Cancellation

Both clients cancelled again.


: (

Cancellation

Both clients were no-shows.

: (

Clinic on 10/30

I observed a session with a college student who reported tinnitus and difficulty hearing in noise. During the case history, the client had no difficulty hearing and understanding. Otoscopy was normal; however, the clinician mentioned that the client had small, straight EAMs. Tympanometry and acoustic reflexes were normal; however, due to equipment failure, the clinician was unable to test reflex decay.
Pure tone testing was completed first with headphones. Thresholds were much worse than expected (~ 40 dB HL bilateral flat loss), and the supervisor recommended discontinuing testing in order to test SRT instead. SRT thresholds were 6 dB HL in the right ear and 8 dB HL in the left ear. Therefore, there was poor agreement between PTA and SRT. The clinician and the supervisor suspected that the client may have been exaggerating his loss.
The supervisor instructed the clinician to re-instruct the client and re-test pure tone threshold using insert earphones. Using insert earphones, thresholds were within normal limits bilaterally. Thus, the client may have been confused or, more likely, he may have had collapsing canals.
Because of his complaints of tinnitus and difficulty hearing in noise, the clinician referred the client to an ENT for a medical evaluation and recommended CAP testing at the WVU Hearing Clinic.