Hearing impairment screening: Difference between revisions
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*All patients with hearing loss should be offered a referral to an [[audiologist]] or an [[Otolaryngologists|otolaryngologist]]. Worrisome symptoms accompanying hearing loss like headache, weight loss, bleeding etc. needs prompt referral to an otolaryngologist for further investigations. | *All patients with hearing loss should be offered a referral to an [[audiologist]] or an [[Otolaryngologists|otolaryngologist]]. Worrisome symptoms accompanying hearing loss like headache, weight loss, bleeding etc. needs prompt referral to an otolaryngologist for further investigations. | ||
== '''<big>Genetic tests</big>''' == | =='''<big>Genetic tests</big>'''== | ||
*[[Genetic testing]] may be considered to be a powerful tool for addressing hearing impairment in [[children]]. Genetic screening is defined as the analysis of human [[DNA]] in order to detect [[heritable]]-related mutations | *[[Genetic testing]] may be considered to be a powerful tool for addressing hearing impairment in [[children]]. Genetic screening is defined as the analysis of human [[DNA]] in order to detect [[heritable]]-related mutations. | ||
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Revision as of 10:47, 16 April 2021
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Hearing impairment Microchapters |
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Hearing impairment On the Web |
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American Roentgen Ray Society Images of Hearing impairment |
Who should be screened ?
There are different recommendations for who should be screened for hearing loss and at what age:[1]
- General rule is; Screening should be done for at-risk adults, little benefit exists on universal screening of adults or suggested interval screening in any group without being at risk for hearing impairment. [2]
- There is insufficient evidence to screening among asymptomatic adults aged 50 years or older by U.S. Preventive Services Task Force [3]
- Medicare mandates screening as part of the annual wellness examination for adults older than 65 years.
- Screen all adults once every decade until age 50 years and every 3 years afterwards by American Speech–Language–Hearing Association.
How to screen? [4]
- Study showed that screening with simple office tests, such as the whisper test, audio-scope, a hand-held combination otoscope and audiometer, or a self-assessment questionnaire, leads to successful therapeutic or compensatory treatment.
| Finger rub | Whisper test | Handheld audiometer[5] | Self-assessment questionnaire | Mobile apps and smartphones[6] |
|---|---|---|---|---|
| Examiner gently rubs fingers together close to the patient's ear. |
Examiner stands at arm's length (approximately 2 feet) behind the patient. The patient blocks 1 ear himslef. Examiner whispers 5-6 letters/number combinations. |
Examiner holds device in patient's ear one at a time. Patient indicates awareness of each tone. | They are often used in practice but have limitations.
|
Advancement of science has let to the development of mobile technology–based screening options, such as use of different mobile apps (for example, uHear, Mimi) and smartphone or tablet based portable audiometers that can be adjusted to perform screening for hearing impairment. |
| A positive result is a failure to identify rub in ≥2 of 6 attempts. | The positive result is failure to repeat ≥3 of the 6 combinations | Positive result is failure to identify either the 1000- or 2000-Hz frequency in both ears or the 1000- and 2000-Hz frequencies in 1 ear. | There are multiple questionnaire assessment tests for example Hearing Handicap Inventory for the Elderly Screening Version. It has a 10-item questionnaire with three options of “no,” “yes” and “sometimes,” | They generally require supra-aural headphones for monitoring. |
- Single question assessment: Do you think you have hearing loss? (yes/no). Self-reported hearing difficulty varies by degree of hearing loss and sociodemographic characteristics and is usually difficult to pick in a person with mild degree of hearing loss. [7][8] There are multiple questionnaire assessment test for example Hearing Handicap Inventory for the Elderly Screening Version. It has 10-item questionnaire with three options of “no,” “yes” and “sometimes,”
- The Weber and Rinne tests should not be used for general screening as they have little sensitivity for detection of hearing loss. Elderly adults who know they have hearing impairment require audiometry, while those who don't know should be screened with the whispered-voice test. Elderly adults who perceive the whispered voice require no further testing, while those unable to perceive the voice require audiometry for screening.[9][10]
- Advancement of science has let to the development of mobile technology–based screening options, such as use of different mobile apps (for example, uHear, Mimi) and smartphone or tablet based portable audiometers that can be adjusted to perform screening for hearing impairment. They generally require supra-aural headphones for monitoring.[11]
- After hearing loss is diagnosed then Weber and Rinne test can be performed to differentiate whether its a conductive, sensorineural or mixed hearing loss.
