearing Loss

A hearing aid, as seen here, is commonly prescribed to patients with moderate hearing loss

Hearing loss encompasses the ear's incremental inability to detect sounds and/or the brain's inability to construe the signals from the ear. [11] Hearing loss adds to the difficulty of hearing within a crowded area and also makes the victim less susceptible to high-pitched tones. Hearing loss can be caused from a myriad of causes including, but not limited to: excessive wax within the ear, punctures in the ear drum, degeneration of internal hair nerve cells due to old age, inordinate exposure to blaring sounds, and more. [12]

The addition of a hearing aid greatly mitigates the detrimental effects of hearing loss. To determine if a hearing aid is necessary, an audiologist schedules an audiometric test to determine exactly which type of hearing aid will best improve hearing ability [7].

Vertigo

Vertigo is the sensation of dizziness and disorientation caused by a disorder in the inner ear fluids. The disruption of fluid equilibrium causes the image received by the brain from the eye to disagree with the body's motion. [13] Causes for vertigo can be completely harmless and have no long-lasting effects, such as a sudden jarring of the head. Other causes, such as a cerebral hemorrhage in which blood leaks onto the back of the brain, can be quite serious and should be treated by an audiologist immediately. [14]

To detect vertigo in patients, audiologists question the patient as to any sensation of movement accompanied by a disturbance in hearing ability. Should vertigo be confirmed in a patient, a regimen of treatment options are provided depending on the severity of the condition. If only mild vertigo is diagnosed, the patient may undergo a series of home-remedies, such as Vitamin D supplements and physical therapy maneuvers. [15] Should more severe forms of vertigo be discovered, the audiologist can prescribe an antibiotic program. If head trauma is suspected to be a cause of vertigo, a CT scan can be administered. [16]

Ménière's Disease

Ménière's disease is a disorder which causes a variety of symptoms, including vertigo, hearing loss, and a sensation of congestion within the ear. Tinnitus, the perceived presence of a continuing drone or buzz within the ear, commonly accompanies these symptoms. In many cases, Ménière's disease is only observed in one ear. Although a relatively common disorder, no definite cause for Ménière's disease has been established. Many popular explanations for the onset of Ménière's disease purports that an accumulation of fluids within a structure of the ear known as the labyrinth causes these symptoms to occur. To diagnose Ménière's disease, audiologist refer to data from a audiometry test to determine if the level of hearing loss is indicative of the condition. Further inquiry as to whether the patient frequently experiences tinnitus and vertigo are used to provide a more definite diagnosis. To remove suspicions of a different disease causing the symptoms, an audiologist can request a brain-scan of the patient to monitor neural activity declarative of Ménière's disease. [17]

While a cure for Ménière's disease does not yet exist, several treatment options are available to those who require alleviation from the effects of the disorder. Typical treatments of this disease include diet plans, antibiotics, and even middle-ear injections. At times, a device designed to fluctuate the pressure within the ear is employed by audiologists to treat the disease. In extreme cases, invasive surgery is required to diminish the effects of the disease. [18]

Job Description

Qualifications

Certification in the field of audiology begins with a bachelor's degree in a biology or communication science-related field[19]. Additional study is required in order to reach a major in audiology. Since 2012, only audiologists with a doctorate degree in the field can become nationally certified. In order to attain this level of training, an additional minimum of four years of study accredited by the American Speech-Language-Hearing Association (ASHA) must be achieved beyond the bachelor level. A full PhD program may run a total of six years due to the heavy emphasis upon research. Many accredited doctoral programs provide the standard 1,820 hours of training needed to acquire national certification. A general passion for science and high level of technological literacy is highly recommended for those seeking to enter the field[20].

Demand and Salary

The US Bureau of Labor Statistics predicts the growth within the field of audiology will be greater than the average for all other occupations. Approximately sixteen percent of the population suffers from significant hearing loss, indicating the growing need for audiology specialists [21]. Despite the expected growth, the openings for audiological jobs are not anticipated to increase significantly due to the small size of the field in general [22] [20]. According to statistics gathered in 2011, a standard audiologists makes an average of $68,390 each year and earned $32.88 per hour. [22] Audiologists employed by hospitals and clinics received the highest salaries, while a lower than average pay was reported from audiologists employed by schools [20].

Job Locations

Audiologists typically work in organizations dedicated to health and wellness, including hospitals, clinics, rehabilitation centers, nursing homes, and more. Audiologists can also be found in educational facilities, such as universities along with public and private schools. Audiologists commonly work tightly with government agencies as well, and at times oversee actions related to workplace safety [19] [20]. While almost all audiologists are employed by medical facilities, a small percentage of audiologists are self-employed [22].

Video

A standard hearing test implemented by an audiologist.

References

  1. Unknown Author. A Brief History of Hearing Aids, Part I: The Audiometer. Embrace Hearing. Web. Published 31 March 2012.
  2. Unknown Author. History of Audiology. Washington. Web. Last updated 10 September 2010.
  3. Goyne, Thomas. Advances in Audiology and Hearing Aid Technology. Slideshare. Web. Last updated 18 September 2007.
  4. Unknown Author. Audiology Advances. Pinetree Society. Web. Last updated 2 November 2011.
  5. Unknown Author. Cochlear Implant. UMM. Web. Last updated 1 July 2013.
  6. Unknown Author. Pure Tone Audiometry. Hopkinsmedicine. Web. Accessed 7 November 2013.
  7. 7.0 7.1 Vorvick, Linda. Audiometry. NIH. Web. Last Updated 30 August 2012.
  8. Hoad-Robson, Rachel. Hearing Tests (Audiometry). Patient. Web. Last Checked 22 October 2013.
  9. Unknown Author. Tympanometry. NIH. Web. Last Updated 31 October 2013.
  10. Unknown Author. Ear Care. Masseyeandear. Web. Last Updated 6 July 2012.
  11. Unknown Author. Hearing Loss. Nihsenor Health. Web. Accessed 7 November 2013.
  12. Vorvick, Linda. Hearing Loss. NIH. Web. Last Updated 22 May 2012.
  13. Swierzewski, Stanley. Vertigo. Healthcommunities. Web. Last Updated 25 July 2012.
  14. Cunha, John. Vertigo Causes. Emedicine Health. Web. Accessed 7 November 2013.
  15. Cunha, John. Vertigo Self-Care at Home. Emedicinehealth. Web. Accessed 7 November 2013.
  16. Cunha, John. Vertigo Medical Treatment. Emedicinehealth. Web. Accessed 7 November 2013.
  17. Unknown Author. Ménière’s Disease. NIH. Web. Last Updated 13 September 2010.
  18. Harms, Roger. Ménière’s Disease. Mayoclinic. Web. Last Updated 11 December 2012.
  19. 19.0 19.1 Alashqer, Hussein. How to Become an Audiologist. Wikihow. Web. Accessed 19 October 2013.
  20. 20.0 20.1 20.2 20.3 Unknown Author. How to Become an Audiologist. Innerbody. Web. Accessed 19 October 2013.
  21. Unknown Author. Audiology. Nhscareers. Web. Accessed 19 October 2013.
  22. 22.0 22.1 22.2 McKay, Dawn Rosenberg. Audiologist: Career Information. About. Web. Accessed 19 October 2013.