ILE Subscription Test Prep/Class Test
Prep
What are 4 ways to correct the occlusion effect? - ANS-1. Reduce the LOWS 2. make
the fitting more "open" like RIC styles or thin tube BTE's coupled to the ear with open
domes. Custom styles like CICs and IICs offer fewer venting options due to small shell
sizes.
3. Increase vent size
4. SAV, is always a safe bet because its always easier to reduce the vent size than
increase it
Occlussion effect can sometimes be described by the wearer as their voice sounding
like an "echo" or "down in a barrel." This is due to their ear being closed off and an
increased amplification due to bone conduction.
Patient's work environment includes both noisy and quiet areas. This requires the
patient to make constant adjustments to the hearing instruments volume controls.
Which specific measurement will be most important to obtain during the patient's
hearing evaluation?
MCL or UCL? - ANS-UCL, because (pg. 115-118) of the constant adjusting. They're
dynamic range needs to fit their work environment.
36 year old female restaurant worker with a family history of hearing loss reports that
she is unable to hear as well as she did two years ago. Testing reveals a moderate
conductive hearing loss. What is the likely cause of the patient's change in hearing?
Meniere's Disease or Otosclerosis - ANS-Otosclerosis pg. Pg. 43-46 disorders of the
middle ear
Otosclerosis is more common in women, and may be triggered by the hormonal
changes of pregnancy.
Otosclerosis is more of a progressive hearing loss.
Meniere's Disease is classified as a SNHL.
What is a Carhart's notch? - ANS-It's an audiometric feature that shows a dip at 2000
Hz when people likely have otosclerosis that results in stapedial fixation. Named for Dr.
,Raymond Carhart.
Patient has moderate to severe SNHL bilaterally. Patient was fit with slim tube BTE
instruments. During the initial follow-up, the hearing healthcare professional performed
probe tube measurements, which fell below targets in the high frequency range.
Patient's validation results reveal low satisfaction with the fitting. What fitting option
should the hearing healthcare professional recommend?
Change to mini-BTE's with open domes
Change to RIC's with custom earmolds and medium vents - ANS-What are mini-BTE's?
Change to mini-BTE's with open domes. This doesn't make sense because they already
have BTE's and they aren't meeting high frequency range targets.
Change to RIC's with custom earmolds and medium vents pg. 195-206. The medium
vents may be able to increase high frequency sounds due to horn theory.
What's horn theory? - ANS-An acoustic horn is a change in diameter of the sound
channel from smaller to larger. This response increases the high frequencies. This
theory is used for a Libby Horn/Horn Tube, or modified canal bore belled/hollowed on
earmold for BTE fittings when programming adjustments for high frequency
enhancement cause distortion and unnatural sound.
Patient with digital BTE's with dual microphones reports difficulty hearing in noisy
environments. Which parameter should the hearing healthcare professional adjust when
reprogramming the HA's?
Compression or Directionality - ANS-Directionality (pg. 171-182) because the noisy
environments have noises coming from different directions, and they help with
understanding speech in background noise. This makes the signal to noise ratio more
favorable or the listener. Sound coming from the front will be louder than sound coming
from the back.
Compression doesn't make sense because it varies gain as the input changes. The
compression kneepoint, or CK is when the intensity of amplification changes from linear
to non-linear.
Patient's assessment shows type A tympanometry values and unremarkable otoscopy
with the tympanic membrane viewed while holding the pinna up and back. Audiometric
findings using TDH-39 circumaural headphones show an air/bone gap of 15 dB at
1000
, Hz to 4000 Hz. What should the findings indicate to the hearing healthcare
professional?
Ossicular disarticulation or Collapsed ear canal pg. 35-38 disorders of the outer ear -
ANS-Collapsed ear canal, because you already know that
Type A tympanometry is classified with normal middle ear function and no conductive
components. So the ossicular disarticulation wouldn't make sense.
What does a Tymp A show? - ANS--normal middle ear compliance, peak pressure and
TW
-no conductive components
-once exception is patients with otosclerosis who have a conductive or mixed hearing
loss with normal ME measured by tympanometry
To reduce occlussion effect should the fitting be deeper into the bony portion of the ear
canal, or farther from the Tympanic Membrane? - ANS-closer to TM means less
occlusion effect because of shorter distance
How is binaural interference characterized? - ANS-Binaural word recognition can
determine if binaural interference or degradation is present. Patients typically show
improved speech rec scores binaurally, but when degredation or happens binaurally
which speech recognition this is interference. More common with patients with
significantly asymmetric word recognition scores.
Patient with binaural dual microphone HA's reports difficulty understanding passengers
in the rear seat of the car when driving. What should the hearing healthcare
professional recommend?
Using cardoid directional setting on both instruments
Using omni-directional setting on both instruments pg. 231-276 -
ANS-Omni-Directional setting makes sense because they need to hear passengers
behind them. pg. 231-276
Cardoid directional setting does not make sense because it's sound coming in directly in
front of the microphone and none behind.
A 65 year old patient states that during previous otoscopic inspections their ear was
scratched, which caused bleeding. The patient has prolapsed canals. How should a
hearing healthcare professional evaluate the ear?
