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Diagnosis can be done by these following method.  

A. CONDUCTIVE TECHNIQUES:

          A. Play audiometry:

 The child is conditioned to perform an act such as placing a marble in a box each time he hears a sound signal.

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                  Each correct performance of the act is reinforced with praise, encouragement.

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                 Ear specific threshold can be determined by standard audiometric technique.

         B. SPEECH AUDIOMETRY:

                   Child is asked to repeat the names to certain objects or to point them on pictures.

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                                               The voice can be gradually lowered.

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                                    Hearing level & speech discrimination can be tested.

B. OBJECTIVE TESTS:

          A. Evoked response audiometry:

  • Auditory brain stem response (ABR): It provides an ear specific information as sound stimulus can be presented to each ear separately by headphones or ear inserts.
  • Electrochleography: Measure auditory sensitivity within 20dB.

          B. Otoacoustic emissions (OAE):

  • Transient evoked emissions (TEOAE)- Absent when hearing loss >30dB.
  • Distortion product emission (DPOAE)- Absent when hearing loss >50dB.

          C. Impedance audiometry: Normally stapedius muscle contracts in response to sound of 70-100dB, hearing loss & this reflex can be recorded.

Absence of acoustic reflex indicates- 1. Middle ear disorder. 2. Retro cochlear hearing loss. 3. Severe to profound SNHL.

Absence of reflex but normal tympanometry- SNHL of severe profound degree.

Absence of reflex but abnormal tympanogram- conductive loss.

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