Audiology and vestibular services
The School of Audiology and Speech Language Pathology provides various scales of behavioral and electrophysiological services to individuals ranging from newborn to elderly population supporting its various clinical activities. All these activities focuses on prevention of hearing loss, early estimation of hearing and selection as well as fitting of the hearing aids and assistive listening devices which is followed by aural rehabilitation of the individuals. These services may be broadly categorized as hearing screening, audiological assessment and management.
Hearing screening:
Neonatal hearing screening is carried out to identify babies who are at risk for hearing loss. All babies visiting the pediatric department as well as babies born in the gynecology department of Bharati Hospital are screened thoroughly followed by detailed audiological evaluations (BOA, OAE, ABR and immittance audiometry) for those who failed in the screening is done.
Audiological assessment:
Hearing evaluation, for children, adults and geriatrics, is carried out using a battery of tests. The test battery used for children includes behavioral observation audiometry, visual reinforcement audiometry, and auditory brainstem response and otoacoustic emissions. Similarly for adults and elderly populations, the test battery which includes pure-tone audiometry, speech audiometry, immittance evaluation, auditory brainstem responses, otoacoustic emissions and special behavioral tests which include glycerol test, SISI, TDT are carried out whenever indicated. Also, the evaluation for cochlear dead region, tinnitus, hyperacusis, auditory neuropathy spectrum disorder etc. are provided.
Audiological management:
With verifying results of audiological evaluation, suitable medical line of referrals or audiological intervention is recommended. Hearing aid trial and fitting is carried out for those who do not benefit from medical/surgical management. A wide range of technology based hearing aids of different types and companies are available for trial purposes. Hearing aid trial is carried out using functional gain measurement and/or insertion gain measurement. A variety of ear moulds is prepared in the lab at college itself, to couple hearing aids to the ear of the user. Ear impressions are taken from the hearing aid users followed by preparation of varieties of custom ear molds. Provision of vent, horn and dampers are provided for adjustment of gain in the hearing aids. Aided individuals with hearing impairment are provided auditory training/ auditory verbal therapy. Depending on the special auditory needs, training on speech reading and usage of communication strategies can be given.
Aided cortical responses are performed to check the usefulness of the hearing aids in difficult-to-test population. These evaluations are also carried out to select individuals who would benefit from cochlear implantation. With higher flow of patients to the college for seeking specific intervention facilities, various specialty clinics have come into existence in recent years as:
Specialty clinic for cochlear implants:
The Cochlear implant unit started during the year 2008 with facilities for intra-operative NRT, mapping and post cochlear implant rehabilitation. The college has a specialty clinic for cochlear implants for rehabilitation of those individuals who do not benefit from hearing aids. Dr. Gauri Belsare, i/c Principal was instrumental in starting the cochlear implant surgery program at the ENT department of the Bharati Hospital. Special training for cochlear implant surgery was imparted by Dr. Miland Kirtane, a renowned surgeon in the field of cochlear implant. The School of Audiology and Speech Language pathology provides complementary services which include the following:
- Cochlear Implant Candidacy Evaluation
- Pre-implant Counseling
- Intra-operative NRT
- Switch-on & Post-implant Mapping
- Auditory Verbal Therapy with licensed therapists
- Mapping of the device
Specialty clinic for Central Auditory Processing Disorders (CAPD):
A screening checklist and tests followed by behavioral tests mostly indigenous to the college are utilized during this procedure. Selection of the tests are done based on the age of the child, domain with auditory difficulties, cognitive status etc. Various special tests and domains are carried out for assessment and management of central auditory processing disorders as:
- Behavioral procedure for temporal processing, binaural integration, auditory closure, binaural separation and binaural interaction.
- Electrophysiological tests (MMN, P300)
Specialty clinic for vestibular disorders :
Trained audiologists deal with the diagnosis and management of balance disorders within a multidisciplinary environment. Different vestibular test are available in our lab that includes:
- Behavioral vestibular tests (Romberg, Fukuda stepping, Past pointing, Tandem gait)
- Vestibular Evoked Myogenic Potential (VEMP Test)
- Video-Nystagmography (VNG)/ Electro-Nystagmography (ENG)
- Subjective Visual Vertical/Horizontal (SVV/SVH)
Vestibular test battery is performed to examine the functioning of balance organs that involves close inspection and recording of nystagmus.