ABR = Auditory Brainstem-evoked Responses

ABR tests are used to test hearing in infants and young children, or to test for brain functioning in unresponsive patients. They measure the timing of electrical waves from the brainstem in response to clicks or tone bursts in the ear. Wave forms are plotted for each ear and represent specific anatomical points along the auditory neural pathway.

Waves I & II: The cochlear nerve and nuclei
Wave III: Superior olivary nucleus
Wave IV: Lateral lemniscus
Wave V: Inferior colliculi

Delays of one side relative to the other suggest a lesion in the 8th cranial nerve between the ear and the brainstem or in the brainstem itself.

a tumor, usually benign, which develops on the hearing and balance nerves and can cause gradual hearing loss, tinnitus, and dizziness.

loss of hearing that occurs or develops over the course of a lifetime; deafness not present at birth.

loss of the sense of taste.

A type of antigen which is able to stimulate the immune system, forming the basis of an allergic reaction. An allergen does not interact with an antigen.

Eye redness and itching associated with a local allergic reaction to a substance.

The swelling of nasal membranes of an allergic origin.

An abnormal, acquired sensitivity to a specific substance, such as pollens, mold spores, animal dander, foods, chemicals, insects, and drugs.   Patients will experience immune-mediated local or systemic inflammatory responses to allergens, such as swelling of the nasal mucosa, eye redness and itching, wheezing, dyspnea and rashes (hives).(Thomas 1997).

A hereditary condition characterized by kidney disease, sensorineural hearing loss, and some difficulties with eye defects.

Manual (hand) language with its own syntax and grammar used primarily by people who are deaf.

The most severe type of anaphylaxis. If left untreated, may lead to death due to respiratory distress

An acute systemic (multi-system) and severe allergic reaction to an allergen.

absence of the sense of smell.

Y-shaped proteins that the immune system uses to identify and neutralize foreign objects, such as bacteria and viruses.

A substance that induces the formation of antibodies that interact specifically with an allergen to create the basis for immunity to that specific allergen.

A drug that is used to treat allergies.

total or partial loss of ability to use or understand language; usually caused by stroke, brain disease, or injury.

complete loss of voice.

inability to make a voluntary movement in spite of being able to demonstrate normal muscle function.

inability to correctly produce speech sounds (phonemes) because of imprecise placement, timing, pressure, speed, or flow of movement of the lips, tongue, or throat.

technical tools and devices such as alphabet boards, text telephones, or text-to-speech conversion software used to assist people with physical or emotional disorders in performing certain actions, tasks, and activities.

a healthcare professional trained to identify and measure hearing impairments and related disorders using a variety of tests and procedures

test used for hearing in infants and young children, or to test for brain functioning in unresponsive patients.

eighth cranial nerve that connects the inner ear to the brainstem.

ability to identify, interpret, and attach meaning to sound.

A blanket term for a group of disorders that affect the way the brain interprets sound information. However, this does not usually affect the normal structure and function of the ear.

device that substitutes or enhances the ability to hear.

tools that help individuals with limited or absent speech to communicate.

techniques used with people who are hearing impaired to improve ability to speak and to communicate.

brain disorder that begins in early childhood and persists throughout adulthood; affects three crucial areas of development: communication, social interaction, and creative or imaginative play.

hearing loss in an individual that may be associated with a tissue-causing disease, such as rheumatoid arthritis or lupus.

biological system that enables individuals to know where their bodies are in the environment and to maintain a desired position; normal balance depends on information from the labyrinth in the inner ear, and from other senses such as sight and touch, as well as from muscle movement.

disruption in the labyrinth, the inner ear organ that controls the balance system allowing individuals to know where their bodies are in the environment.

injury to the middle ear caused by a reduction of air pressure.

balance disorder that results in a sudden onset of dizziness, spinning, or vertigo that occurs when suddenly moving the head from one position to another.

A drug used to help control hypertension, such as norepinephrine and epinephrine that may complicate allergy skin testing and immunotherapy. They block the beta receptors which are used by epinephrine during the treatment of anaphylaxis.

auditory prosthesis that bypasses the cochlea and auditory nerve to help individuals who cannot benefit from a cochlear implant because the auditory nerves are not working.

Clinical Laboratory Improvement Amendments

text display of spoken words presented on a television or a movie screen that allows a deaf or hard-of-hearing viewer to follow the dialogue and the action of a program simultaneously.

inability of individuals with normal hearing and intelligence to differentiate, recognize, or understand sounds.

disorders or diseases of smell or taste.

accumulation of dead cells in the middle ear caused by repeated middle ear infections.

snail-shaped structure in the inner ear that contains the organ of hearing.

medical device that bypasses damaged structures in the inner ear and directly stimulates auditory nerve to allow some deaf individuals to learn to hear and interpret sounds and speech.

a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

Allergy antigen received from vendor supplier in its strongest format.

The weight to volume ratio of a medication or allergenic extract.

A certain food that, when ingested by a person who is sensitive to certain allergens, may increase the sensitivity to that specific allergen when that person is exposed to the allergen at the same time that he/she is ingesting the food.

hearing loss caused by dysfunction of the outer or middle ear.

When more than one antigen reacts with a specific antibody.

method of communication that combines speech reading with a system of handshapes placed near the mouth to help deaf or hard-of-hearing individuals differentiate words that look similar on the lips

one group of herpes viruses that infect humans and can cause a variety of clinical symptoms including deafness or hearing impairment; infection with the virus may be either before or after birth.

unit that measures the intensity or loudness of sound.

A medication that when used produces shrinkage of congested nasal mucosa that allows the sinuses “to drain.”

An inert substance used in the preparation of allergy extracts to adjust the strength of concentrated allergy extract. The more diluent added to the mixture, the less concentrated the extract becomes.

physical unsteadiness, imbalance, and lightheadedness associated with balance disorders.

A Doctor of Audiology is a person who, by virtue of academic degree, clinical training and license to practice and/or professional credential, is uniquely qualified to provide a comprehensive array of professional services related to the prevention of hearing loss and the audiologic identification, assessment, diagnosis, and treatment of persons with impairment of auditory and vestibular function, and to the prevention of impairments associated with them.

The central focus of audiology is auditory impairments and their relationship to disorders of communication. Doctors of audiology identify, assess, diagnose and treat individuals with impairment of either peripheral or central auditory and/or vestibular function and strive to prevent such impairments.

Doctors of audiology provide clinical and academic training to students of audiology. They teach physicians, medical students, residents and fellows about the auditory and vestibular system. Specifically, they provide instruction about identification, assessment, diagnosis, prevention and treatment of persons with hearing and/or vestibular impairment. They provide information and training on all aspects of hearing and balance to other professions including psychology, counseling, rehabilitation and education. Doctors of audiology provide information on hearing and balance, hearing loss and disability, prevention of hearing loss and treatment to business and industry. They develop and oversee hearing conservation programs in industry. Further, doctors of audiology serve as expert witnesses within the boundaries of forensic audiology.

group of speech disorders caused by disturbances in the strength or coordination of the muscles of the speech mechanism as a result of damage to the brain or nerves.

any disturbance of balance.

disruption in the smooth flow or expression of speech.

distortion or absence of the sense of taste.

distortion or absence of the sense of smell.

difficulty swallowing.

any impairment of the voice or difficulty speaking.

partial loss of the ability to consistently pronounce words in individuals with normal muscle tone and coordination of the speech muscles.

abnormal muscle tone of one or more muscles.

presence and growth of bacteria or viruses in the ear.

yellow secretion from glands in the outer ear (cerumen) that keeps the skin of the ear dry and protected from infection.

The first positive wheal produced during IDT that initiates progressive whealing.

fluid in the labyrinth - the organ of balance located in the inner ear.

A division of plantlike organisms that includes molds and yeasts (Taber & Thomas, 1997).

A preservative contained in most antigen concentrations (extracts).

Application of an intradermal glycerin wheal containing no antigen at the same dilution number as an antigen.

act or sensation of tasting.

sensory cells of the inner ear, which are topped with hair-like structures (stereocilia), which transform the mechanical energy of sound waves into nerve impulses.

Seasonal allergic rhinitis caused by pollens of specific seasonal plants.

series of events in which sound waves in the air are converted to electrical signals that are sent as nerve impulses to the brain where they are interpreted.

electronic device that brings amplified sound to the ear.

disruption in the normal hearing process; sound waves are not converted to electrical signals and nerve impulses are not transmitted to the brain to be interpreted.

A substance in the body that exerts a pharmacologic action when released from injured cells (Taber & Thomas 1997). Many times, this type of reaction is noted as an inflammation on the skin in the form of a wheal.

Creation of a 4-mm wheal using dilute histamine to demonstrate a positive reaction in allergy testing to confirm the presence of an intact capability for a wheal and flare response (Derebery, 2006).

abnormally rough or harsh-sounding voice caused by vocal abuse and other disorders.

Abnormal sensitivity to a stimulus of any kind(Thomas, 1997). In allergy, it is an excessive reaction to a specific antigen.

diminished sensitivity to taste.

diminished sensitivity to smell.

A program designed to desensitize a patient to those substances to which the person is allergic.  Sterile extracts are prepared from allergy-producing substances, such as pollens, mold spores, house dust, and animal dander. The extract is introduced into the body on a regular schedule by either injection form (allergy shots) or sublingual drops.

Testing for allergies by testing of the blood.

A substance that enters the body through the respiratory system. Inhalant allergies are antigens that are breathed in through the nose/mouth.

part of the ear that contains both the organ of hearing (the cochlea) and the organ of balance (the labyrinth).

Another term for Intradermal testing (Derebery, 2006).

Injection of testing antigen just under the outermost layer of the epidermis to form a wheal (Derebery 2006).

organ of balance located in the inner ear. The labyrinth consists of three semicircular canals and the vestibule.

excessive fluid in the organ of balance (labyrinth) that can cause pressure or fullness in the ears, hearing loss, dizziness, and loss of balance.

viral or bacterial infection or inflammation of the inner ear that can cause dizziness, loss of balance, and temporary hearing loss.

A childhood disorder of unknown origin that can be identified by gradual or sudden loss of the ability to understand and use spoken language.

system for communicating ideas and feelings using sounds, gestures, signs, or marks.

problems with verbal communication and the ability to use or understand the symbol system for interpersonal communication.

abnormal growths in the larynx (voice box) that can be cancerous or noncancerous.

noncancerous, callous-like growths on the inner parts of the vocal folds (vocal cords).

loss of function or feeling of one or both of the vocal folds.

surgery to remove part or all of the larynx or voice box.

hoarse voice or the complete loss of the voice because of irritation to the vocal folds (vocal cords).

valve structure between the trachea (windpipe) and the pharynx (the upper throat) that is the primary organ of voice production.

a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

back portion of the temporal bone behind the ear.

surgical procedure to remove infection from the mastoid bone.

A movement disorder that can involve excessive eye blinking (blepharospasm) with involuntary movements of the jaw muscles, lips, and tongue (oromandibular dystonia).

inflammation of the meninges, the membranes that envelop the brain and the spinal cord; may cause hearing loss or deafness.

part of the ear that includes the eardrum and three tiny bones of the middle ear, ending at the round window that leads to the inner ear.

inaccurately produced speech sound (phoneme) or sounds.

Screening using multiple prick tests with confirmatory intradermal tests using the dilutions predicted by the prick test results to give quantitative results with increased efficiency (Derebery, 2006).

The growth of fungus on the surface of decaying of non-organic matter and/or parasitic or saprophytic fungi which causes molds. Many molds are potential inhalant allergens.

dizziness, sweating, nausea, vomiting, and generalized discomfort experienced when an individual is in motion.

group of disorders caused by the inability to accurately produce speech sounds (phonemes).

A prick-puncture test using a multipronged device to introduce multiple antigens with a single application. For example, using the “Multi-Test” applicator (Derebery, 2006).

An inner ear disorder that can affect both hearing and balance; can cause vertigo, hearing loss, tinnitus, and the sensation of fullness in the ear.

A skin test wheal made using only diluent without added antigens to rule out primary skin hypersensitivity (Derebery, 2006).

ability of the brain and/or certain parts of the nervous system to change in order to adapt to new conditions, such as an injury.

devices that substitute for an injured or diseased part of the nervous system to enhance the function.

to activate or energize a nerve through an external source.

a group of inherited disorders in which noncancerous tumors grow on several nerves that may include the hearing nerve.

inability to exchange information with others because of hearing, speech, and/or language problems caused by impairment of the nervous system.

hearing loss that is caused either by a one-time or repeated exposure to very loud sound(s) or sounds at various loudness levels over an extended period of time.

hearing loss or deafness that is inherited and is not associated with other inherited clinical characteristics.

