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5 Site of Lesion
5 Site of Lesion
Distinguishing: Sensory (cochlear) from neural (retrocochlear) disorder. Different sources of conductive disorder
Recruitment:
"Abnormal growth of loudness" or, persistence of normal loudness above threshold. More common at higher frequencies.
Decruitment:
Abnormal impairment of loudness growth loudness curve actually moves away from normal line lack of functioning nerve cells to code intensity associated with retro-cochlear (VIIIth n.) lesions.
Decruitment
120 100 80 60 40 20 0 10 dB 30 dB 40 dB 50 dB 100 Normal Decruitment
ABLB
tones pulse alternating between ears 2 or 3 times per judgement. pt is asked which ear is louder or same - begin at 20 SL in poorer ear, - 0 SL in better ear. - adjust level in better ear 5 dB steps.
ABLB
- find level where loudness judged equal. - increase poorer ear by 10 or 20 dB and repeat adjustments in better ear.
ABLB SUCCESS?
Sensitivity = 51% Specificity = 88%
SISI SUCCESS?
Sensitivity = 68% Specificity = 90%
Tone Decay:
Loss of audibility for a tone that is on continuously. Greater decay is indicative of retrocochlear problem. There are different methods:
Bekesy Audiometry:
Pt. controls level of tone, Continuous tone: tone on constantly (C) Interrupted tone: pulsed on and off (I) Adaptation should only occur for C, not I
Bekesy Results:
I: C and I overlap: norm or cond. II: C below I at freqs of HL: Cochlear III: I follows loss, C drops to bottom: Retro IV: C below I by 20-25 dB: Coch or Ret V: I below C: False hearing loss
ABR SUCCESS?
Sensitivity = 97% Specificity = 88%
P-300
Obtained in oddball task Not just auditory Reflects Change in Working Memory-Aha! Changes in latency and amplitude with variety of disorders