shudhamaaya toonn audiometry

oru vyakthiyude kelvi paridhi thirichariyaan upayogikkunna pradhana kelvi parisodhanayaanu pyoor-toonn audiometry, ithu kelvikkuravinte alavu, tharam, krameekaranam enniva nirnnayikkaan praapthamaakkukayum angane roganirnayathinum maanejmentinum oru adisthaanam nalkukayum cheiyunnu. shudhamaaya swaram" uthejakangalodulla rogiyude prathikaranangale aashrayikkunnathinaal kelvi paridhiyude aathmanishtavum perumattaparavumaaya alavaanu shudhamaaya swara audiometry. athinaal, pareekshana prakriyayumaayi sahakarikkaan kazhiyunna prayamaaya muthirnnavarilum kuttikalilum maathrame shudhamaaya toonn audiometry upayogikkunnulloo. mikka klinikkal parisodhanakalileyum pole, testt parithasthithiyude staanderd calibration, pareekshanam thudarunnathinu munbu upakaranangalum uthejakangalum aavasyamaanu (iso, aansi allengil mattu standerdisation bodiye paraamarshikkumbol). shabda praadeshikavalkkaranam, samsara thirichariyal thudangiya kelvishakthiyude mattu vashangalekkaal shudha-toonn audiometry kelvishakthiyude paridhi maathrame alakkunnulloo. ennirunnaalum, click oodittari brainstem response (eiii. bii. aarr) polulla mattu tharatthilulla shravana parishodhanakalekkaal shudhamaaya toonn audiometry upayogikkunnathinu gunangalundu. shudhamaaya toonn audiometry chevikk nirddishta paridhi nalkunnu, koodaathe prathyeka prathikaranangal nalkunnathinu aavruthi nirddishta shudhamaaya tonukal upayogikkunnu, angane kelvikkuravinte krameekaranam thirichariyaan kazhiyum. shudhamaaya toonn audiometry vaayuvum asthikalude chaalaka audiometriyum upayogikkunnathinaal, vaayu-asthi vidavu vazhiyum nashtatthinte tharam thirichariyaan kazhiyum. shudhamaaya toonn audiometric niravadhi klinikkal gunangalundenkilum, kokliyayude 'dedd regions', audiori prosessing desorder (apd) polulla neuropathy thudangiya ellah nashtangalum thirichariyaan ithu anuyojyamalla. ithu oraalude vaikalyathinte alavu audiograamukal krithyamaayi pravachikkunnundo illayo enna chodyam uyarthunnu.
shudhamaaya toonn audiometry nadapadikrama maanadandangal.
shudha-toonn audiometrikkaayulla nilavile anthaaraashtra oorganaiseshan phoor standerdisation (iso) staanderd 1983 ll aadyamaayi prasidheekaricha iso 8253-1 aanu. shudha-toonn audiometrikkaayulla nilavile american naashanal staanderds instittyoott (aansi) staanderd ansi/aasaa s3.21-2004 aanu, ithu american shabda samooham thayyarakkunnu.
yunaittad kingdatthil, britiish sosaitti oof oodiyoolaji (bsa) shudhamaaya toonn audiometricum mattu niravadhi audiological nadapadikramangalkkumaayi shupaarsha cheytha nadapadikramangal prasidheekarikkunnathinu utharavaadithamaanu. britiish shupaarsha cheiyunna nadapadikramam anthaaraashtra nilavaaratthe adisthaanamaakkiyullathaanu. chila vyathyaasangalundengilum, bsa shupaarsha cheiyunna nadapadikramangal iso 8253-1 staanderdinu anusrithamaanu. bsa shupaarsha cheiyunna nadapadikramangal professionalukalkku pinthudaraan oru "mikacha practies" testt protocol nalkunnu, saadhuta vardhippikkukayum brittaniludaneelam phalangalude standerdisation anuvadikkukayum cheiyunnu.
amerikkayil, american speach-langwej-hearing association (aasha) 2005 ll maanuval pyoor-toonn threashold audiometricaayi maargganirddeshangal prasidheekarichu.
vyathiyanangal.
parambaraagatha shudha-toonn audiometry threashold testinginte uchithamo phalapradamo aaya reethiyallaatha kesukalundu. kelvi paridhi nedunnathinaayi testumaayi sahakarikkaan kazhiyaatha janasamkhyaykku parambaraagatha testt reethiyilulla nadapadikrama mattangal aavashyamaayi vannekkaam. rogikalkku eayarphonukal dharikkan kazhiyaathappol soundu feeld audiometry kooduthal anuyojyamaayekkaam, kaaranam uthejakangal saadhaaranayaayi uchabhashakaliloodeyaanu avatharippikkunnath. eee reethiyude oru poraayma, paridhi nedaan kazhiyumenkilum, phalangal chevikk prathyekamalla ennathaanu. koodaathe, shudhamaaya toonn uthejakangalodulla prathikaranam parimithamaayirikkam, kaaranam oru shabda mekhalayil shudhamaaya tonukal nilkkunna tharamgangal srishtikkunnu, ithu shabda mekhalaykkullile shabda theevrathaye maattunnu. athinaal, shabda feeld testingil warble tonukal polulla mattu uthejakangal upayogikkendathu aavashyamaayi vannekkaam. cheria kuttikalkkum sisukkalkkumaayi prathyekamaayi roopakalppana cheythirikkunna parambaraagatha audiometry testinginte vyathiyaanangalund, udaaharanathinu behavioural observation audiometry, vishwal reinforcement audiometry, play audiometry.
