Samenvatting Totaalbestand gehoor en evenwicht diagnostiek - TM
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Course
Gehoor en evenwicht diagnostiek
Institution
Thomas More Hogeschool (tmhs)
Book
Gehoorverlies bij kinderen
Alle hoorcolleges van gehoor en evenwicht werden beluisterd en uitgeschreven. Ook de PowerPoint werd hiervoor gebruikt.
De oefencolleges van gehoor werden hier ook in verwerkt. De kennisclips werden uitgeschreven, de oefeningen en opdrachten werden toegevoegd.
Er werd een examenvoorbeeld toeg...
Veronique De Nutte
Alle hoorcolleges van gehoor en evenwicht
werden hierin verwerkt, alsook de
oefencolleges van gehoor.
GEHOOR DIAGNOSTIEK
2022-2023
1
,Inhoud
Deel 1: gehoor.................................................................................................................... 12
1 HC 1: inleiding .............................................................................................................12
1.1 Wat zijn de beroepsdomeinen van de audioloog? .........................................12
1.2 Enkele inleidende begrippen .............................................................................14
1.2.1 Decibelschalen ............................................................................................. 14
1.2.2 Dimensies van het hoorgebied ...................................................................17
1.2.3 Basisfuncties van horen ................................................................................20
1.3 Het audiologische diagnostische proces .......................................................... 20
1.3.1 Anamnese .....................................................................................................21
1.3.2 Inspectie van oorschelp, gehoorgang en trommelvlies ........................... 21
1.3.3 De audiologische diagnostische testbatterij en crosscheck principe .....22
2 HC 2 en 3: Toonaudiometrie ...................................................................................... 23
2.1 Uitrusting................................................................................................................23
2.1.1 Audiometer ...................................................................................................24
2.1.2 Transducers....................................................................................................25
2.1.2.1 Hoofdtelefoon (luchtgeleiding) ....................................................................... 25
2.1.2.2 Insert phones (luchtgeleiding) .......................................................................... 26
2.1.2.3 Luidsprekers (luchtgeleiding) ............................................................................ 27
2.1.2.4 Beentriller (beengeleiding → geen kleurencode) ..................................... 27
2.1.3 Testomgeving of geluidsdichte cabine ...................................................... 28
2.2 Luchtgeleidingsaudiometrie zonder maskeren .................................................29
2.3 Beenbegeleidingsaudiometrie zonder maskeren .............................................30
2.4 Testprocedure voor ongemaskeerde drempelbepaling en de
gemodificeerde Hughson-Westlake methode ............................................................ 32
2.4.1 Stappenplan om gehoordrempels op een gestandaardiseerde manier te
bepalen. ...................................................................................................................... 32
2.5 Overhoren en maskeren ..................................................................................... 36
2.5.1 Terminologie ..................................................................................................38
2.5.1.1 Testoor vs niet-testoor.......................................................................................... 38
2.5.1.2 Overhoren = beengeleidingsmechanisme .................................................. 38
2.5.1.3 Interaurale attenuatie/verzwakking (= IA) .................................................... 39
2.5.1.4 Maskeerruis ............................................................................................................. 41
2.5.1.5 Occlusie-effect ..................................................................................................... 42
2.5.2 Klinisch maskeren .......................................................................................... 43
2
, 2.5.2.1 Is er een kans op overhoren? ........................................................................... 44
2.5.2.2 Maskeerprocedure voor zuivere toonaudiometrie .................................... 45
2.6 Interpretatie ..........................................................................................................49
2.6.1 Het audiogram .............................................................................................. 51
2.6.2 Classificatie....................................................................................................51
2.6.2.1 Graad of ernst ....................................................................................................... 52
2.6.2.2 Type of aard .......................................................................................................... 54
2.6.2.3 Configuratie of vorm ........................................................................................... 57
2.7 Kinderaudiometrie ............................................................................................... 59
2.8 Uncomfortable loudness level (UCL) en dynamisch bereik ............................. 60
2.9 Aanvullende stemvorkproeven ..........................................................................61
2.9.1 Weber test .....................................................................................................62
2.9.2 Rinne test .......................................................................................................64
3 HC 4: Spraakaudiometrie ........................................................................................... 66
3.1 Spraak als stimulus (spraakaudiometrie) ............................................................ 68
3.1.1 Redundantie .................................................................................................69
