Scope of Practice in Audiology
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Consultation Diagnoses and Procedures Billed Among Recent Graduates Practicing General Otolaryngology – Head & Neck Surger
Eskander et al. Journal of Otolaryngology - Head and Neck Surgery (2018) 47:47 https://doi.org/10.1186/s40463-018-0293-8 ORIGINALRESEARCHARTICLE Open Access Consultation diagnoses and procedures billed among recent graduates practicing general otolaryngology – head & neck surgery in Ontario, Canada Antoine Eskander1,2,3* , Paolo Campisi4, Ian J. Witterick5 and David D. Pothier6 Abstract Background: An analysis of the scope of practice of recent Otolaryngology – Head and Neck Surgery (OHNS) graduates working as general otolaryngologists has not been previously performed. As Canadian OHNS residency programs implement competency-based training strategies, this data may be used to align residency curricula with the clinical and surgical practice of recent graduates. Methods: Ontario billing data were used to identify the most common diagnostic and procedure codes used by general otolaryngologists issued a billing number between 2006 and 2012. The codes were categorized by OHNS subspecialty. Practitioners with a narrow range of procedure codes or a high rate of complex procedure codes, were deemed subspecialists and therefore excluded. Results: There were 108 recent graduates in a general practice identified. The most common diagnostic codes assigned to consultation billings were categorized as ‘otology’ (42%), ‘general otolaryngology’ (35%), ‘rhinology’ (17%) and ‘head and neck’ (4%). The most common procedure codes were categorized as ‘general otolaryngology’ (45%), ‘otology’ (23%), ‘head and neck’ (13%) and ‘rhinology’ (9%). The top 5 procedures were nasolaryngoscopy, ear microdebridement, myringotomy with insertion of ventilation tube, tonsillectomy, and turbinate reduction. Although otology encompassed a large proportion of procedures billed, tympanoplasty and mastoidectomy were surprisingly uncommon. Conclusion: This is the first study to analyze the nature of the clinical and surgical cases managed by recent OHNS graduates. -
Balancing Everything out Fifteen Years of Research Into Dizziness, Balance and the Pathology of Ménière’S Disease
Making It Better Balancing Everything Out Fifteen years of research into dizziness, balance and the pathology of Ménière’s disease The Ménière’s Society The Page 1 www.menieres.org.ukMénière’s Society Making It Better Index of References and Sources Further details of the reference sources and research projects discussed in this paper can be found at the following locations: V Osei -Lah, B Ceranic and L M Luxon (2008). Kirby, S.E. and Yardley, L. (2009) Clinical value of tone burst vestibular evoked The contribution of symptoms of post-traumatic myogenic potentials at threshold in acute stress disorder (PTSD), health anxiety and and stable Ménière’s disease. The Journal intolerance of uncertainty to distress in Ménière’s of Laryngology & Otology, 122, pp 452 457 disease. Journal of Nervous and Mental Disease, doi:10.1017/S0022215107009152 197,(5), 324-329 www.journals.cambridge.org/action/ www.eprints.soton.ac.uk/54655 displayAbstract?fromPage=online&aid=1850772 Yardley L., Dibb B. and Osborne G. (2003) A W Morrison, M E S Bailey and G A J Morrison Factors associated with quality of life in Meniere’s (2009). Familial Ménière’s disease: clinical and disease. Clinical Otolaryngology, 28, (5), 436-441. genetic aspects. The Journal of Laryngology (doi:10.1046/j.1365-2273.2003.00740.x). & Otology, 123, pp 29-37. doi:10.1017/S0022215108002788. Yardley L, Kirby S. Evaluation of booklet-based www.journals.cambridge.org/action/ self-management of symptoms in Ménière’s displayAbstract?fromPage=online&aid=3107936 disease: a randomized controlled trial. Psychosom Med 2006;68:762–9 Clinical and cost effectiveness Sandhu, J. -
Eardrum Regeneration: Membrane Repair
