Hearing Journal最新文献

{"title":"Business Management Considerations: Hearing Health Care Consumerism","authors":"Amyn M. Amlani","doi":"10.1097/01.hj.0000947684.65847.61","DOIUrl":"https://doi.org/10.1097/01.hj.0000947684.65847.61","url":null,"abstract":"There has been a shift in both the manner that providers care for individuals, and the manner that consumers access health care services and providers. In its earliest years, hearing health care was a covenant between a consumer and a provider welded by empathy and commitment. Here, the practice’s success and profitability were linked to the provider’s reputation, underwritten by accountability not only to consumers, but their families and communities.www.shutterstock.com. Consumerism, Silent Generation, Baby Boomers, Gen Xers, Millennials, Gen Z, business management.Figure 1: Consumer purchasing trends and mean disposable income as a function of generation. Consumerism, Silent Generation, Baby Boomers, Gen Xers, Millennials, Gen Z, business management.Over the past two decades, hearing health care has transitioned from the covenant service model into a team-based approach, where care is delivered through a mosaic of providers (i.e., primary, specialty, allied health) under the control of managed care. In this contemporary model, providers balance accountability not only to individuals, but also to health plans and stakeholders (e.g., suppliers, corporate entities). Success, in most instances, is commodity-based, quantified by productivity using metrics, such as billable hours, average selling price, conversion rate, and profitability. More recently, service delivery of care has migrated from a model of professional care to permitting consumer self-care. On October 17, 2022, U.S. legislation went into effect expanding consumer access and availability of non-prescription amplification technology to individuals with perceived mild-to-moderate hearing loss. 1 This legislation empowers this population of U.S. consumers to access hearing health in a number of ways: 2 self-fit, direct-to-consumer (DTC) devices without the need for professional diagnostic services nor treatment support (e.g., Bose) self-fit DTC devices that provide treatment support without professional diagnostic services (e.g., Nuheara) DTCs that provide professional support via telehealth (e.g., Blamey Saunders hears) prescriptive devices online with provider support available via telehealth (e.g., Lively) prescriptive and DTC devices with in-person provider support. CONSUMER DYNAMICS Health Care Consumerism. The shift toward a managed care health care delivery system—where a larger portion of financial responsibility and out-of-pocket costs befall the consumer—and the increase in access to self-care has induced health care consumerism3 Health care consumerism is a movement where individuals take an active role in managing their well-being needs through activities such as researching available treatments, understanding costs, and comparing providers. This means that: Today’s consumer is an active participant when it comes to their health-related well-being. Providers must determine the appropriate intersect between demand and service provision to meet the functional, well-being, and ","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"637 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135756192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Care for Medicaid Patients: Why You Should Get Involved","authors":"Sarah Curtis","doi":"10.1097/01.hj.0000947688.63913.a1","DOIUrl":"https://doi.org/10.1097/01.hj.0000947688.63913.a1","url":null,"abstract":"When I opened my practice, I did so with bright eyes and optimism. I was a blank slate, having never worked or trained as a student in a private practice. However, along the way, I serendipitously picked up a lot of relevant knowledge. Driven by idealism and the motivation to improve our profession for all, my goal was to create the kind of practice where all patients wanted to go, all audiologists wanted to work, and all students wanted to learn. Therefore, on August 1, 2018, after over four years of education, eight years of practice, and zero years in a private practice, I officially became my own boss.www.shutterstock.com. Medicaid, business management, access, affordability.Sounds of Life Hearing Center, which is approaching its fifth anniversary, has experienced growth. We’ve expanded our staff from just me to three full-time members, soon to be four, along with externs. Our financial growth has been continuous, with a 28% increase in gross revenue from FY 2021 to 2022, and we anticipate a further 25%-30% growth this year. Since 2019, I have managed to maintain some level of profitability. Despite serving a significant number of Medicaid patients and engaging in charitable services in our community, we have achieved our growth. We firmly believe that income and financial status should not determine one’s right to better communication and improved quality of life through better hearing. To further support our charitable initiatives, we established a 501(c)(3) nonprofit project called Hearing the Call – Northeast Ohio in 2021. Running a practice has not been easy. It involves crunching numbers, working late nights, and battling with Medicaid for payment. Nevertheless, someone needs to do this work, and here are some reasons why. INCOME, AFFORDABILITY, AND ACCESS In the United States, 1.6 million people live in extreme poverty, with less than $2 per person per day. 1 Even those above the Federal Poverty Level struggle to afford anything beyond necessary expenses. Just because someone makes above “minimum” wage does not mean it’s a livable wage. There are many who may not qualify for Medicaid and have commercial health insurance, but by no means can afford anything beyond their necessary expenses. Often, for this population caught in the financial middle, access to diagnosis and treatment of hearing loss is even more difficult. Lower income is associated with reduced life expectancy and increased prevalence of health conditions. 