These are low level, audio-frequency sounds that are produced by the cochlea as part of the normal hearing process. OAEs are a measure of pre-neural function in the inner ear that can be accessed using noninvasive techniques without sedation.

substance that stimulates the sense of smell.

the act of smelling.

device for estimating the intensity of the sense of smell.

understanding speech without visual clues.

inflammation of the outer part of the ear extending to the auditory canal.

inflammation of the middle ear caused by infection.

low-intensity sounds produced by the inner ear that can be quickly measured with a sensitive microphone placed in the ear canal.

physician/surgeon who specializes in diseases of the ears, nose, throat, and head and neck.

physician/surgeon who specializes in diseases of the ear.

abnormal growth of bone in the inner ear, which prevents structures within the ear from working properly, resulting in a gradual loss of hearing.

drugs that can damage the hearing and balance organs located in the inner ear.

external portion of the ear, consisting of the pinna, or auricle, and the ear canal.

any disease or perversion of the sense of smell, especially the subjective perception of odors that do not exist.

process of knowing or being aware of information through the ear.

Allergens that are present all year round, such as dust, mold, roaches, and so forth.

leakage of inner ear fluid to the middle ear that occurs without apparent cause or is associated with head trauma, physical exertion, or barotrauma.

study of speech sounds.

Pollen comes from the fertilization of flowering plants, including grasses, weeds, and trees, which make up potential allergen sources.

a computer-based imaging technique that uses radioactive substances to examine body processes. For example, a PET scan of the heart provides information about the flow of blood through the coronary arteries to the heart.

individual who becomes deaf after having learned language

individual who is either born deaf or who lost hearing early in childhood, before learning language.

loss of hearing that gradually occurs because of changes in the inner or middle ear in individuals as they grow older.

A puncture test where skin is pierced with a drop of antigen introducing it into the skin. Also called epicutaneous testing.

Short for radioallergosorbent, this is a blood test used to determine what a person is allergic to.

Irritation and inflammation of the nose.

membrane separating the middle ear and inner ear.

Skin end point titration.

hearing loss caused by damage to the sensory cells and/or nerve fibers of the inner ear

language of hand shapes, facial expressions, and movements used as a form of communication.

A vial of antigen containing extract for one allergy injection.

Also known as “prick testing,” skin testing is a series of pricks and/or scratches into the patient’s skin with small amounts of allergens. If the patient is allergic to the allergen, a visible inflammatory reaction will occur.

to perceive odor or scent through stimuli affecting the olfactory nerves.

inability to perceive odors that may be temporary or permanent.

ability to produce voice.

momentary disruption of voice caused by involuntary movements of one or more muscles of the larynx or voice box.

difficulty with the organized-symbol-system communication in the absence of problems such as mental retardation, hearing loss, or emotional disorders

making definite vocal sounds that form words to express thoughts and ideas.

defect or abnormality that prevents an individual from communicating by means of spoken words.

part of a cochlear implant that converts speech sounds into electrical impulses to stimulate the auditory nerve.

health professional trained to evaluate and treat people who have voice, speech, language, or swallowing disorders, including hearing impairment, that affect their ability to communicate.

frequent repetition of words or parts of words that disrupts the smooth flow of speech.

An alternative delivery of immunotherapy by using allergy extract drops under the tongue instead of traditional allergy shots (injections).

loss of hearing that occurs quickly from such causes as explosion, a viral infection, or the use of some drugs.

The physician does not have to be present in the room throughout the performance of allergy testing and treatment but must be present in the office suite and immediately available to furnish assistance and direction to the person performing the procedure (DHHS, 2001).

The procedure is furnished under the physician’s overall direction and control but the physician’s presence is not required during the performance of the procedure. Under general supervision, the physician trains the non-physician personnel to perform the diagnostic procedures and to maintain the necessary equipment and supplies (DHHS, 2001).

A physician must be in attendance in the room during the performance of the procedure (DHHS 2001).

any of a group of problems that interfere with the transfer of food from the mouth to the stomach.

hearing loss or deafness that is inherited or passed through generations of a family.

Certain foods that, when combined and eaten in the same meal, can cause an allergic reaction.