OUTLINE Watch an animation at: Infographic: go.nature.com/2smjfq8 Pages S6–S7 EARDRUM REGENERATION: MEMBRANE REPAIR Can tissue engineering provide a cheap and convenient alternative to surgery for eardrum repair? DIANA GRADINARU he eardrum, or tympanic membrane, forms the interface between the outside world and the delicate bony structures Tof the middle ear — the ossicles — that conduct sound vibrations to the inner ear. At just a fraction of a millimetre thick and held under tension, the membrane is perfectly adapted to transmit even the faintest of vibrations. But the qualities that make the eardrum such a good conductor of sound come at a price: fra- gility. Burst eardrums are a major cause of conductive hearing loss — when sounds can’t pass from the outer to the inner ear. Most burst eardrums are caused by infections or trauma. The vast majority heal on their own in about ten days, but for a small proportion of people the perforation fails to heal natu- rally. These chronic ruptures cause conductive hearing loss and group (S. Kanemaru et al. Otol. Neurotol. 32, 1218–1223; 2011). increase the risk of middle ear infections, which can have serious In a commentary in the same journal, Robert Jackler, a head complications. and neck surgeon at Stanford University, California, wrote that, Surgical intervention is the only option for people with ear- should the results be replicated, the procedure represents “poten- drums that won’t heal. Tympanoplasty involves collecting graft tially the greatest advance in otology since the invention of the material from the patient to use as a patch over the perforation. -
Audiology 101: an Introduction to Audiology for Nonaudiologists Terry Foust, Aud, FAAA, CC-SLP/A; & Jeff Hoffman, MS, CCC-A
NATIONALA RESOURCE CENTER GUIDE FOR FOR EARLY HEARING HEARING ASSESSMENT DETECTION & & MANAGEMENT INTERVENTION Chapter 5 Audiology 101: An Introduction to Audiology for Nonaudiologists Terry Foust, AuD, FAAA, CC-SLP/A; & Jeff Hoffman, MS, CCC-A Parents of young Introduction What is an audiologist? children who are arents of young children who are An audiologist is a specialist in hearing identified as deaf or hard identified as deaf or hard of hearing and balance who typically works in of hearing (DHH) are P(DHH) are suddenly thrust into a either a medical, private practice, or an suddenly thrust into a world of new concepts and a bewildering educational setting. The primary roles of world of new concepts array of terms. What’s a decibel or hertz? an audiologist include the identification and a bewildering array What does sensorineural mean? Is a and assessment of hearing and balance moderate hearing loss one to be concerned problems, the habilitation or rehabilitation of terms. about, since it’s only moderate? What’s of hearing and balance problems, and the a tympanogram or a cochlear implant? prevention of hearing loss. When working These are just a few of the many questions with infants and young children, the that a parent whose child has been primary focus of audiology is hearing. identified as DHH may have. In addition to parents, questions also arise from Audiologists are licensed by the state in professionals and paraprofessionals who which they practice and may be members work in the field of early hearing detection of the American Speech-Language- and intervention (EHDI) and are not Hearing Association (ASHA), American audiologists. -
Is One Ear Good Enough? Unilateral Hearing Loss and Preschoolers’ Comprehension of the English Plural
JSLHR Research Note Is One Ear Good Enough? Unilateral Hearing Loss and Preschoolers’ Comprehension of the English Plural Benjamin Davies,a,b,c Nan Xu Rattanasone,a,b,c Aleisha Davis,b,d and Katherine Demutha,b,c Purpose: The plural is one of the first grammatical morphemes whether an auditorily presented novel word was singular acquired by English-speaking children with normal hearing (e.g., tep, koss)orplural(e.g.,teps, kosses)bytouchingthe (NH). Yet, those with hearing loss show delays in both plural appropriate novel picture. comprehension and production. However, little is known Results: Like their NH peers, children with UHL demonstrated about the effects of unilateral hearing loss (UHL) on children’s comprehension of novel singulars. However, they were acquisition of the plural, where children’s ability to perceive significantly less accurate at identifying novel plurals, fricatives (e.g., the /s/ in cats) can be compromised. This withperformanceatchance.However,thereweresigns study therefore tested whether children with UHL were able that their ability to identify novel plurals may improve with to identify the grammatical number of newly heard words, age. both singular and plural. Conclusion: While comparable to their NH peers at identifying Method: Eleven 3- to 5-year-olds with UHL participated in novel singulars, these results suggest that young children a novel word two-alternative forced choice task presented with UHL do not yet have a robust representation of plural on an iPad. Their results were compared to those of 129 NH morphology, particularly on words they have not encountered 3- to 5-year-olds. During the task, children had to choose before. -
