nonorganic hearing loss

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Author:
jacwill
ID:
259628
Filename:
nonorganic hearing loss
Updated:
2014-02-01 14:36:55
Tags:
355 aud
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Description:
aud
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  1. nonorganic hearing loss
    shows evidence of a hearing loss with no organic basis to explain the loss or pathologic evidence to indicate severity of loss
  2. causes of nonorganic hearing loss
    • to gain benefit such as financial gain
    • win attention
    • avoid a task
    • psychologic disturbance
  3. indications that the hearing loss might be nonorganic
    • source of referralĀ 
    • patients history
    • behavior during interview
    • performance on routine hearing tests
    • exaggerated hearing postures
    • reliance on lipreading
  4. sources of referral
    • va
    • insurance
    • attorney
    • physician
  5. routine hearing tests with expose
    • incompatibility of pure tones and speech reception threshold
    • test-retest is greater than 5 db for pt or srt
    • acoustic reflex threshold is less that 10 db above given pure tone thresh
    • repeating only half of a spondee (base instead of baseball)
    • bone conduction responses normal when presented in the poorer ear
    • if bone is more than air then something is wrong
  6. test for nonorganic hearing loss
    • acoustic reflex testing
    • aud evoked potential (brainstem response)
    • otoacoustic emissions (cilia response in ear)
    • stenger/speech stenger (in sound in both ears and you turn up one of the ears)
    • ascending pure tone (for children, start at bottom and work up)
    • number of presentations
    • NONE OF THESE ARE HEARING TESTS BUT HELP TO VALIDATE, DO MORE THAN ONE
  7. management of nonorganic
    • reinstruct as to what is expected
    • talk to patient without seeing your mouth
    • give instructions to do something and watch for response

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