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Cerumen Removal Case Study

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When removing this patient’s cerumen, there are two factors that influence my decision to use suction as my method of removal. First of all, his cerumen is soft and near the entrance of the canal, which is ideally removed with suction. Secondly, this patient has diabetes. Diabetic patients’ cerumen has a significantly higher pH than patients without diabetes who have more acidic cerumen. Because of this, using irrigation can lead to external otitis, which can develop into pseudomonas osteomyelitis. To avoid this, it is best to avoid irrigation as a means of cerumen removal in this population. When fitting this patient with his mid-level receiver-in-the-ear hearing aids with custom ear pieces, I would choose NAL-NL2 for my fitting algorithm. …show more content…

To do this, we have the patient fill out one or more subjective questionnaires about their specific desires and goals for their hearing through the amplification process. Verification, on the other hand, is the process of making sure the hearing aids are providing the gain and output necessary to bring them closer to those goals. To do this, we perform different tests to measure whether or not aided gain thresholds are reaching the levels we expect them to. To validate our success with this patient, I would have them fill out a Client Oriented Scale of Improvement or COSI. On the COSI, the patient names 4-5 specific situations where they would like to see improvement and ranks them from most important to least important. I would have them fill out one COSI before their fitting to identify what their goals are, then I would have them fill out another COSI after the fitting and compare their results. This way we could ensure we met their amplification goals. To verify that the hearing aid is providing the amplification we expect it to, I would perform a Speechmap test through Verifit. This is a specific assessment of the gain and output at different levels of the same speech signal, recorded using probe-mic measures from in the ear canal. This would ensure that the patient is getting the proper amount of gain across all frequencies and input levels where speech regularly

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