Non-Commercial Use Only
Audiology Research 2013; volume 3:e6 Comparison of cervical and ocular vestibular evoked myogenic potentials in dancers and non-dancers Sujeet Kumar Sinha, Vaishnavi Bohra, Himanshu Kumar Sanju Department of Audiology, All India Institute of Speech and Hearing, India Abstract Introduction The objective of the study was to assess the sacculocollic and otolith In recent years, cervical vestibular evoked myogenic potentials ocular pathway function using cervical vestibular evoked myogenic (cVEMP) have been utilized for the diagnosis of various disorders such potentials (cVEMP) and ocular vestibular myogenic potentials as, Meniere’s disease,1,2 acoustic neuroma,2-5 superior canal dehis- (oVEMP) in dancers and non dancers. Total 16 subjects participated in cence,6 vestibular neuritis,7 benign paroxysmal positional vertigo,8 the study. Out of 16 participants, 8 were trained in Indian classical noise induced hearing loss,9,10 auditory neuropathy/audiovestibular form of dance (dancers) and other 8 participants who were not trained neuropathy,10,11 as well as other disorders such as cerebellopontine in any dance form (non dancers). cVEMP and oVEMP responses were angle tumor,12 and multiple sclerosis.2 Similarly, ocular vestibular recorded for all the subjects. Non Parametric Mann-Whitney U test evoked myogenic potentials (oVEMP) also have been utilised in diag- revealed no significant difference between dancers and non dancers 13 for the latency and amplitude parameter for cVEMP and oVEMP, i.e. nosing superior semicircular canal dehiscence syndrome, internu- 14 P13, N23 latency and P13-N23 complex amplitude and N10, P14 laten- clearophthalmoplegia, to differentiateonly between cerebellar and brain- cy, N10-P14 complex amplitude respectively. -
Laryngology and Otology
The Journal of Laryngology and Otology (Founded in 1887 by MORELL MACKENZIE and NORRIS WOLFENDEN) March 1972 Can present day audiology really help in diagnosis ? — An otologist's question By R. R. A. COLES* (Southampton) THE question asked in the title of this lecture is apt, and one which I have been asked on many occasions. Therefore, I am glad of this opportunity to answer it both formally and at some length. The key words in the title are 'diagnosis' and 'otologist', and they were intended to convey two points. Firstly, that the scope of this presentation is restricted to the diagnostic role of audiology and to its practice in hospital or associated clinics in support of the otologist, as distinct from paedo-audiology which is concerned more with local health and educational authorities. I will, however, touch on some of the electrophysiological techniques of measure- ment used in support of conventional paedo-audiological assessment, as these have uses in the hospital type of audiology as well and the facilities for them may often be sited in Department of Health and Social Security (D.H.S.S.) establishments. The second point derived from the key words is to stress that it is the otologist and not the audiologist who has responsibility for making the diagnosis, except perhaps in those occasional instances where the audiologist is medically qualified. On the other hand, any specialist investigation infers not only the performance of tests but also the freedom to select those tests most appropriate to the particular patient, their appropriateness often only becoming apparent as the examination itself proceeds. -
Audiology and Hearing Aid Services
