A Day in the Life of an Audiologist in PretoriaWhether based in Pretoria or in any other city, by definition, an audiologist is a registered healthcare professional with specialist knowledge of the anatomy of the ear and the physiology of hearing. His or her role is to examine a patient’s hearing for evidence of auditory impairment and, if indicated, to determine more detail regarding its nature and possible cause. Armed with these findings, he or she will then advise upon and, if the patient agrees, implement the steps required in order to manage that impairment as effectively as possible.
Many patients will have been referred to an audiology clinic by their GP, although the audiologists at Ear Institute clinics, such as that in Pretoria, do not actually insist on a formal referral and are happy to arrange appointments upon enquiry. The prime purpose of that appointment will be to conduct a series of hearing tests, but before embarking on the testing programme, the healthcare professional will first conduct a physical examination of the patient’s ears.
This is a necessary preliminary as, for example, a build-up of wax in the external ear can result in temporary hearing loss that is easily reversed by softening the wax and irrigating the ear with a syringe. Likewise, an infection may also result in temporary deafness reversed by antibiotics. In such cases, an audiologist in the Pretoria clinic, for instance, would then simply refer the patient back to his or her GP for the appropriate treatment.
In the absence of such findings, the healthcare professional may then proceed with the task of checking for signs of auditory insufficiency. The main component of the examination is the audiogram. This is a graphical representation of a patient’s auditory acuity at each of several frequencies within the range of human audibility.
The patient listens through headphones for a series of tones that gradually increase in volume, indicating when they first become audible. Each event creates a point on a graph from which the audiologist is then able to locate any hearing difficulties. In Pretoria and worldwide, patients tend to display difficulties with the higher frequencies in the early stages of hearing loss, while lower frequencies may only pose a problem if the deterioration is permitted to continue unchecked. The procedure is applied separately to both left and right ears.
Both the extent and the nature of hearing loss must be considered when seeking the best means with which to manage it. To this end, determining whether its cause is conductive or sensorineural impairment will be the next task for the audiologist at a typical audiometry clinic in Pretoria. Conductive hearing loss is caused by anomalies in the middle ear that leave the tiny ossicles unable to transmit the vibrations from the eardrum to the inner ear. By contrasts, sensorineural loss arises in the inner ear, and is due to damage and death of the tiny hair cells that line the cochlea and convert mechanical signals to nerve impulses for interpretation by the hearing centres in the brain.
To differentiate between them, an audiologist at the Pretoria centre will normally perform two tests involving the use of a vibrating tuning fork. In the Weber test, a vibrating tuning fork is positioned on the forehead or just beneath the nose, and equidistant from each ear. The patient must then indicate if it is equally loud in each ear, or louder in one or the other. Louder in the affected ear indicates conductive loss, while better reception in the normal ear indicates sensorineural origin. In the Rinne test, the time taken for all sound to fade when the fork is positioned on the mastoid bone is compared with that when positioned just outside of the ear, and offers confirmation of the Weber findings.
Depending upon the routine followed by the audiologist, the hearing test should take about 30 minutes. Thereafter, he or she will discuss the findings and suggest how best to manage any hearing loss, if detected.
In most cases, the option offered will be a hearing aid, which will then be tuned to enhance sounds at the frequencies shown to be problematical by the audiogram. In rare cases, where the hearing loss is moderate to severe and due to sensorineural damage, a cochlear implant may be the only option, and in this instance, the audiologist will enlist the services of a specialist ENT surgeon in Pretoria or the neighbouring city of Johannesburg to evaluate the case.