Hearing loss and the role of the physician.

As a physician, your role starts by asking hearing-related questions as part of the case history interview and by screening your patients' hearing. As you may know, hearing plays an important role in both the emotional and physical well being of your patients. You can be an important source of information for your patients who are hearing impaired. The more you know about hearing loss and its effects on your patients' lives, the better you will be able to assist them in making informed decisions that will allow them to live their lives more fully despite the hearing impairment.

Audiologists help doctors help their patients hear better

The field of audiology is the assessment and treatment of hearing disorders. Audiologists are hearing healthcare professionals who identify, assess, and manage disorders of the auditory system. They select, fit, program, and dispense hearing aids and assistive listening devices to help patients who are hearing impaired, hear clearer and better. Essentially, an audiologist provides rehabilitation to improve the quality of a patient's life through better hearing.

For a consultation, please contact: RBordenick@aol.com or call (410) 668-9198.

Definition of diagnostic testing services available at the Bordenick Audiology Group.

Auditory Brainstem Response (ABR)

ABR is an electrophysiologic test which determines the sensitivity of the ear to sound, in ongoing or spontaneous brain wave activity. It can be used to estimate the sensitivity of the ear to sound in newborns, in older children who did not perform well on a regular hearing test, and in adults who are unable to accurately complete a regular hearing test. For adults, the most common reason an ABR is recommended is to help eliminate the possibility of a disorder along the hearing nerve or in the brain itself. Response to a sound stimulus is imperative in determining the extent of hearing loss and the recommended (needed) amplification. To perform an ABR, electrodes are pasted and taped to the scalp and earlobes and soft foam tips are inserted down into the ear canals. Sounds are delivered through the ear tips at a comfortable-to-fairly-loud level. These sounds cause nerve responses that are picked up by the electrodes and passed on to sophisticated equipment that records the responses. An audiologist can then measure the responses to determine if they are normal or abnormal. The results are provided to the physician, so he or she can determine the need for further medical evaluation.

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Cerumen (Earwax) Removal

It is recommended that you refer your patients for cerumen management if they experience a progressive hearing loss over several weeks, their ears feel full, plugged, or achy, or if they hear constant or occasional ringing noises.

When a patient is referred to the Bordenick Audiology Group for earwax removal, a certified audiologist performs a thorough video otoscopic evaluation of the ear canal. If there are no contraindications such as recent otalgia, ear drainage, family history of diabetes, medical history of acquired immune deficiency syndrome, mastoid or extensive middle ear surgery, or the use of anti-coagulant medications, cerumen is extracted utilizing instrumentation or suction, depending on the extent of wax buildup.

Remember the ol' adage: "Never put anything smaller than an elbow into your ear."

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Electronystagmography (ENG)

An ENG is generally performed on patients who have episodes of dizziness or balance problems. It is an electronic measuring instrument that charts a patient's eye movements during a vestibular evaluation.

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Evaluation of Vestibular Problems

Most people at one time or another in their lives have experienced some type of "dizziness" associated with lightheadedness, an imbalance disorder, or true spinning sensation commonly known as vertigo. In fact dizziness is a common complaint physicians hear from their elderly patients. There is a close relationship between the hearing and balance systems because they share the same space called "the inner ear." The inner ear is comprised of two parts, the cochlea that houses the sensory organs responsible for our hearing and the semicircular canals that contain the structure, which help us maintain our balance. We call the semicircular canals and the nerve that innervates from the brain the "vestibular system." This system works in conjunction with other important systems such as visual and sensory to maintain balance as well.

Symptoms of peripheral vestibular dysfunction include:

Causes of dizziness disorders include:

Treatments of dizziness disorders include: