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For Hearing Health Professionals
For Hearing Health Professionals
Indiana Jones & the Lost Art of Tuning Fork Testing
By Robert L. Folmer, Ph. D., Assistant Professor of Otolaryngology, Oregon Health Sciences University, Portland, OR
Abstract: An excellent article by Dr. Folmer. Patients experiencing severe chronic tinnitus have many characteristics in common with chronic pain patients. This study explored these similarities in order to formulate treatment strategies that are likely to be effective for patients experiencing phantom auditory pain. Answers…
By Dr. Max S. Chartrand Ph.D.
This presentation steps the reader through the fundamentals of one of the most effective tinnitus treatment programs in the world today, and compares the underlying physiological model to Dr. Chartrand's current methodology.
TRT: Pioneering Research into the Mind of the Tinnitus Sufferer
A report on the relevance of TRT in current amplification strategies in patients…
Table of Contents
TA2002 Research Study Design
TA2002 Study Objectives/Outcome Measures
TA2002 Supervision & Compilation
TA2002 FAQ Sheet mailed to prospective participants prior to scheduling first visit
TA2002 Patient Prospectus Summary mailed to prospective participants prior to scheduling first visit
Forms utilized in TA2002
Supporting documents:
Post-Study I: "Tinnitus Management in the Dispensing Practice" (1993)
From Study I: "Tinnitus &…
By Dr. Max S. Chartrand Ph.D.
RECENT STUDIES by the American Tinnitus Association (ATA) indicate a much higher incidence of tinnitus in the U.S. population than previously accepted. In fact, it is now believed that up to 25% of the U.S. population experience some degree of tinnitus, either of an intermittent or constant nature.
Taking into account that these Figures…
By Dr. Max S. Chartrand Ph.D.
From Audiology Online
Abstract: This study addresses measures and methods for identifying three under-recognized neuroreflexes of the external ear canal. These three neuro-reflexes are related to hearing instrument dispensing practice, as they often complicate and may cause failure to fit hearing instruments. By using an External Ear Neuro-reflex Checklist (EENC) clinical tasks such as…
By Max S. Chartrand Ph.D. and Glenys Anne Chartrand
Frequent complaints of earmold discomfort, non-acoustic occlusion, sensations of fullness, and chronic itching while wearing hearing aids still continue to drive at least some of the failure-to-fit rate for dispensing professionals. We must apply our science to both acoustic and non-acoustic issues that influence customer satisfaction
Despite steady progress in the…
By Max S. Chartrand Ph.D. and Glenys Anne Chartrand, OTR, BC-HIS
If a Tree Fell in the Forest: What's Really Holding Back the Market?
Appropriate auditory rehabilitation is no longer an option; it's an ethical imperative and a matter of professional survival.
Recently, the question of over-the-counter hearing aids (OTC) has been proposed. Additionally, sales of Internet and mail-order hearing…
By Dr. Max S. Chartrand Ph.D.
Tie American National Standards Institute (ANSI) refers to human auditory threshold as 'the minimum effective sound pressure of the signal that is capable of evoking an auditory sensation in a specified fraction of the trials.' In this case, we seek two out of three responses at a given sensation level, or better than 50…
By Dr. Max S. Chartrand Ph.D.
For our purposes here we will go on to describe some other essential factors relative to speech discrimination testing, keeping in mind that, again, we are taking primarily the rehabilitative focal point:
Because of the prevalence of phonemic regression in many sensorineural and presbycusis cases, it is dubious at best to expect to obtain…
By Dr. Max S. Chartrand Phd
Fine-tuning of the psychological and sociological infrastructure of the hearing evaluation is a hallmark of the professional hearing instrument specialist.
Introduction
Without "the facts" in front of all concerned, the debate concerning hearing loss and recommended amplification often becomes a pitting of wills and opinions, an exercise in futility. The psychological and sociological importance…
By Dr. Max S. Chartrand Ph.D.
Introduction
Within the eight brief "red flag" otological-screening provisions of the U.S. Food & Drug Administration Hearing Aid Rule we find inclusive, comprehensive and uniform standards of observation for professionals involved in evaluating hearing status, dispensing hearing instruments and assistive devices, and making medical referral1.
Codified into federal regulation in 1977, the wisdom and…
By Dr. Max S. Chartrand Ph.D.
Despite the hearing healthcare profession's growing acceptance of transcranial fitting principles and other concepts in aural rehabilitation that were once regarded as exotic, there remains a lingering stigma attached to the practice of "fitting a dead ear." Recently, however, the conventional wisdom appears to be making room for more effective fitting approaches in these…
By Max S. Chartrand Ph.D.
Far too many first-time hearing instrument fittings are lost due to factors clearly within the control of the Hearing Instrument Specialist. Part of the problem may simply be a lack of appreciation of the importance of family and loved ones' involvement in the rehabilitative process.
But, probably more common is that the specialist may not…
By Max S. Chartrand Ph.D.
