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Examination Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
Be gentle with the otoscope. Make sure when you are moving it around in the EAC that your movements are slow and considered, otherwise you will cause the patient pain. In the examination the ‘patient’ will have had his or her ears examined a number of times before, hence their tolerance to any sudden movements is quite low.
Postmortem Examination in Case of Asphyxial Death
Published in Sudhir K. Gupta, Forensic Pathology of Asphyxial Deaths, 2022
Otoscope can be used for detailed examination of the external auditory meatus, tympanic membrane and middle ear in cases of ruptured tympanic membrane. Otoscope can also be used for capturing photographs of these findings. The anterior and posterior aspects of ear lobules should be examined for the presence of any injuries. External auditory meatus has to be examined for any injuries or hemorrhages. Tympanic membrane can also be examined as many cases of mechanical asphyxia can show tympanic hemorrhages, but these are considered as a nonspecific finding by many authors.
Chronic Otitis Media
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Symptoms alone cannot determine diagnosis, and otoscopy is critical to visualise middle ear pathology (using a microscope or endoscope where available), and an audiogram to evaluate hearing loss. A tympanogram can confirm the presence of effusion or perforation.
Audiology in the time of COVID-19: practices and opinions of audiologists in the UK
Published in International Journal of Audiology, 2021
Gabrielle H. Saunders, Amber Roughley
In terms of clinical practice, limitations in procedures that can be currently conducted using teleaudiology, such as the inability to assess audiometric thresholds and conduct otoscopy, were given as a reason for not using it. Until technological innovations overcome these limitations, they will remain barriers to the provision of remote care. Other reasons were associated with a lack of need (before COVID-19) to use remote care and maintenance of the status quo; i.e. audiologists said that they had not needed to use remote care previously, or that they had simply not thought about doing so. Both can be understood in the context of practicing in high demand situations with limited availability of time and staff, and the complexities of implementing change within an established system (Scott et al. 2003). On a positive note, now the need to use remote care has arisen, audiologists seem to be re-evaluating the situation. Finally, some audiologists cited a preference for providing face-to-face care over remote care. This will likely be a difficult barrier to overcome because attitudes and beliefs are difficult to change. However, experience with use has been shown to change attitudes for the positive (Hanson, Calhoun, and Smith 2009; Cottrell et al. 2018) as has education and training (Smith et al. 2020). This is illustrated here by the high proportion of audiologists who say they will continue to use remote care.
Is cortical automatic threshold estimation a feasible alternative for hearing threshold estimation with adults with dementia living in aged care?
Published in International Journal of Audiology, 2020
Anthea Bott, Louise Hickson, Carly Meyer, Fabrice Bardy, Bram Van Dun, Nancy A. Pachana
Following consent/assent a family member or the individual completed the participant demographic questionnaire and the first author confirmed participants’ medical history with the clinical care coordinator of the ACH. Informant and participant interviews were completed by the first author to assess dementia severity, using the CDR. To reduce the impact of audibility on CDR rating, participant interviews were conducted using a Pocket Talker Pro personal sound amplifier (William Sound, Minnesota, Eden Prairie, MN) or using their hearing aids. Following this, otoscopy was performed. For residents with cerumen occlusion, a referral for wax management was arranged and where possible testing was performed following cerumen removal. Where participants had unilateral cerumen occlusion, testing was performed on the non-occluded ear. Most participants had testing attempted in both ears.
Surgical, speech, and hearing outcomes at five years of age in internationally adopted children and Swedish-born children with cleft lip and/or palate
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Johnna Sahlsten Schölin, Åsa Jonasson, Jessica Axelsson, Christina Havstam, Christina Persson, Radi Jönsson, Hans Mark
The otological and audiological investigations were performed at the 5-year visit, i.e. on the same day as the speech and surgery assessment for all children. A control group of 20 children from the general pediatric population without CL/P and without any known disability was assessed in the same manner at age 5 years (±2 weeks). The children were examined by microscopic otoscopy to assess the status of the external ear, ear canal, tympanic membrane, and middle ear. Pneumatic otoscopy was performed when deemed appropriate in the clinical setting. Age and developmentally appropriate psychoacoustic testing and acoustic impedance testing (tympanometry) were performed on the same day. ISO 389, ISO 8253–1, and ISO 8253–2 standards were used. The type of hearing impairment was defined according to hearing levels with a screening level of 20 dB, tympanometry findings, and clinical investigation findings. Hearing loss was defined according to clinical definitions: pure-tone average (0.5–4 kHz) >20 dB hearing level. The number of children and ears with in situ tympanostomy tubes was reported.