For more information, call the Hearing Aid Services office nearest you: Comprehensive hearing aid related services Barbourville Bowling Green are available to children diagnosed with (800) 348-4279 (800) 843-5877 permanent childhood hearing loss (PCHL). (606) 546-5109 (270) 746-7816 Elizabethtown Hazard Who should be referred to the OCSHCN (800) 995-6982 (800) 378-3357 Hearing Aid Services program? (270) 766-5370 (606) 435-6167 Children who are in need of new or Lexington Louisville replacement hearing aids and want to (800) 817-3874 (800) 232-1160 receive hearing aids and related services (859) 252-3170 (502) 429-4430 through a OCSHCN audiologist and wish to Morehead Owensboro receive Otology care outside of the (800) 928-3049 (877) 687-7038 clinical Otology program. (606) 783-8610 (270) 687-7038 What audiology services are available Paducah Prestonsburg (800) 443-3651 (800) 594-7058 through the OCSHCN Hearing Aid Services (270) 443-3651 (606) 889-1761 program? Licensed, certified audiologists conduct Somerset (800) 525-4279 periodic comprehensive hearing evaluations, (606) 677-4120 hearing aid checks, hearing aid repairs and Audiology and hearing aid evaluations according to ASHA best practices guidelines. Comprehensive Kentucky Cabinet for Health and Family Services Hearing Aid Services Office for Children with Special Health Care Needs reports are provided to the managing 310 Whittington Parkway, Suite 200, Louisville, KY 40222 otolaryngologist on an on-going basis; Phone: (502) 429-4430 or (800) 232-1160 FAX: (502) 429-4489 additional follow up testing will be http://chfs.ky.gov/agencies/ccshcn Information for Parents and Equal Opportunity Employer M/D/F completed at physician request. -
Audiometry Procedures Manual
Audiometry Procedures Manual January 2008 TABLE OF CONTENTS Chapter Page 1 INTRODUCTION ........................................................................................... 1-1 1.1 History and Overview of Hearing Examinations in NHANES........... 1-1 1.2 Basic Principles of Sound................................................................... 1-5 1.3 Basic Principles of Audition............................................................... 1-8 1.4 Basic Principles of Hearing Loss........................................................ 1-10 2 EQUIPMENT .................................................................................................. 2-1 2.1 Description of Exam Room in MEC................................................... 2-1 2.2 Description of Equipment and Supplies ............................................. 2-2 2.2.1 Otoscope.............................................................................. 2-9 2.2.2 Tympanometer .................................................................... 2-9 2.2.3 Audiometer.......................................................................... 2-9 2.2.4 Bioacoustic Simulator ......................................................... 2-10 2.2.5 Sound Level Meter and Accessories ................................... 2-10 2.2.6 Inventory Procedures .......................................................... 2-11 2.3 Start of Stand Procedures.................................................................... 2-11 2.3.1 Room Setup........................................................................ -
Cochlear Implant Guide
Cochlear Implant Guide Ear & Hearing Center at Texas Children’s Hospital® Dear Families, Welcome to the Cochlear Implant Program at Texas Children’s Hospital! Our goal is to provide comprehensive, specialized care for children with severe hearing loss, and help them achieve the best possible communication outcomes. Since our program started in 2001, we have performed more than 700 implants. Your child may be a candidate for a cochlear implant in one or both ears. Cochlear implants, or CIs, are innovative devices which can directly stimulate the auditory nerve and provide access to sound in children with severe or profound hearing loss. The decision about whether to recommend a CI is highly individualized, and requires the input of specialists in multiple areas, including Otolaryngology, Audiology, Speech Pathology, and Neuropsychology, among others. These specialists make up the members of the Cochlear Implant Team. They work in close collaboration to determine who is a candidate for a CI, perform the implantation surgery, and help patients through the rehabilitation afterwards. This guide will help you understand the entire process, who may be considered a CI candidate, the basics of how the device works, how the surgery is done, and the necessary rehabilitation to achieve a successful outcome. Thank you for the opportunity to help your family through this journey. All of our team members are dedicated to helping children with hearing loss achieve their full potential. If you have any questions or concerns, please do not hesitate to contact us. Sincerely, The Cochlear Implant Team at Texas Children’s Hospital Table of Contents 1. -
