Note from Judy Huch, AuD, Editor: I have the privilege to supervise 4th year Audiology Externs at our offices in Tucson. We are fortunate that most of what we see is routine, but we do have “teaching moments”. Not all of these moments are as health-altering as this case, fortunately, when an Acoustic Neuroma was found. We also want to give the Externs the opportunity to document their experiences, as in this article by Victoria Johnson. We welcome your thoughts.
By Victoria Jackson, Audiology 4th year Extern
As a fourth year Extern, I still have fresh memories of the testing and evaluation procedures used by audiologists during my graduate school experiences. Although inter-professional education was emphasized in my program, successful inter-professional relationships simply cannot be taught in a classroom. In my externship, however, I recently learned the value of a long inter-professional relationship our clinic has with a local Otologist/Neurotologist.
A 42 year old male came into an appointment, prior to a dizziness consultation, reporting occasional dizziness and a general “off” feeling for the past 3 years. At the age of 13 years, he suffered a traumatic brain injury on the left side of his head which resulted in a concussion and bleeding from the left ear.
The current audiologic evaluation showed normal hearing sensitivity in the right ear and a moderate to severe sensorineural hearing loss at 3-8 kHz in the left ear. Otoscopy was clear, and type A tympanograms were obtained for both ears. Bilateral acoustic reflexes were present via left contralateral stimulation from 500-2000 Hz, and elevated/absent via right contralateral stimulation. Additionally, contralateral reflex decay was negative with left stimulation and positive with right stimulation. Word recognition was 100% in the right ear and 88% in the left ear, and the QuickSIN was within the normal range. Distortion product otoacoustic emissions (DPOAEs) were present and robust, consistent with normal outer hair cell function and relative peripheral sensitivity in the right ear, and were reduced in the left ear.
The patient was referred to a local Neurotologist for further evaluation of the asymmetry and dizziness. Since this Private Practice clinic has an excellent inter-professional relationship with the Neurotologist doctor, a full report was received for the patient in a few days: his MRIs showed a fairly large, left-sided, cerebellopontine angle tumor and he had chosen a surgery treatment option.
Because of the extensive testing that was performed as standard practice, there is trust with many local physicians with the clinics results. This particular Neurotologist appreciates the Private Practice’s contributions as health professionals to the patient’s overall treatment plan.
This was my first experience receiving MRIs and a full report from a physician as standard response to our referral. It has helped me appreciate the importance of developing inter-professional relationships, and the impact it has on the patient’s plan of care. As I progress through my externship and into my audiology career, I will make it a point to develop professional relationships for the patient’s best interest.
Feature Image Courtesy of Medscape
VICTORIA “BARRY” J. KARIM is an extern at Oro Valley/Tanque Verde Audiology in Tucson, Arizona. She is pursuing her AuD at the Louisiana State University Health Sciences Center in New Orleans, LA. As a member of Alpha Delta Pi Sorority and a proud Baylor Bear, she enjoys keeping up to date, and informing everyone who will listen, with Baylor life.