The Audiology group in the UAB Department of Otolaryngology-Head and Neck Surgery includes three main components: diagnostic testing, hearing aid services, and implantable technologies.
Diagnostic Testing
Hearing Tests
- Impedance measures
- Audiometry
- Otoacoustic emissions
- Auditory brainstem response testing
Hearing tests, including pure tone and speech audiometry, otoacoustic emissions, and auditory brainstem response testing, are performed and aim to define a patient's hearing level and type of hearing loss if present.
Once the degree and type of hearing loss are determined, additional diagnostic and treatment options are considered and offered to the patient where appropriate. Treatment for hearing loss is best determined by the underlying cause of the hearing loss, and can include medical treatment, surgical procedures, or the use of hearing amplification.
Vestibular Tests
- Videonystagmography
- Vestibular evoked myogenic potentials
- Electrocochleography
Vestibular (dizziness or balance) tests focus on testing the vestibular (balance) portion of the inner ear. Once baseline measurements of vestibular and visual function are performed, results are combined with clinical presentation, physical examination, and additional diagnostic evaluation to determine the proper explanation for dizziness and balance disorders.
Hearing Aids
State of the art hearing aids are provided through the UAB Department of Otolaryngology-Head and Neck Surgery and include several prominent brand names, such as ReSound, Oticon, and Starkey.
Types of hearing aids include Receiver-in-the Canal (RIC), Behind the Ear (BTE), In the Ear (ITE), Completely in the Canal (CIC), or Contralateral Routing of Signal (CROS).
In the last few years, modern advances in hearing aid technology have dramatically improved hearing aid functionality, and with it, patient satisfaction. These advances include features such as open fit, directional microphones, digital signal processing, noise reduction algorithms, feedback cancellation, and programming options for different sound environments. Other features include Bluetooth connectivity, direct cellphone pairing capability, remote control of programs and volume, and additional assistive listening devices.
Cochlear Implants
Patients with moderately-severe to profound hearing loss, who have little improvement with hearing aids, may become candidates for cochlear implantation. Candidacy for implantation is determined with a special battery of testing under specific conditions to determine the amount of communication improvement gained through the patient's reliance on hearing aids.
After candidacy is confirmed with audiologic testing, neurotology consultation is necessary to evaluate for medical and surgical limitations, underlying disease processes, and concurrent medical disease.
After surgery for cochlear implantation, implant programming is performed in a series of visits. The implant is activated; with activation of the implant, stimulus limits are determined for initial perception of sound and uncomfortable stimulus levels. Once initial limits are determined, initial programming of the implant is completed, and the patient begins the process of hearing rehabilitation. As neuroplastic changes occur in response to the new stimulus within the patient's brain over the ensuing 18 to 24 months, several visits with reprogramming of the implant are necessary to optimize the patient's outcome.
Bone Anchored Hearing Implants
Patients with conductive hearing loss not correctable with other surgical intervention may be candidates for a bone anchored hearing implant. Additionally, patients who have one non-hearing ear with normal to mild hearing in the other ear may also be candidates for a bone anchored hearing implant. Candidacy for this type of hearing implant is determined with an evaluation with audiology and neurotology to look at the patients hearing as well as all possible treatment options. After surgery for a bone anchored hearing implant, the implant integrates with the patient’s bone. Once this integration is complete, the external sound processor is programmed for the patients unique hearing loss. Follow up visits allow for reprogramming of the sound processor to optimize the patient’s outcome.
Auditory Brainstem Implants
The UAB Department of Otolaryngology-Head and Neck Surgery is one of the few auditory brainstem implant programming centers in the nation. Auditory brainstem implants are a solution for individuals with hearing loss due to a non-functioning auditory nerve (Neurofibromatosis Type 2). Candidacy for implantation is determined through a series of tests that provide your doctor information about your auditory pathway from the ear to the brain.
The auditory brainstem implant uses technology similar to that of the cochlear implant, but instead of electrical stimulation being used to stimulate the cochlea, it is used to stimulate the brainstem of the recipient.