parambaraagatha audiometry 250 hearts (hearts) num 8 keey. echu. esinum edayilulla aavruthikale parishodhikkunnu, athesamayam 8 keey. echu. ezz-16 keey. echu. ezz mekhalayile uyarnna aavruthi audiometry parisodhanakal. autotoxic marunnukal, shabda exposure thudangiya chila paaristhithika gadakangal, madhya allengil thaazhnna aavruthikalekkaal uyarnna aavruthi samvedanakshamathaykku kooduthal haanikaramaanennu thonnunnu. athinaal, eee gadakangal moolamundaayathaanennu samshayikkunna nashtangal nireekshikkunathinulla phalapradamaaya reethiyaanu uyarnna freekwansi audiometry. vaardhakyathodoppam sambhavikkunna shravana samvedanakshamathayile mattangal kandethunnathinum ithu falapradamaanu.
cross hearing, interveral attenyuyeshan.
 
oru cheviyil shabdam prayogikkumbol thalayotiyile asthikaliloodeyulla vaibreshanukaliloode kontraalaattal kokliya vyathyastha alavukalil uthejippikkaanum kazhiyum. testt cheviyil avatharippikkunna uthejakangal testt cheyyaatha cheviyude kokliya uthejippikkumbol, ithine cross hearing ennu vilikkunnu. cross hearing undennu samshayikkumbozhellaam masking upayogikkunnathaanu nallath. munkootty nischayicha thalatthil oru masking shabdam avatharippichu, noonn-testt cheviyude paridhi thaalkkaalikamaayi uyarthiyaan ithu cheiyunnathu. ithu testt chevikk nalkunna testt signal kandethunnathil ninnu noonn-testt chevye thadayunnu. testt cheviyude paridhi alakkunnathu testt cheyyaatha cheviyil masking shabdam avatharippikkunna athe samayathaan. athinaal, masking prayogikkumbol labhikkuna paridhi, testt cheviyude yadhaartha shravana paridhi nilayude krithyamaaya praathinidhyam nalkunnu.
cross hearingiloode oorjjam kurayukayo nashtappedukayo cheiyunnu, ithine interoral attenyuyeshan (iaa) allengil transcranial transmission loss ennu vilikkunnu. transducer tharam anusarichu iaa vyathyaasappedunnu. suuppar-ooral headphoneukal upayogichu ithu 40 db muthal 80 db vare vyathyaasappedunnu. ennirunnaalum, insert eayarphonukal 55 db mekhalayilaanu. insert eayarphonukalude upayogam maskinginte aavasyakatha kuraykkunnu, kaaranam avaa upayogikkumbol sambhavikkunna valia aii. eiii. (chithram 1 kaanuka).
vaayuchalanam ottappedalinu kaaranamaakunnu, kelvikkuravinte tharathekkurichu kurachu vivarangal maathrame nalkoo. vaayuchaalanathiloode labhikkuna paridhi asthikalude chaalakatthiloode nediyathinoppam parishodhikkumbol, kelvikkuravinte krameekaranam nirnnayikkaan kazhiyum. ennirunnaalum, asthi chaalanatthiloode (chevikk pinnilulla maastoyid asthiyil oru vibrator sthaapich nadathunnu), rund kokliyakalum uthejippikkappedunnu. asthi chaalakathinulla iaa 0-20 db muthalullathaanu (chithram 2 kaanuka). athinaal, masking prayogikkumbol, vaayuvinteyum asthikaludeyum chaalaka audiometriyumaayi bandhappett parambaraagatha audiometry chevikk prathyekamaanu.
shudhamaaya toonn audiometry paridhi, kelvi vaikalyam.
kelvikkuravu vilayiruthunathinulla swarnna nilavaaramaayi pyoor-toonn audiometriye visheshippikkunnu, ennaal kelvikkuravu, kelvi vaikalyam ennivayude kaaryatthil oru vyakthiyude kelvikkuravu tharamthirikkunnathil pyoor-toonn audiometry ethratholam krithyamaanennu chodyam cheyyaan kazhiyum. onno rando cheviyil 25 db yill kooduthal paridhi ulla kelvikkuravaanu kelvi vaikalyamenn lokaarogya samghadana (doubleuecho) nirvachichirikkunnu. kelvikkuravinte alavu mithamaaya, mithamaaya, kadinamaaya allengil aazhathilullathayi tharamthirickunnu. ennirunnaalum, shudhamaaya toonn audiometriyude phalangal kelvi vaikalyathinte valare nalla soochakamaanu.
