HAC Hearing Aid Audiology & Hearing Assessment 3 — Questions and Answers
Question 1: Which measure reflects the degree of cochlear dead regions and influences hearing aid gain recommendations?
- Threshold equalizing noise (TEN) test result (Correct answer)
- Speech reception threshold
- Acoustic reflex decay
- Loudness discomfort level
Correct answer: Threshold equalizing noise (TEN) test result
The TEN test identifies cochlear dead regions where inner hair cells are absent, indicating that amplification at those frequencies may be ineffective.
Question 2: What is the primary purpose of Real-Ear-to-Coupler Difference (RECD) measurements in pediatric fitting?
- To measure the child's speech recognition
- To convert real-ear targets to 2-cc coupler values for accurate hearing aid programming (Correct answer)
- To assess eardrum compliance
- To determine the need for bone-anchored amplification
Correct answer: To convert real-ear targets to 2-cc coupler values for accurate hearing aid programming
RECD accounts for differences between an individual's ear canal acoustics and the standard 2-cc coupler, ensuring targets are applied accurately.
Question 3: A patient's bone-conduction thresholds are normal but air-conduction thresholds show a 40 dB loss. What type of hearing loss is present?
- Sensorineural
- Mixed
- Conductive (Correct answer)
- Functional
Correct answer: Conductive
When bone conduction is normal but air conduction is elevated, the air-bone gap indicates a conductive hearing loss.
Question 4: Which reflex arc is tested when measuring the acoustic stapedial reflex?
- CN V and CN VII
- CN VIII afferent and CN VII efferent bilaterally (Correct answer)
- CN IX and CN X
- CN III and CN VII
Correct answer: CN VIII afferent and CN VII efferent bilaterally
The acoustic reflex involves CN VIII carrying afferent signals and CN VII driving the stapedius muscle bilaterally.
Question 5: What is 'rollover' on a performance-intensity function, and what does it suggest?
- Improvement in WRS at high intensities, indicating cochlear pathology
- Decline in WRS at high intensities, suggesting retrocochlear pathology (Correct answer)
- Stable WRS across intensities, indicating normal function
- A flat PI function, indicating conductive loss
Correct answer: Decline in WRS at high intensities, suggesting retrocochlear pathology
Rollover is a decrease in word recognition scores as intensity increases beyond the optimal level, which is a sign of retrocochlear dysfunction.
Question 6: According to the Carhart notch, a mechanical notch at 2000 Hz on bone conduction thresholds is most associated with which condition?
- Noise-induced hearing loss
- Otosclerosis (Correct answer)
- Presbycusis
- Ménière's disease
Correct answer: Otosclerosis
The Carhart notch is a characteristic dip at 2000 Hz bone-conduction threshold caused by the mechanical effects of otosclerosis on cochlear bone conduction.
Question 7: Which masking approach is used to prevent the test ear signal from crossing to the non-test ear during bone-conduction audiometry?
- Ipsilateral masking with broadband noise
- Contralateral masking with narrow-band noise (Correct answer)
- No masking is needed for bone conduction
- Binaural masking with speech noise
Correct answer: Contralateral masking with narrow-band noise
Narrow-band noise is presented to the non-test ear contralaterally to prevent cross-hearing during bone-conduction testing.
HAC Hearing Aid Audiology & Hearing Assessment 3
Which measure reflects the degree of cochlear dead regions and influences hearing aid gain recommendations?