HEARING   ∙   TINNITUS   ∙   BALANCE

Hearing Loss is a public health concern of high priority.

Recent research in peer-reviewed medical journals suggests that age-related hearing loss is a growing public health concern requiring pre-emptive attention from physicians.

Studies show that hearing loss is the second most common health complaint in patients over the age of 65. In fact, over half of the Canadian population over the age of 65 deals with some form of hearing loss, however, it is often a hidden disability that is not visible to patients and their support systems, including physicians.

As hearing loss is often linked to other chronic medical conditions such as diabetes, depression, cardiovascular disease, and cognitive decline, Audiologists are increasingly viewed as an essential component of patient care for a broad range of disease processes which previously, were not considered relevant to hearing impairment.

Studies suggest that age-related hearing loss has implications well beyond affecting basic communication skills. Left untreated, hearing loss can leave patients feeling withdrawn and isolated, reducing their quality of life, and putting them at risk for cognitive decline later in life.

In 2017, Canada passed the National Strategy for Alzheimer’s Disease and Other Dementias Act to address the overwhelming scale, impact, and cost of dementia. It is the position of Speech-Language & Audiology Canada (SAC) that speech-language pathologists and audiologists are integral to the care of people living with dementia, as well as to their families and caregivers, and must be part of the dementia care team.

Hearing loss imposes a heavy social, economic burden on individuals, families, and communities. According to the American Geriatrics Society:

All individuals over the age of 55 should have a baseline hearing screening, and patients with a history of depression, cardiovascular disease, diabetes, and dementia should have their hearing assessed. 

HEARING

COMPREHENSIVE EVALUATION AND MANAGEMENT

Our registered Audiologists have graduate and post graduate training in comprehensive audiology diagnostics,
and the specialized equipment to perform and fully assess both peripheral and central hearing.

TINNITUS RETRAINING THERAPY

Our Audiology team has received specialized training in tinnitus assessment and care for those suffering from persistent, bothersome tinnitus and/or hyperacusis (reduced sound tolerance). Patients undergo diagnostic audiologic evaluation, followed by group or individual education, counselling, and sound therapy provided by an audiologist trained in Progressive Tinnitus Management and Tinnitus Retraining Therapy. Treatments are aimed to lessen the impact of tinnitus on daily life.

COLLABORATIVE TINNITUS GROUP SUPPORT SESSIONS

Support groups are held once every three months and are co-hosted by Nichole Sorensen, Audiologist, and Glynnis Tidball, Audiologist, St. Paul’s Hospital Tinnitus and Sound Sensitivity Clinic.

VESTIBULAR TESTING

Our collaborative team of experienced professionals will provide your patients with an unparalleled level of care, using state-of-the-art technology to assess vestibular function and applying evidence-based rehabilitation protocols.

The following comprehensive battery is tailored to the patient’s symptoms, and includes highly specialized balance tests that enable the Audiologist to analyze information about the vestibular system in the inner ear, and its connections with the eyes and the vestibular centres in the brain.

Test results determine whether there is a vestibular disorder, quantify it, and localize it within the peripheral and/or central vestibular system. This allows for a personalized treatment plan to be implemented and assists the physician in determining the cause of the disorder.

These tests and protocols are adapted from the St. Paul’s Vestibular Clinic and the American Institute of Balance, and allow for local, timely, and cost-effective assessment and treatment.

VNG (VIDEONYSTAGMOGRAPHY)
Involuntary eye movements (nystagmus) are recorded and measured through infrared goggles while the patient’s balance system is stimulated
in different ways to assess vestibular function with great precision.

There are three main parts to the VNG:

1. Oculomotor (central control of eye movements, as it also assesses brainstem
   and cortex)
2. Positional/positioning tests (assessment for BPPV and central positional nystagmus)
3. Calorics (evaluates each horizontal semicircular canal and its central pathways)

VEMP (VESTIBULAR EVOKED MYOGENIC POTENTIAL)

VEMP (Vestibular Evoked Myogenic Potential) assess the utricle and saccule and their connections to the brainstem through the vestibular nerve. The utricle and saccule cannot be assessed with VNG or the vHIT.

VEMPs are used to assist in the diagnosis of Meniere’s, superior canal dehiscence, utricular/ saccular dysfunction, and conditions affecting the vestibular nerve, such as vestibular neuritis.

There are two separate VEMPs:

1. cVEMP: Cervical Vestibular Evoked Myogenic Potential assesses the saccule and the inferior portion of the vestibular nerve.
2. oVEMP: Ocular Vestibular Evoked Myogenic Potential assesses the utricle and the superior portion of the vestibular nerve.

GANS SENSORY ORGANIZATION PERFORMANCE TEST (GSOPT)

Evaluates the ability to utilize and integrate sensory input for postural control utilizing 3 standardized tests of balance function (95% sensitive to vestibular dysfunction).

VIDEO HEAD IMPULSE TEST (vHIT)

Objectively measures the function of all six semicircular canals, comparing results to a normal population. Using infrared technology, it analyses eye movement in response to head impulses, providing a precise measurement of the vestibuloocular reflex (VOR) and recording of corrective saccades that occur when the VOR is deficient.

COMPUTERIZED DYNAMIC VISUAL ACUITY TEST (CDVAT)

Provides information about the high frequency horizontal and vertical vestibulo-ocular reflex (VOR), assessing gaze stability during motion (relating to normal daily life activities such as walking, bending, and turning).

VESTIBULAR TESTING