Abstract: Maintaining independence and control over one's life are of great concern to those over 80 years of age. An important tool in achieving this end is the amplification they wear for the correction of hearing loss. In a Likert-like pretest-posttest nonequivalent control study, we utilized a Hearing Aid Manipulation Training Protocol (HATP) to find…
By Dr. Max S. Chartrand Ph.D.
Digital Audio Chemistry: R&D Notes
Preliminary findings with applications of Neon Post-Auricular Digital Audio Chemistry by Puretone
General Description
Digital Audio Chemistry is proprietary software driven DSP hearing technology available in custom and production hearing instruments from Puretone, LTD. DAC circuitry continuously interacts with the sound environment, and is programmed to monitor discrete characteristics…
By: Dr. Max S Chartrand PhD and Glenys Anne Denyer Chartrand AdDipOT
Sherlock & Watson Mysteries of Auditory Rehabilitation Lecture Series: The Case of the Missing Brain Cells
The case history below is accompanied with audiometric data for an older adult, from which the reader will prescribe various facets of an auditory rehabilitation program. There are additional psychosocial components relative…
By Dr. Max S. Chartrand Ph.D.
'My head feels plugged up when I wear these hearing aids!' exclaimed my new patient, a middle-aged female who had used her new instruments for less than a week.
'Mmmmm, let me see,' I said as she removed her hearing instruments.
I quickly inspected them to see if the earmold vents were plugged. They…
By Dr. Max S. Chartrand Ph.D.
COGNITIVE MANIFESTATIONS IN UNMITIGATED HEARING LOSS
We know today that the very essence of cognition---or one's awareness and connection to life around them---is fed more through the auditory sense, than through all of the other senses combined. Certainly an understanding of auditory-cognitive relationships would shed more light on how human beings depend upon "normal"…
By Dr. Max S. Chartrand Ph.D.
This article originally appeared in The Hearing Professional, July—August 2004
The keratin or keratinocyte layer is the outermost portion of the stratum corneum or outer layer of tissues of the external ear canal. Its physiological role is critical in maintaining homeostasis and adapting comfortably to hearing aids and should garner the attention of every member of…
By Max S. Chartrand Ph.D.
VIDEO OTOSCOPY OBSERVATIONS IN HEARING HEALTH PRACTICE UTILIZING MIRACELL BOTANICALS SOLUTION
Introduction
Over a 20-month period we observed marked physical changes in the external and middle ears in many of the 960 hearing impaired patients who followed a specified regimen with Miracell Botanicals solution. From video otoscopic and comparative history data gathered during these observations,…
By Dr. Max S. Chartrand Ph.D.
The question "What if these hearing aids don't work?" is asked with the implication that there are no finite limitations to correcting one's hearing loss; just limitations in hearing aids. More often than not, though, for the severely hearing impaired patient, the question should be: "What if I need more than hearing aids to…
By Dr. Max S. Chartrand Ph.D.
In Part I of this series published in the January-February 2000 issue of The Hearing Professional, we discussed the prevalence of severely hearing impaired (SHI) patients within the Hearing Instrument Specialists's practice, and introduced a true "total communication concept" with which to supplement the communicative needs of SHI patients who need more than amplification…
By Dr. Max S. Chartrand Ph.D.
Almost always, those who require extended compensation beyond amplification are moderately severe, severe, severe-to-profound or profound patients. As a population of the typical hearing instrument practice they comprise approximately 15 percent of all patients. The most debilitated portion of the population is in the severe-to-profound and profound cases, comprising approximately two percent of the…
By Dr. Max S. Chartrand Ph.D.
In-depth counseling instruction for solving the most difficult fitting problem cases
COUNSELING CONCEPTS IN SOLVING PROBLEM CASES
"The scenes change, but the story line stays much the same: Lack of foresight brings the most unexpected of consequences, even though we've been there, done that,a hundred times already. Each perplexing scene makes us more determined…
Why Volume Controls?
By Dr. Max S. Chartrand Ph.D.
If normal ears came equipped with a volume control (VC) and, for the sake of example, it was turned up slightly louder than one's most comfortable loudness (MCL), one would undoubtedly complain that their own voice sounds "bright, hollow, in a well." If it was turned slightly downward from MCL, one…
By Dr. Max S. Chartrand Ph.D.
Volume Controls: Essential to meet physiological and acoustic needs
To VC or not to VC
The recent practice of leaving user volume controls off of hearing aids has presented new challenges for the hearing impaired.
It was with great interest that I read the MarkeTrack VI follow-up paper ("Isolating the Impact of the Volume…
The lost art of tuning fork testing has been found again in this DigiCare tutorial on the vital techniques for measuring human hearing and amplification performance.
By Dr. Max S. Chartrand, PhD
Introduction
Once upon a time, hearing professionals had no electroacoustic audiometers, real ear probe tubes, or electronic soundfield. As in all fields where technological metamorphosis followed practice, hearing…
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