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ABR Evaluations

dzapala at aol.com dzapala at aol.com
Fri Nov 8 00:12:54 EST 1996

Joel R. Bealer wrote:
>...He was referred to an ENT group whose audiology department did a
threshold ABR (did not repeat any of >the recordings) that had suspect
peaks in the affected ear below 60 dBnHL.  The report stated that the
>affected ear actually had "normal hearing" and that the audiological
evaluation must have been in error or the >patient was faking the loss.  

I've been there.  The last time it was a baby with a peripherial auditory
neuropathy (present OAEs no ABR).  An audiologist tracked unreplicated
noise down to 40 dB and told the mother there was no problem.  Auditory
neuropathies are rare, so I find little fault missing that diagnosis (no
telling where the referenced letter went that came with the referral!) 
But the quality of the ABR study was terible!  So what to do?!?  I figure
if it's me in the idiot role, I want my collegues to tell me up front.  So
I called the audiologist and in my nice way succeded in making her angry
at me.  

We can't grow if we can't take it on the chin when we are wrong.  And if
we are right, we need to be able to explain our thought process in a
respectful but firm manner.  So give them a call.  No self-policing, no
profession I say.   Its worth being up front with the audiologist and
taking the heat.  If they don't respond well to your polite, respectfully
presented concern, present the case in your regional grand rounds as an
example of how not to do things.  

Good Luck

David Zapala

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