Otolaryngology is the branch of medicine that specializes in the diagnosis and treatment of ear, nose, throat, and head & neck disorders.

The full name of the specialty is otolaryngology-head and neck surgery.

Practitioners are called otolaryngologists-head and neck surgeons, or sometimes otorhinolaryngologists (ORL). A commonly used term for this speciality, although somewhat out of favor, is ENT (ear, nose and throat).

 An audiologist is a professional specializing in testing, monitoring, and diagnosing disorders of the auditory and vestibular system portions of the ear. Audiologists are trained to diagnose, manage and treat hearing or balance problems.

Picture of an otoscope at the entrance of the auditory canal

The observation of the auditory canal and the eardrum is done with an otoscope. The audioprosthetist uses it to ensure that he can perform a hearing test, make an earmold, and places an intra-auricular device (musician's earplug) (bouchons de musiciens) in the ear. This exam takes a few seconds and is not painful.

Within the Quebec medical system an audioprosthetist is defined as the professional responsible for correcting hearing deficiencies with the use of mechanical or electroacoustic devices.

Hearing correction or hearing aid fitting includes advising the patient on selection,  taking measurements, as well counseling upon delivery of   the hearing instrument. In addition, The audioprosthetist provides guidance and psychological support to the patient.

The audioprosthetist assumes a continuous role in order to ensure the efficiency of the hearing instrument.

These are the actual sensory receptors of the inner ear. These cells are equipped with tiny cilia on their surface. Sounds that are perceived by the external ear and the middle ear causes these tiny cilia to move, which will set in motion  a series of reactions that will transform the mechanical signal into an electrical signal. The electrical signal will then make its way to the brain via the auditory nerve.

Once the cilia are damaged or destroyed from exposure to loud noise the signal can no longer be transformed, and the sound will not be heard. Unfortunately, these ciliated cells cannot be replaced. Their destruction is permanent as is the hearing loss that ensues.

At birth we possess approximately 15000 ciliated cells  that correspond with our auditory potential. There are different factors that can damage these cells such as, noise, aging, certain medications, chemical products in addition to genetic factors. 

Unfortunately, you can damage your hearing without feeling pain, it is a major risk for the audiophile. In fact, there is a zone below the pain threshold (sound levels where the sensation of pain is felt)  where sound levels can be increased to the point of traumatizing the ear without causing pain. It is a bit like getting a sunburn, and not feeling the pain until hours later.

 In addition, the pleasure associated with listening to music lowers our vigilance when it comes to controlling the volume. We become more aware of being in that zone when we attend a concert, or if we have to yell to talk to the person next to us. If this is the case, try to move away from loudspeakers, or wear hearing protection. You should be aware that each time you multiply the distance you are from loudspeakers by two, the sound intensity is reduced by 6 dB. This reduces the sound energy that reaches your ears by 4.

Auditory Function

Auditory is a superb sense that allows us to situate ourselves in the environment. It allows us to detect potential danger, to identify what is familiar as well as to perceive human speech. Hearing depends on the proper functioning of a group of organs to function at its best.

The Ear 

An organ of sound and perception When sound is heard, it signifies that air is in movement. This movement of air is captured by the pinna and enters the external auditory canal. At the back of this canal is the eardrum which is very fine membrane that vibrates. The vibration of the eardrum then spreads to the 3 small bones of the middle ear , the malleus, incus, and stapes, that each in turn begins to move. The stapes supports the wall of the internal ear, which is full of liquid. This liquid movs and causes the ciliated cells to move (like lashes) inside the cochlea. Those that are at the base of the cochlea react to the highest frequency sounds, those that are above the cochlea react to the lowest frequency sounds. Inside the cochlea, the Corti translates the movements of ciliated cells into an electronic message that goes to the auditory nerve and the brain.

Beyond the Ear

 The Brain The message that is heard is sent in electrical form to the auditory nerve. This message follows a complex path towards different parts of the brain in both hemispheres. For example ; certain cerebral regions allow you to to determine where sound is coming from, some what those sounds signify, while others interpret speech.

Strategies for friends and family

  • Get the person’s attention before speaking
  • Be patient with the hard of hearing person
  • Repeat information and rephrase to clarify
  • Speak slowly and clearly
  • Don’t shout or speak too slowly
  • Provide them with the subject and indicate when the subject changes
  • Look directly at the person when you speak
  • Avoid speaking from other rooms, or with your back turned to them
  • Encourage the person to use other assistive listening devices
  • Modify light and seating arrangements if necessary to provide the person with an unobstructed view
  • Make sure only one person talks at a time

Strategies for the person with a hearing loss

  • Inform speakers about your hearing loss and how they should speak to you
  • Ask others to look directly at you when they speak to you, to come closer if necessary, and to speak slowly and slightly louder
  • Think of new ways to ask for repetition other than huh?
  • Ask for the topic, then verify if you understood
  • Use your hearing aids and other assistive devices at theatres and places of worship
  • Modify light and seating arrangements if necessary to obtain an unobstructed view
  • Eliminate or reduce background noises
  • Turn off television or stereo, move away from fans and air conditioners, or seek a quieter room.
  • Make sure only one person talks at a time
  • Be understanding and caring when someone forgets that you have a hearing problem
  • Seek additional communication and coping strategies from an audioprosthetist at our offices.
  • Keep a sense of humour about communication errors
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