3.1.2 Vocabularium ............................................................................................... 69
3.2 Praktische afname ............................................................................................... 70
3.2.1 Spraakmateriaal ........................................................................................... 70
3.2.2 Spraakdiscriminatie vs spraakverstaan ....................................................... 71
3.2.3 Wijze van aanbieden ...................................................................................71
3.2.3.1 Transducers ............................................................................................................ 72
3.2.4 Wijze van antwoorden .................................................................................72
3.2.5 Instructies aan patiënt ..................................................................................72
3.2.6 Afnamemethode .......................................................................................... 73
3.2.6.1 Spraakaudiometrie in stilte ................................................................................ 73
3.2.6.2 Spraakaudiometrie in ruis ................................................................................... 75
3.2.7 Scoringwijze: Scoring van veelgebruikt spraakmateriaal .......................... 76
3.2.7.1 BLU (Brugge-Leuven-Utrecht) woordenlijst.................................................... 76
3.2.7.2 NVA (Nederlandse Vereniging voor Audiologie) woordenlijst ................ 76
3.2.7.3 Brugse lijst ................................................................................................................ 77
3.2.7.4 LIST (Leuven Intelligibility Sentence Test) ........................................................ 77
3.2.7.5 LINT (Leuven Intelligibility Numbers Test) ........................................................ 78
3.3 Resultaat en weergave ....................................................................................... 78
3.3.1 Het spraakaudiogram als resultaat van spraakaudiometrie in stilte ........78
3
, 3.3.1.1 Verschillende types/Mogelijke vormen ......................................................... 82
3.3.1.2 Het spraakaudiogram als resultaat van spraakaudiometrie in ruis (geen
examen) ................................................................................................................................. 83
3.3.1.3 Overeenkomst met het toonaudiogram ....................................................... 84
3.3.2 Toepassingen ................................................................................................ 85
3.3.3 Spraakaudiometrie bij kinderen...................................................................86
4 HC 5: immitantiemetrie – impedantiemetrie ............................................................ 87
4.1 Principe .................................................................................................................89
4.2 Impedantiemetrietesten ..................................................................................... 92
4.2.1 Tympanometrie ............................................................................................. 92
4.2.1.1 Doel .......................................................................................................................... 93
4.2.1.2 Principe ................................................................................................................... 93
4.2.1.3 Materiaal ................................................................................................................ 94
4.2.1.4 Afnamemethode ................................................................................................. 94
4.2.1.5 Instructie aan patiënt .......................................................................................... 98
4.2.1.6 Resultaat en interpretatie .................................................................................. 98
4.2.2 Akoestische reflexmetingen ....................................................................... 106
4.2.2.1 De stapediusreflex.............................................................................................. 106
4.2.2.2 Materiaal .............................................................................................................. 109
4.2.2.3 Afnamemethode ............................................................................................... 109
4.2.2.4 Instructie aan patiënt ........................................................................................ 112
4.2.2.5 Resultaat en interpretatie ................................................................................ 112
5 HC 6: Otoakoestische emissies en auditief geëvokeerde potentialen ................ 117
5.1 Otoakoestische emissies: OAE .......................................................................... 120
5.1.1 Onderverdeling/types van de OAE’s ........................................................ 121
5.1.1.1 Spontane OAE’s.................................................................................................. 121
5.1.1.2 TEOAE’s.................................................................................................................. 122
5.1.1.2.1 Stappenplan om OAE te interpreteren ................................................ 127
5.1.1.3 DPOAE’s : distortion product OAE’s .............................................................. 130
5.1.2 Toepassing van OAE’s ................................................................................ 132
5.1.3 Testafname.................................................................................................. 133
5.1.3.1 Materiaal .............................................................................................................. 133
5.1.3.2 Instructie ................................................................................................................ 134
5.1.3.3 Verwerking van de meetresultaten .............................................................. 134
5.1.4 Interpretatie van de meetresultaten ......................................................... 135
4
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