Author: Tracy James

Cochlear Anatomy

Personally my mind boggles when it comes to this subject. Cochlear anatomy is amazing and the cochlear itself is so tiny only 36mm in length and yet it does so much. Whilst there are many good explanations out there, anatomist Dr Sam Webster description from Swansea University is one of my favourites. Watch his video below for more information on cochlear anatomy. Be prepared to get a cup of coffee or tea and set 30 minutes aside to watch his explanation!

Whats new with TJ Audiology Training

Its been a long while since we have posted a blog!!!!!!!!

TJ Audiology Training as you may have noticed has changed its name ever so slightly and we now have a new a fantastic new logo.  Watch this space for new developments  in the next 6-12 months. Like our new wax course Ear Wax Removal/ Aural Care Course

We will be running the wax removal course again on 22nd -23rd January 2025; with volunteer human ears to practice on too! Our students loved the September course which we ran using equipment from  Puretone   so please get in touch if you would like to know more.

New course dates announced for Audiology training by @TracyJamesAudiologist

Our 4th of December @ The British Society of Audiology  accredited course in impression-taking is set to go ahead as planned at @Newbury College as impression-taking comes under the category medical services. Making a good impression of the ear is a skill that develops with experience, but first and foremost must be safe. Our courses focus on safety to each other and our patients / clients as a priority and will follow the British Society of Audiology guidance for both the procedure and covid-19 safety. As a result, we are pleased to announce another date on the 29th of January 2020 for impression-taking and a course in February for Audiometry and Tympanometry.

https://tjaudiology.com/wp-content/uploads/1st-September-Audiology-and-Otology-Guidance-during-COVID-19-Final-1.pdf

BSA_PPC_RP_Impressions_FINAL_12Feb2013 (2)

#audiology #hearing #ears #hearingprotection #training #audiologytraining

Introducing Louise Hart

Louise Hart joins Tracy James to deliver tinnitus and hyperacusis services to adults and children from October 2020. She will also be providing her expertise in our training courses delivered to provide British Society of Audiology Certificates in impression-taking, hearing surveillance and audiometry and tympanometry.

Louise says ‘ I am excited to be providing more independent work, alongside my NHS work. I really enjoy training and have pride in helping individuals enable their skills to the recognised standard of the British Society of Audiology. We will be training GPs, teachers of the deaf, assistant audiologists and any professional who works in the hearing industry, and I look forward to meeting our new delegates at the next course in Newbury.’

‘With regards to tinnitus, I will be providing the only independent tinnitus and hyperacusis management service in West Berkshire at Tracy James Hearing. We know the earlier we intervene in helping people manage their tinnitus and hyperacusis the more successful the outcome for them’

Despite research on drug or physical interventions on tinnitus, at present none seem to consistently reduce tinnitus well enough; this is why management techniques are used to combat tinnitus.  For over 20 years chronic pain sufferers have successfully been using cognitive behavioural techniques to manage pain, and we now have more studies showing the same success with tinnitus.

Louise will tailor a programme to you to help your tinnitus and/or hyperacusis; these can be provided face to face or through video consultation. For further information on tinnitus and or to book an appointment, go to Tracy’s website tjhearing.co.uk.

For further information on audiology training courses, go to tjaudiology.com

 
 

OTIS Simulation software

Audiometry Simulation Software

 

Otis the virtual patient (from Innoforce.com) can be used to practise basic audiometry and tympanometry and masking. We use it in our classes and its a great way of developing your skills in audiometry without having the pressure of time or the client’s ability to focus, while getting used to the controls and techniques required. If you’re learning how to carry out masking, it is an invaluable learning and evaluation tool and you don’t need to rely on your supervisor to explain results.

 

Otis is a little bit like a real person, for example, your client can fall asleep if you take too long or shout if you present sounds that are too loud. You can view your otoscopy, history and tymp data as part of the assessment. There is reference data for masking and symbols. You have real-time evaluation and assessment of your procedure as you do the audiometry – it tracks your accuracy, time and errors. You can also progress from easier audiograms, to more difficult cases.

 

For further information please see our course guide to Audiometry & Tympanometry

Covid-19 and Online Audiology Training

Unfortunately, due the closing of colleges as a result of the coronavirus pandemic, audiology courses at Newbury College will not resume until government advice changes and you will be informed with further notice regarding new dates.

We will let you know as soon as new dates for courses are possible again.

If you wish to update your skills while you are working from home, then Tracy James provides online tutorials, training courses and refreshers – for all your audiology training needs.

Keep safe everyone.

Rule 3 explained? Masking Training with Tracy

In this post I would like to share some thoughts about rule 3.

This is the rule that many people scratch their head over, mainly because it can be difficult to see, but also because it doesn’t come up that often (and generally only in more complex cases). Therefore, if you’re used to testing routine cases you may not have to think about rule 3 very much. That’s why it’s good to refresh your knowledge so that you don’t miss it when it does come along. Completing rule 3 means that your hearing test will be more accurate; the end result may affect your diagnosis and also your hearing aid prescription.

How does Rule 1 differ to Rule 3 in masking?

We know that Rule 3 is only needed when Rule 1 has not been carried out and that both involve air conduction masking. But why?

Masking is carried out when there is a difference of 40dB between cochleae when using headphones. When we look at Rule 1 the difference between the two cochleae are obvious:

Masking 1

We mask the air conduction, and find the following:

Masking 2

Rule 1 was carried out at all the frequencies as there was a difference of >40 dB  at all the frequencies between the 2 ears. Headphones were used and the left ear was the test ear, and the right ear was the non-test ear, to be masked.

However, the difference between the two cochleae can be hidden when the non-test ear has a conductive component. Say for example the same patient as above comes back a few weeks later with a hideous cold that has affected his right ear.

Masking 3

There was no need to do air conduction masking in this scenario (Rule 1 not required).

Bone conduction was carried out on the worse ear:

Masking 4

As the there was an air bone gap of >10dB between the air and bone conduction thresholds (Rule 2), bone conduction masking needed to be carried out at 0.5, 1, 2 and 4 kHZ. The left ear was the test ear using bone conduction, and the right ear was the non-test ear, to be masked.

Once bone conduction was completed, we could see an asymmetry once again:

Masking 5

In this case we could only see that the right cochlea was >40dB better than the left cochlea because bone conduction had been completed. So we went back to using headphones again and masked the air conduction, with the masking noise in the right ear (non-test ear), and retested the hearing thresholds on the left ear (test ear). This revealed the following:

Masking 6

Moderate to severe sensorineural hearing loss on the left. Mild conductive hearing loss on the right.

Rule 3 explained? (Some tips):

  • Rule 3 is usually required because the non-test ear has a conductive component
  • The asymmetry that is present between the 2 cochleae (as you would visibly see in Rule 1) is hidden until you carry out the bone conduction. That is why you only carry out Rule 3 if Rule 1 has not been carried out.
  • Rule 3 is often missed because the BC that relates to the better ear (non-test ear) is recorded on the side on which the BC is placed (worse ear). Therefore you have to think to which ear the not-masked BC belongs to.
  • Although you check the BC to ascertain an asymmetry, you don’t use the BC in your masking procedure – you are masking the AC thresholds only.
  • At frequencies where no b-c thresholds have been measured – if there is a possibility that a-c threshold at these frequencies (including 250 Hz and 8000 Hz) are not the true thresholds, they should be masked.

If you have any questions please send an email to admin@tjaudiology.com and either myself or Louise will get back to you