- All patients with hearing loss should be offered a referral to an audiologist or an otolaryngologist. Worrisome symptoms accompanying hearing loss like headache, weight loss, bleeding etc. needs prompt referral to an otolaryngologist for further investigations.
Genetic tests
- Genetic testing may be considered to be a powerful tool for addressing hearing impairment in children. Genetic screening is defined as the analysis of human DNA in order to detect heritable-related mutations.
References
- ↑ Nieman CL, Oh ES (2020). "Hearing Loss". Ann Intern Med. 173 (11): ITC81–ITC96. doi:10.7326/AITC202012010. PMID 33253610 Check
|pmid=value (help). - ↑ "Integrated Care for Older People: Guidelines on Community-Level Interventions to Manage Declines in Intrinsic Capacity". WHO Guidelines Approved by the Guidelines Review Committee. 2017. PMID 29608259.
- ↑ Moyer VA, U.S. Preventive Services Task Force (2012). "Screening for hearing loss in older adults: U.S. Preventive Services Task Force recommendation statement". Ann Intern Med. 157 (9): 655–61. doi:10.7326/0003-4819-157-9-201211060-00526. PMID 22893115.
- ↑ Nieman CL, Oh ES (2020). "Hearing Loss". Ann Intern Med. 173 (11): ITC81–ITC96. doi:10.7326/AITC202012010. PMID 33253610 Check
|pmid=value (help). - ↑ Strawbridge WJ, Wallhagen MI (2017). "Simple Tests Compare Well with a Hand-held Audiometer for Hearing Loss Screening in Primary Care". J Am Geriatr Soc. 65 (10): 2282–2284. doi:10.1111/jgs.15044. PMC 5641245. PMID 28799200.
- ↑ Sandström J, Swanepoel de W, Carel Myburgh H, Laurent C (2016). "Smartphone threshold audiometry in underserved primary health-care contexts". Int J Audiol. 55 (4): 232–8. doi:10.3109/14992027.2015.1124294. PMID 26795898.
- ↑ Yueh B, Shapiro N, MacLean CH, Shekelle PG (2003). "Screening and management of adult hearing loss in primary care: scientific review". JAMA. 289 (15): 1976–85. doi:10.1001/jama.289.15.1976. PMID 12697801.
- ↑ Goman AM, Reed NS, Lin FR, Willink A (2020). "Variations in Prevalence and Number of Older Adults With Self-reported Hearing Trouble by Audiometric Hearing Loss and Sociodemographic Characteristics". JAMA Otolaryngol Head Neck Surg. 146 (2): 201–203. doi:10.1001/jamaoto.2019.3584. PMC 6902177 Check
|pmc=value (help). PMID 31750866. - ↑ Bagai A, Thavendiranathan P, Detsky AS (2006). "Does this patient have hearing impairment?". JAMA. 295 (4): 416–28. doi:10.1001/jama.295.4.416. PMID 16434632. Review in: Evid Based Nurs. 2006 Oct;9(4):120 Review in: Evid Based Med. 2006 Aug;11(4):116
- ↑ Goman AM, Reed NS, Lin FR, Willink A (2020). "Variations in Prevalence and Number of Older Adults With Self-reported Hearing Trouble by Audiometric Hearing Loss and Sociodemographic Characteristics". JAMA Otolaryngol Head Neck Surg. 146 (2): 201–203. doi:10.1001/jamaoto.2019.3584. PMC 6902177 Check
|pmc=value (help). PMID 31750866. - ↑ Sandström J, Swanepoel de W, Carel Myburgh H, Laurent C (2016). "Smartphone threshold audiometry in underserved primary health-care contexts". Int J Audiol. 55 (4): 232–8. doi:10.3109/14992027.2015.1124294. PMID 26795898.