2 Low-income individuals face numerous challenges in receiving adequate hearing care due to lack of insurance coverage and limited financial resources. Geographic limitations and a shortage of providers in rural areas contribute to delays in accessing care, affecting job performance and educational opportunities. Data shows that individuals who do not fit the non-Hispanic white, high-income, older, educated man living in an urban or suburban location profile are less likely to access audiological care. 3 HEARING LOSS AN","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135755989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear Implants Offer Revenue Stream for Private Practice Audiologists","authors":"Chuck Holt","doi":"10.1097/01.hj.0000947692.55079.11","DOIUrl":"https://doi.org/10.1097/01.hj.0000947692.55079.11","url":null,"abstract":"Since cochlear implants were approved by the FDA for adults with bilateral hearing loss in 1985, the external and internal components have undergone significant technological improvements.www.shutterstock.com. Cochlear implants, cochlear provider network.Over time, every component of the external system of a cochlear implant has seen upgrades, from the magnets and microphones that capture acoustic signals to speech processors that transform sounds into electrical signals sent to the nerve fibers of the cochlea. The internal portion of the device consists of a receiver-stimulator and electrode array that offer better control of electrical signals that stimulate the cochlea and provide patients with more detailed pitch and improved loudness. Some cochlear implant manufacturers also offer FDA-approved bone-conduction devices for patients with conductive hearing loss, mixed hearing loss, and single-sided deafness. The bone-conduction device uses different technology than the cochlear implant, in that, instead of transmitting electrical signals to the auditory nerve the acoustic signal is transduced into vibrations to stimulate the inner ear directly. Because of the ongoing technological advances, more patients are candidates for an implanted hearing loss treatment than ever before. Yet, only a fraction of eligible patients have undergone the surgery—less than 10%, in fact, by most estimates. “The thing that has me concerned is that penetration is still very low,” said Dr. William Shapiro, AuD, CCC-A, Co-Director of the New York University (NYU) Langone Health Cochlear Implant Center. The problem, he said, “is paradoxical.” “As technology improves and the criteria for selection expands, more individuals with hearing loss become candidates for cochlear implants—but we’re not getting to them,” he continued. “And so we need to do a much better job of raising awareness, which is why I say it’s paradoxical. Because although we have better technology, we aren’t reaching the number of patients we need to serve.” To help increase patient awareness and adoption of cochlear implants, Shapiro serves as a liaison of sorts between the community audiologists and the cochlear provider network (CPN) of the world’s largest manufacturer of surgical implants for hearing loss, Cochlear Limited. The relationships portend more CI surgeries to benefit the private practitioner, the Implant Center, and mostly importantly the patient. This, of course depends on the degree of buy-in by the private practitioner, Shapiro said. The buy-in varies from audiologist to audiologist. “Some audiologists in private practice just want to be able to explain the benefits of a trusted treatment and give them some CI brochures,” he said. “And then other audiologists want to be involved in all aspects of the cochlear implant process.” “These are the audiologists who want to do the pre- and post-operative testing,” he continued. “They want to refer their patients to our surgeon, and then have us","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135756190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights From The Hearing Journal","authors":"","doi":"10.1097/01.hj.0000947712.25198.0a","DOIUrl":"https://doi.org/10.1097/01.hj.0000947712.25198.0a","url":null,"abstract":"","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135756194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms: Bilateral Mixed Hearing Loss","authors":"Madelyn Frank, Karen Tawk, Mehdi Abouzari, Hamid R. Djalilian","doi":"10.1097/01.hj.0000947720.76010.f6","DOIUrl":"https://doi.org/10.1097/01.hj.0000947720.76010.f6","url":null,"abstract":"A 22-year-old patient with hearing loss beginning at age 12 presented to the clinic for hearing aid clearance. She reports bilateral hearing loss more severe