Use an earlight
Prep
What are 4 ways to correct the occlusion effect? - ANS-1. Reduce the LOWS 2. make
the fitting more "open" like RIC styles or thin tube BTE's coupled to the ear with open
domes. Custom styles like CICs and IICs offer fewer venting options due to small shell
sizes.
3. Increase vent size
4. SAV, is always a safe bet because its always easier to reduce the vent size than
increase it
Occlussion effect can sometimes be described by the wearer as their voice sounding
like an "echo" or "down in a barrel." This is due to their ear being closed off and an
increased amplification due to bone conduction.
Patient's work environment includes both noisy and quiet areas. This requires the
patient to make constant adjustments to the hearing instruments volume controls.
Which specific measurement will be most important to obtain during the patient's
hearing evaluation?
MCL or UCL? - ANS-UCL, because (pg. 115-118) of the constant adjusting. They're
dynamic range needs to fit their work environment.
36 year old female restaurant worker with a family history of hearing loss reports that
she is unable to hear as well as she did two years ago. Testing reveals a moderate
conductive hearing loss. What is the likely cause of the patient's change in hearing?
Meniere's Disease or Otosclerosis - ANS-Otosclerosis pg. Pg. 43-46 disorders of the
middle ear
Otosclerosis is more common in women, and may be triggered by the hormonal
changes of pregnancy.
Otosclerosis is more of a progressive hearing loss.
Meniere's Disease is classified as a SNHL.
What is a Carhart's notch? - ANS-It's an audiometric feature that shows a dip at 2000
Hz when people likely have otosclerosis that results in stapedial fixation. Named for Dr.
,Raymond Carhart.
Patient has moderate to severe SNHL bilaterally. Patient was fit with slim tube BTE
instruments. During the initial follow-up, the hearing healthcare professional performed
probe tube measurements, which fell below targets in the high frequency range.
Patient's validation results reveal low satisfaction with the fitting. What fitting option
should the hearing healthcare professional recommend?
Change to mini-BTE's with open domes
Change to RIC's with custom earmolds and medium vents - ANS-What are mini-BTE's?
Change to mini-BTE's with open domes. This doesn't make sense because they already
have BTE's and they aren't meeting high frequency range targets.
Change to RIC's with custom earmolds and medium vents pg. 195-206. The medium
vents may be able to increase high frequency sounds due to horn theory.
What's horn theory? - ANS-An acoustic horn is a change in diameter of the sound
channel from smaller to larger. This response increases the high frequencies. This
theory is used for a Libby Horn/Horn Tube, or modified canal bore belled/hollowed on
earmold for BTE fittings when programming adjustments for high frequency
enhancement cause distortion and unnatural sound.
Patient with digital BTE's with dual microphones reports difficulty hearing in noisy
environments. Which parameter should the hearing healthcare professional adjust when
reprogramming the HA's?
Compression or Directionality - ANS-Directionality (pg. 171-182) because the noisy
environments have noises coming from different directions, and they help with
understanding speech in background noise. This makes the signal to noise ratio more
favorable or the listener. Sound coming from the front will be louder than sound coming
from the back.
Compression doesn't make sense because it varies gain as the input changes. The
compression kneepoint, or CK is when the intensity of amplification changes from linear
to non-linear.
Patient's assessment shows type A tympanometry values and unremarkable otoscopy
with the tympanic membrane viewed while holding the pinna up and back. Audiometric
findings using TDH-39 circumaural headphones show an air/bone gap of 15 dB at
1000
, Hz to 4000 Hz. What should the findings indicate to the hearing healthcare
professional?
Ossicular disarticulation or Collapsed ear canal pg. 35-38 disorders of the outer ear -
ANS-Collapsed ear canal, because you already know that
Type A tympanometry is classified with normal middle ear function and no conductive
components. So the ossicular disarticulation wouldn't make sense.
What does a Tymp A show? - ANS--normal middle ear compliance, peak pressure and
TW
-no conductive components
-once exception is patients with otosclerosis who have a conductive or mixed hearing
loss with normal ME measured by tympanometry
To reduce occlussion effect should the fitting be deeper into the bony portion of the ear
canal, or farther from the Tympanic Membrane? - ANS-closer to TM means less
occlusion effect because of shorter distance
How is binaural interference characterized? - ANS-Binaural word recognition can
determine if binaural interference or degradation is present. Patients typically show
improved speech rec scores binaurally, but when degredation or happens binaurally
which speech recognition this is interference. More common with patients with
significantly asymmetric word recognition scores.
Patient with binaural dual microphone HA's reports difficulty understanding passengers
in the rear seat of the car when driving. What should the hearing healthcare
professional recommend?
Using cardoid directional setting on both instruments
Using omni-directional setting on both instruments pg. 231-276 -
ANS-Omni-Directional setting makes sense because they need to hear passengers
behind them. pg. 231-276
Cardoid directional setting does not make sense because it's sound coming in directly in
front of the microphone and none behind.
A 65 year old patient states that during previous otoscopic inspections their ear was
scratched, which caused bleeding. The patient has prolapsed canals. How should a
hearing healthcare professional evaluate the ear?
Use an earlight