Audiology 101: an Introduction to Audiology for Nonaudiologists Terry Foust, Aud, FAAA, CC-SLP/A; & Jeff Hoffman, MS, CCC-A
NATIONALA RESOURCE CENTER GUIDE FOR FOR EARLY HEARING HEARING ASSESSMENT DETECTION & & MANAGEMENT INTERVENTION Chapter 5 Audiology 101: An Introduction to Audiology for Nonaudiologists Terry Foust, AuD, FAAA, CC-SLP/A; & Jeff Hoffman, MS, CCC-A Parents of young Introduction What is an audiologist? children who are arents of young children who are An audiologist is a specialist in hearing identified as deaf or hard identified as deaf or hard of hearing and balance who typically works in of hearing (DHH) are P(DHH) are suddenly thrust into a either a medical, private practice, or an suddenly thrust into a world of new concepts and a bewildering educational setting. The primary roles of world of new concepts array of terms. What’s a decibel or hertz? an audiologist include the identification and a bewildering array What does sensorineural mean? Is a and assessment of hearing and balance moderate hearing loss one to be concerned problems, the habilitation or rehabilitation of terms. about, since it’s only moderate? What’s of hearing and balance problems, and the a tympanogram or a cochlear implant? prevention of hearing loss. When working These are just a few of the many questions with infants and young children, the that a parent whose child has been primary focus of audiology is hearing. identified as DHH may have. In addition to parents, questions also arise from Audiologists are licensed by the state in professionals and paraprofessionals who which they practice and may be members work in the field of early hearing detection of the American Speech-Language- and intervention (EHDI) and are not Hearing Association (ASHA), American audiologists. -
Otology & Neurotology
Otology & Neurotology 2017 Journal Citation Report® (Clarivate, 2018) 2017 Journal Citation Reports® -- Key Metrics 2016 2017 Impact Factor 2.024 2.182 5-Year Impact Factor 2.163 2.264 Immediacy Index 0.326 0.194 Citable Items 279 309 Total Cites 6,695 7,427 Cited Half-life 6.3 6.7 Citing Half-life 9.2 9.1 Eigenfactor™ Score .01216 .01161 Article Influence™ Score .595 .584 Category Ranking Clinical Neurology 121/194 121/197 Otorhinolaryngology 13/42 13/41 2017 Impact Factor calculation Cites in 2017 to items published in: 2016 = 505 Number of items published in: 2016 = 279 2015 = 763 2015 = 302 Sum: 1268 Sum: 581 Calculation: Cites to recent items 1268 = 2.182 Number of recent items 581 2017 5-year Impact Factor calculation Cites in 2017 to items published in: 2016 = 505 Number of items published in: 2016 = 279 2015 = 763 2015 = 302 2014 = 758 2014 = 330 2013 = 629 2013 = 266 2012 = 609 2012 = 265 Sum: 3264 Sum: 1442 Calculation: Cites to recent items 3264 = 2.264 Number of recent items 1442 2017 Immediacy Index calculation Cites in 2017 to items published in 2017 = 60 Number of items published in 2017 = 309 Calculation: Cites to current items 60 = 0.194 Number of current items 309 Impact Factor: 2013- 2017 2013 2014 2015 2016 2017 Citations 834 949 1164 1279 1268 Articles 522 531 596 632 581 Impact Factor 1.598 1.787 1.953 2.024 2.182 Citations Articles Impact Factor 1400 2.5 2.182 1200 1.953 2.024 1.787 2 1000 1.598 Factor Impact 800 1.5 600 1 400 0.5 200 0 0 2013 2014 2015 2016 2017 Category Ranking: 2013-2017 Category 2013 2014 2015 2016 2017 Clinical Neurology 135/194 122/192 115/193 121/194 121/197 Otorhinolaryngology 15/44 17/44 13/43 13/42 13/41 Journal Self Cites Self Cites 1141(15.363% of 7427) Self Cites to Years Used in Impact Factor Calculation 246(19.401% of 1268) Impact Factor without Self Cites 1.759 Top Cited Papers in 2017 Published in 2015-2016 Cites Pub In Total Rank Title Authors Year Vol Iss 2017 Cites Epidemiology of Balance Symptoms and Disorders in the Community: A Murdin, Louisa; Schilder, Anne G.