on the right with aural fullness and occasional otalgia. She additionally endorses allergic rhinitis and recurrent otitis media. On exam, there were multiple pre-auricular pits present. On microscopic exam of the ear the right ear showed mucoid effusion and pale middle ear mucosa on the right with a normal exam of the left ear. Tympanic membranes were otherwise intact bilaterally except for some thickening observed on the right (see Figure 1). Tympanogram was flat on the right and normal on left. Her audiogram is shown in Figure 2.Figure 1: Image of patient’s tympanic membrane showing some thickening of the tympanic membrane. Clinical Consultation, bilateral mixed hearing loss, congenital cholesteatoma.Figure 2: Image of patient’s audiogram. Clinical Consultation, bilateral mixed hearing loss, congenital cholesteatoma.Figure 3: Axial (horizontal) CT of right temporal bone showing the middle ear opacification indicating fluid or soft tissue. Clinical Consultation, bilateral mixed hearing loss, congenital cholesteatoma.Figure 4: Coronal (parallel to the face) CT of right temporal bone showing the entire middle ear and mastoid is opacified indicating fluid or soft tissue. Clinical Consultation, bilateral mixed hearing loss, congenital cholesteatoma.Figure 5: Axial (horizontal) T2-weighted MRI showing hyperintensity (bright white) in middle ear and mastoid indicating either fluid or cholesteatoma. Clinical Consultation, bilateral mixed hearing loss, congenital cholesteatoma.Figure 6: Coronal (parallel to the face) HASTE sequence MRI showing hyperintensity (brightness) in middle ear indicating cholesteatoma presence. Clinical Consultation, bilateral mixed hearing loss, congenital cholesteatoma.Diagnosis: Congenital Cholesteatoma Madelyn Frank, BA; Karen Tawk, MD; Mehdi Abouzari, MD, PhD; and Hamid R. Djalilian, MD A 22-year-old presenting with hearing loss since childhood can have a range of etiologies including congenital, autoimmune, infectious, or neoplastic. A thorough diagnostic workup should include a detailed history, physical exam, audiological evaluation, and imaging. This patient’s preauricular pits, otorrhea, otalgia, and aural fullness in addition to bilateral asymmetric mixed hearing loss invite a wide differential diagnosis. Preauricular pits and sinuses are a result of incomplete fusion of the first and second brachial arch that does not usually result in middle or inner ear abnormality. In patients with bilateral preauricular pits, an evaluation for brachio-oto-renal spectrum disorders (BORSD) is warranted. While patients typically present in childhood, health care access challenges can lead to presentation as an adult. BORSD is a syndrome with variable phenotypes consisting of second brachial arch malformations, otologic abnormalities, and renal pathology. Brachial cleft cysts pr","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"186 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135755992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manufacturers News","authors":"","doi":"10.1097/01.hj.0000946112.89432.91","DOIUrl":"https://doi.org/10.1097/01.hj.0000946112.89432.91","url":null,"abstract":"","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"182 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135309072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptoms: Sudden Sensorineural Hearing Loss and Aural Fullness","authors":"Karen Tawk, Mehdi Abouzari, Hamid R. Djalilian","doi":"10.1097/01.hj.0000938636.11370.5c","DOIUrl":"https://doi.org/10.1097/01.hj.0000938636.11370.5c","url":null,"abstract":"A 40-year-old man presented to our clinic with left-sided sudden sensorineural hearing loss and aural fullness. He also complained of left tongue numbness and a metallic taste in the mouth. He denied tinnitus, otalgia, and dizziness. He denied any facial weakness, pain, or numbness. He denied hemifacial spasm, dryness or tearing of the eyes, swallowing difficulty, or hoarseness. The patient had been treated with oral and intratympanic steroids with no improvement in hearing. An audiogram showed profound hearing loss with no measurable audiometric thresholds in the left ear. There was no sign of ptosis. The microscopic exam of the bilateral ears did not show significant findings. The audiogram showed a profound left hearing loss. The MRI image of the patient is to the right (see Figure 1).Figure 1: Axial (horizontal) T1-weighted post-gadolinium MRI showing a bilobed mass with dilation of the left internal auditory canal (IAC) and a narrow porus acusticus with a sizeable cerebellopontine angle (CPA) portion.Figure 2: Coronal (parallel to the face) post-gadolinium T1-weighted MRI of IAC showing the bilobed tumor with a narrow (normal sized) IAC segment in between.Figure 3: Coronal (parallel to the face) post-gadolinium T1-weighted MRI of IAC showing the tumor extending above the cochlea laterally and in contact with the cochlea.Figure 4: Coronal (parallel to the face) CISS sequence MRI of IAC showing the tumor extending above the cochlea laterally and in contact with the cochlea.Figure 5: Axial (horizontal) CT of the left temporal bone showing dilated IAC with erosion intro the petrous apex air cells.Figure 6: Coronal (parallel to the face) CT of the left temporal bone demonstrating the erosion of the tumor into the cochlea and the dilation of the labyrinthine