SLP Hearing and Aural Rehabilitation 4 — Questions and Answers
Question 1: During otoacoustic emission (OAE) testing, a pass result indicates which of the following?
- Normal cochlear outer hair cell function (Correct answer)
- Normal auditory nerve transmission
- Absence of retrocochlear pathology
- Normal middle ear pressure
Correct answer: Normal cochlear outer hair cell function
OAEs are generated by the outer hair cells of the cochlea; a pass result indicates that outer hair cell function is intact at the tested frequencies.
Question 2: A patient with bilateral moderate-to-severe sensorineural hearing loss and poor word recognition scores is evaluated for cochlear implantation. Which word recognition threshold typically indicates candidacy under current FDA guidelines for adults?
- ≤50% on sentence recognition in the best-aided condition (Correct answer)
- ≤70% on monosyllabic word lists in quiet
- ≤30% on sentence recognition in quiet
- ≤80% on HINT sentences in noise
Correct answer: ≤50% on sentence recognition in the best-aided condition
Current FDA/CMS cochlear implant candidacy for adults generally requires ≤50% sentence recognition in the best-aided condition.
Question 3: Which tympanogram type, according to Jerger's classification, is most consistent with a middle ear effusion?
- Type A
- Type As
- Type B (Correct answer)
- Type C
Correct answer: Type B
A Type B tympanogram shows a flat tracing with no discernible peak, indicating little or no mobility of the tympanic membrane, consistent with middle ear effusion.
Question 4: An SLP recommends FM system use in the classroom for a child with hearing loss. The primary advantage of an FM system over hearing aids alone is that it:
- Eliminates the need for hearing aids
- Improves the signal-to-noise ratio by transmitting the teacher's voice directly (Correct answer)
- Amplifies all classroom sounds equally
- Provides bone-conduction amplification
Correct answer: Improves the signal-to-noise ratio by transmitting the teacher's voice directly
An FM system transmits the speaker's voice directly to the listener's receiver, dramatically improving the signal-to-noise ratio regardless of distance or background noise.
Question 5: A patient newly fitted with hearing aids reports that their own voice sounds hollow or like they are speaking in a barrel. This perception is caused by:
- Feedback oscillation in the hearing aid
- The occlusion effect from the earmold blocking the ear canal (Correct answer)
- Excessive high-frequency amplification
- Recruitment of loudness in the cochlea
Correct answer: The occlusion effect from the earmold blocking the ear canal
The occlusion effect occurs when a vent-less or tightly-fitting earmold traps bone-conducted sound energy in the ear canal, making the user's own voice sound hollow.
Question 6: Which auditory brainstem response (ABR) wave is generated by the auditory nerve (CN VIII) and is the most clinically significant for estimating cochlear sensitivity?
- Wave I
- Wave III
- Wave V (Correct answer)
- Wave VII
Correct answer: Wave V
Wave V of the ABR, generated at the level of the inferior colliculus, is the most robust and is used to estimate hearing threshold through threshold ABR testing.
Question 7: A patient with asymmetric sensorineural hearing loss and unilateral tinnitus is referred to rule out which condition before aural rehabilitation proceeds?
- Otosclerosis
- Vestibular schwannoma (acoustic neuroma) (Correct answer)
- Noise-induced hearing loss
- Presbycusis
Correct answer: Vestibular schwannoma (acoustic neuroma)
Unilateral or asymmetric SNHL with ipsilateral tinnitus raises concern for vestibular schwannoma, which requires medical imaging before audiological management.
SLP Hearing and Aural Rehabilitation 4
During otoacoustic emission (OAE) testing, a pass result indicates which of the following?