117 lines
5.8 KiB
Mathematica
117 lines
5.8 KiB
Mathematica
DVBCWAU5 ;BPOIFO/RLC AUDIO WKS TEXT - 1 ; 26 DEC 2006
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;;2.7;AMIE;**118**;FEB 2,2004;Build 3
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;
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TXT ;
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;; The Handbook of Standard Procedures and Best Practices for Audiology
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;; Compensation and Pension Exams is available online. ( This is a PDF file.
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;; You need Acrobat Reader to open pdf files. It is a free download. )
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;;
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;;Narrative: An examination of hearing impairment must be conducted by a
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;;state-licensed audiologist and must include a controlled speech
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;;discrimination test (specifically, the Maryland CNC recording) and a
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;;pure tone audiometry test in a sound isolated booth that meets American
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;;National Standards Institute standards (ANSI S3.1.1991) for ambient noise.
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;;Measurements will be reported at the frequencies of 500, 1000, 2000, 3000,
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;;and 4000 Hz. The examination will include the following tests: Pure tone
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;;audiometry by air conduction at 250, 500, 1000, 2000, 3000, 4000, and
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;;8000 Hz, and by bone conduction at 250, 500, 1000, 2000, 3000, and
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;;4000 Hz, spondee thresholds, speech recognition using the recorded
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;;Maryland CNC Test, tympanometry and acoustic reflex tests, and, when
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;;necessary, Stenger tests. Bone conduction thresholds are measured
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;;when the air conduction thresholds are poorer than 15 dB HL. A modified
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;;Hughson-Westlake procedure will be used with appropriate masking. A
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;;Stenger must be administered whenever pure tone air conduction
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;;thresholds at 500, 1000, 2000, 3000, and 4000 Hz differ by 20 dB or more
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;;between the two ears. Maximum speech recognition will be reported with
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;;the 50 word VA approved recording of the Maryland CNC test. When speech
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;;recognition is 92% or less, a performance intensity function will be
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;;obtained with a starting presentation level of 40dB re SRT. If necessary,
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;;the starting level will be adjusted upward to obtain a level at least 5 dB
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;;above the threshold at 2000 Hz. The examination will be conducted without
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;;the use of hearing aids. Both ears must be examined for hearing
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;;impairment even if hearing loss in only one ear is at issue.
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;;
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;;A. Review of Medical Records: Indicate whether the C-file was reviewed.
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;;
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;;B. Medical History (Subjective Complaints):
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;;
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;; Comment on:
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;;
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;; 1. Chief complaint.
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;; 2. Situation of greatest difficulty.
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;; 3. Pertinent service history.
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;; 4. History of military, occupational, and recreational noise
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;; exposure.
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;; 5. Pertinent family and social history; history of ear disease,
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;; head or ear trauma, etc.
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;; 6. Tinnitus - If present, state:
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;;
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;; a. Date and circumstances of onset.
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;; b. Whether it is unilateral or bilateral.
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;; c. Whether it is persistent or recurrent.
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;;
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;; 7. Describe effects on occupational functioning and activities
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;; of daily living.
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;;
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;;C. Physical Examination (Objective Findings):
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;;
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;; 1. Measure puretone thresholds in decibels at the indicated
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;; frequencies (air conduction):
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;;
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;; = = = = =RIGHT EAR= = = = = = = = = = = = = LEFT EAR = = = = = =
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;; A* B C D E ** A* B C D E **
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;; 500|1000|2000|3000|4000|average 500|1000|2000|3000|4000|average
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;; | | | | | | | | | |
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;;
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;; * The puretone threshold at 500 Hz is not used in determining the
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;; evaluation but is used in determining whether or not a ratable
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;; hearing loss exists. Puretone thresholds should not exceed 105
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;; decibels or the tolerance level.
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;; ** The average of B, C, D, and E.
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;;
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;; 2. Speech Recognition Score: Maryland CNC word list
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;;
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;; _____% right ear _____% left ear.
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;;
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;; When only puretone results should be used to evaluate hearing loss,
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;; the examiner, who must be a state-licensed audiologist, should certify
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;; that language difficulties or other problems (specify what the problems
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;; are) make the combined use of puretone average and speech
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;; discrimination inappropriate.
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;;
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;; Thresholds should not exceed 100 decibels or the tolerance level.
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;;
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;;D. Diagnostic and Clinical Tests:
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;;
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;; 1. Report middle ear status, confirm type of loss, and indicate
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;; need for medical follow-up. In cases where there is poor
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;; inter-test reliability and/or positive Stenger test results,
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;; obtain and report estimates of hearing thresholds using a
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;; combination of behavioral testing, Stenger interference levels,
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;; and electrophysiological tests.
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;; 2. Include results of all diagnostic and clinical tests conducted
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;; in the examination report.
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;;
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;;E. Diagnosis:
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;;
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;; 1. Summary of audiologic test results. Indicate type and degree
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;; of hearing loss for the frequency range from 500 to 4000 Hz.
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;; For type of loss, indicate whether it is normal, conductive,
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;; sensorineural, central, or mixed. For degree, indicate whether
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;; it is mild (26-40 HL), moderate (41-54 HL), moderately severe
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;; (55-69 HL), severe (70-89 HL), or profound (90+ HL).
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;; [For VA purposes, impaired hearing is considered to be a
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;; disability when the auditory threshold in any of the frequencies
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;; 500, 1000, 2000, 3000, and 4000 Hz is 40 dB HL or greater; or
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;; when the auditory thresholds for at least three of these
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;; frequencies are 26 dB HL or greater; or when speech recognition
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;; scores are less than 94%]
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;; 2. Note whether, based on audiologic results, medical follow-up
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;; is needed for an ear or hearing problem, and whether there is
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;; a problem that, if treated, might cause a change in hearing
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;; threshold levels.
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;;
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;;
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;;Signature: Date:
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;;END
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