segment of the facial nerve.Diagnosis: Facial Schwannoma When a patient presents with unilateral hearing loss associated with otologic symptoms such as aural fullness, clinicians should consider a mass within the inner ear, the internal auditory canal (IAC), or the cerebellopontine angle (CPA) in the differential diagnosis. Other differential diagnoses include migraine; Meniere’s disease; cholesteatoma; and infectious, autoimmune, neoplastic, or traumatic etiologies. Thus, it is imperative to get a thorough medical history, examination, and to obtain magnetic resonance imaging (MRI) of the internal auditory canals to help determine the etiology behind the patient’s presentation. A cholesteatoma produces a low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI. However, since the patient had no history of ear surgery or deep retraction of the tympanic membrane on examination, acquired cholesteatoma was unlikely. In contrast to cholesteatoma lesions, which do not enhance on postcontrast MRI, schwannomas are diffusely enhancing lesions that appear hypo- to isointense to the brain on T1-weighted MRI. Vestibular schwannomas represent 8% of intracranial tumors, whereas ","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"105 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135090581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audiologist Innovates Digital Hearing Health Space With Teleaudiology","authors":"","doi":"10.1097/01.hj.0000938648.77092.50","DOIUrl":"https://doi.org/10.1097/01.hj.0000938648.77092.50","url":null,"abstract":"","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"365 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135090449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manufacturers News","authors":"","doi":"10.1097/01.hj.0000938652.32781.05","DOIUrl":"https://doi.org/10.1097/01.hj.0000938652.32781.05","url":null,"abstract":"","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135090453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Care for Ukrainian Refugees in Poland","authors":"Helle Gjønnes Møller","doi":"10.1097/01.hj.0000938644.32269.62","DOIUrl":"https://doi.org/10.1097/01.hj.0000938644.32269.62","url":null,"abstract":"This is the second part in a series about hearing loss found in Ukrainian refugees and the humanitarian work provided by the Heart of Hearing team. \"We were evacuating, it was dark. I fell on my face and my ears were hurting. Before, I had some hearing, but now my hearing is much worse.” This account was shared by a Ukrainian refugee, who, after fleeing the war-inflicted country, currently resides in neighboring Poland — traumatized by the conflict and with aggravated hearing damage to make matters worse.Students from Northern Illinois University and University of Sao Paulo, Bauru, test the hearing thresholds of Ukrainian refugees before hearing aid fitting.The Heart of Hearing team in Kraków, Poland, in March 2023.Student volunteers with the Heart of Hearing team gave hearing aid orientation to new hearing aid users through interpreters.A child with hearing loss receives a pair of rechargeable hearing aids donated by ReSound.LOSING HOME AND HEARING A little over a year has passed since President Vladimir Putin first commanded his troops across the Ukrainian border. Since, the world has become painfully familiar with the atrocities of the war. Casualties are constantly increasing, and though the stamina of the Ukrainians is indeed remarkable, the effects of the conflict stretch far beyond what most of us can fathom. Among these are the hearing damages caused or exacerbated by blast injuries from bomb explosions and artillery fire. To address this issue, the Heart of Hearing team — an international group of audiology professors and students — decided to commit their time and expertise. Organized by Dr. King Chung, PhD, CCC-A, Professor of Audiology at Northern Illinois University, the team went on a humanitarian trip to Kraków, Poland, in late 2022. Collaborating with staff at the Jewish Community Centre (JCC), they tested around 150 individuals and identified significant hearing loss for nearly half. The team had struggled to secure sponsored hearing aids initially and only brought four pairs from the lab on their first trip. But after they reported their story in The Hearing Journal, ReSound stepped in and donated 125 rechargeable hearing aids. Since then, a second trip has been organized to fit the donated devices. With a task force consisting of Dr. Chung, Dr. Magali Caldana from the University of São Paulo, FOB (Brazil), Dr. Hannalice Gottschalck Cavalcanti from the Federal University of Paraiba-UFPB (Brazil), Dr. Valeriy Shafiro from Rush University, and nine audiology students from three of the universities, the team returned to Kraków and fitted 44 refugees. The Heart of Hearing team also screened the hearing of around 220 Polish school children. EVERYTHING IS CONNECTED “These people are in a new country, they often don’t speak the language, they’re scared and uncertain,” said Dr. Shafiro. “We treat hearing as a separate thing, but really, it’s all connected. It’s the well-being, it’s the overall health. Gradually, the patients go through ","PeriodicalId":39705,"journal":{"name":"Hearing Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135090450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}