A reaction that can usually be identified when the patient has generalized itching of the skin, throat, or face, a mild cough, watering eyes, sneezing, sudden plugging of the nose, or mild case of hives due to being exposed to an allergen to which he is highly sensitive.

sensation produced by a stimulus applied to the gustatory nerve endings in the tongue; the four tastes are salt, sour, sweet, and bitter; some say there is a fifth taste described as savory.

groups of cells located on the tongue that enable one to recognize different tastes.

inability to perceive different flavors.

A tray that contains multiple antigens at different diluent (concentration) strengths used for allergy testing.

disorders or diseases of the larynx (voice box) or esophagus.

surgical technique to improve voice by altering the cartilages of the larynx. Also known as laryngeal framework surgery.

sensation of a ringing, roaring, or buzzing sound in the ears or head; often associated with various forms of hearing impairment.

The determination of quantity of antibody in an antiserum. A bioassay involving the application of progressively stronger antigen concentration to determine the point at which reactivity is first noted.

large muscle on the floor of the mouth that manipulates food for chewing and swallowing; the main organ of taste, and assists in forming speech sounds.

Neurological disorder characterized by recurring movements and sounds (called tics).

surgical opening into the trachea (windpipe) to help someone breathe who has an obstruction or swelling in the larynx (voice box) or upper throat.

Antigens in varying concentrations used to mixed patient extract.

surgical repair of the eardrum (tympanic membrane) or bones of the middle ear.

A hereditary disease that affects hearing and vision.

VEMP = vestibular evoked myogenic potential

The purpose of the VEMP is to determine if the saccule, one portion of the otoliths, as well as the inferior vestibular nerve and central connections, are intact and working normally. The saccule, which is the lower of the two otolithic organs, has a slight sound sensitivity that can be measured.

The uticle and saccule are sensory organs in the inner ears, which primarily respond to linear accelerations (up and down movement) such as orientation to gravity. However, the saccule is also sensitive to sound.

Information courtesy of Dr. Timothy Hain, M.D. www.dizziness-and-balance.com

VNG Testing includes the following battery of subtests:

Oculomotor Testing – These tests are performed with the patient sitting upright and looking at both stationary and moving lights across a screen. This is very comfortable and easy for the patient to perform.

Dix-Hall Pike/Positional Testing - The goal of positional testing is first to detect positional nystagmus, and if there is positional nystagmus, to determine if it is due to the ear (usually BPPV), brain (central positional nystagmus) or neck (cervical nystagmus).

Caloric testing – part of the VNG. This test is designed to measure the responses in the vestibular system and to determine how symmetric the responses are between the left and right ears. It is a test of the lateral semicircular canals; it does not test the vertical canal function or otolithic function.

illusion of movement; sensation that the external world is revolving around an individual (objective vertigo) or that the individual is revolving in space (subjective vertigo).

infection at the vestibular nerve.

system in the body that is responsible for maintaining the body's orientation in space, balance, and posture; also regulates locomotion and other movements and keeps objects in visual focus as the body moves.

bony cavity of the inner ear.

Treatment allergy extract vials are mixed specifically for patients per their testing results. Prior to giving a patient an injection with the new allergy extract, a “vial test” must be given to ensure the concentration of the antigen(s) is appropriate. This is done by performing an intradermal test producing a wheal. Vial testing is done before any new vial is used for immunotherapy.

mechanical instruments that help individuals who are deaf detect and interpret sound through the sense of touch.

inability of one or both vocal folds (vocal cords) to move because of damage to the brain or nerves.

muscularized folds of mucous membrane that extend from the larynx (voice box) wall; enclosed in elastic vocal ligament and muscle that control the tension and rate of vibration of the cords as air passes through them.

trembling or shaking of one or more of the muscles of the larynx resulting in an unsteady-sounding voice.

sound produced by air passing out through the larynx and upper respiratory tract.

group of problems involving abnormal pitch, loudness, or quality of the sound produced by the larynx (voice box).

Hereditary deafness that is characterized by hearing impairment, a white shock of hair, and/or distinctive blue color to one or both eyes, as well as wide-set inner corners of the eyes; balance problems are also associated with some types of Waardenburg syndrome.

An elevated area on the skin that determines whether the person has a positive reaction to a skin test. The more severe the allergy, the “bigger the wheal”.