kelvi vaikalyam moolamundaakunna shaanthavum shabdamullathumaaya anthareekshathil (saadhaarana kelvishakthiyulla aalukalumayi thaarathamyappeduthumbol) shabdangal kelkkanulla kazhivu kurayunnathaanu kelvi vaikalyathe nirvachichirikkunnathu. svayam report cheytha shravana prasnangal (chodyaavalikaliloodeyum abhimukhangaliloodeyum) shudhamaaya toonn audiometriyil ninnulla falangalumaayi bandhappettirikkunno ennu niravadhi padanangal anweshichittundu. eee padanangalude kandethalukal soochippikkunnathu pothuve, shudhamaaya toonn audiometriyude phalangal svayam report cheytha shravana prasnangalumaayi poruthappedunnu ennaanu (athaayath.iii. kelvi vaikalyam). ennirunnaalum, chila vyakthikale sambandhichidatholam ithu anganeyalla; oru vyakthiyude kelvi vaikalyam nirnnayikkaan shudhamaaya toonn audiometriyude phalangal maathram upayogikkaruthu.
kelvi vaikalyavum (audiogram adisthaanamaakki) shravana vaikalyavum (shabdathile samsara vivechanathe adisthaanamaakki) daatta rainiyar plomp avalokanam cheythu. ithu samavaakyangalude roopeekaranathilekku nayichu, ithu samsaarakshamathayil kelvikkuravinte anantharafalangal vivarikkunnu. eee avalokanathinte phalangal soochippikkunnathu samsaarasheshikk kaaranamakunna rund gadakangalaanu kelvikkuravinu kaaranamaayath ennaanu. eee gadakangale ghadakam eiii, ghadakam dii ennu namakaranam cheythu. samsaarathe durbalappeduthunnathiloodu swaadheenamulla samsaarabodhathe gadakamaakkuka, athesamayam dii ghadakam samsaarathe valachodikkunnathiloode samsara bodhavalkkaranathe badhikkunnu.
samsaarathinte 50 sathamaanam shariyaayi thirichariyunna shabda mardha nilayaanu speach recognission threashold (srt) ennu nirvachichirikkunnathu. shaanthamaayirikkumbol conductive hearing loss (cl) ulla oru vyakthikk, saadhaarana kelvishakthiyulla oru vyakthiyekkaal srt kooduthalaayirikkanam. srtyile vardhanavu kelvikkuravinte alavine maathram aasrayichirikkunnu, athinaal a ghadakam aaa vyakthiyude audiogram prathifalippikkunnu. shabdathil, oru cl ulla vyakthikk saadhaarana kelvishakthiyulla vyakthiyude athe prashnamund (chithram 10 kaanuka).
shaanthamaaya censorinural kelvikkuravulla (snl) oru vyakthikk, saadhaarana kelvishakthiyulla oru vyakthiyekkaal srt kooduthalaayirikkanam. kaaranam oru cllnum oru snln nishabdathayil pradhaanamaaya oreyoru ghadakam shabdathinte kelvishakthiyaan, athu gadakamaaya ayumaayi poruthappedunnu. shabdathil, oru snl ulla vyakthikk saadhaarana kelvishakthiyulla vyakthiyum cll ulla vyakthiyum pole athe prakadana nilavaaram kaivarikkaan mikacha signal-tuu-noys anupatham aavasyamaanu. shabdathil, oru snl ulla oru vyakthiyude prasnangal vishadeekarikkaan eiii ghadakam paryaapthamallenn ithu kaanikkunnu. athinaal, mattoru prashnamund, athu ghadakam dii aanu. nilavil, ghadakam dii yude kaaranam enthaanennu ariyilla. athinaal, shabdathil audiogram aprasakthamaan. eee saahacharyathil pradhaanappettath kelvikkuravaanu.
eee kandethalukalkk shravanasahaayikalude roopakalppanayil pradhana prathyaaghaathangalundu. nilavil sravanasahaayikalkku a gadakathinu nashtapariharam nalkaan kazhiyumennathinaal, dii gadakathinte kaaryatthil ithu anganeyalla. ithukondaayirikkaam kelvi upakaranangal dhaaraalam aalukalkk thripthikaramallaathathu.
audiograamukalum kelvikkuravum.
shudhamaaya toonn audiometriyil ninnu undaakunna audiograafathinte aakruthi kelvikkuravinte tharatheyum saadhyamaaya kaaranangaleyum soochippikkunnu. madhya cheviyile vaikalyangal moolamundaakunna chaalaka shravana nashtam aavruthi paridhiyiludaneelamulla paridikk neriya vardhanayaayi kaanikkunnu. censorinural kelvikkuravinu kaaranatthe aashrayich oru contoured aakruthi undaakum. udaaharanathinu, presbicusis allengil praayavumaayi bandhapetta kelvikkuravu uyarnna aavruthi roll-oof (paridhi vardhanavu) aanu. shabdathaal undaakunna kelvikkuravinu 4000 hearts enna savisheshathayundu. mattu rooparekhakal kelvikkuravinulla mattu kaaranangale soochippichekkaam.

