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WHICH ONE IS MORE BETTER HEADPHONE, INSERT-PHONE OR FREE FIELD???

Hi I'm back again,

Today I want to share about the selection of appropriate transducer during pure tone audiometry test (PTA) based on my experience in UKM Audiology Clinic.

Basically, our PTA have 3 different types of transducer that we can use in measuring the patient's hearing level (headphone, insert phone and free field). But, how we can choose the best transducer during the hearing test?

Note: Always be flexible in selecting your transducer and you must have a good reason why you choose that transducer in planning your test.

Please choose the headphone as your transducer if you face the situation below:


1) Patient with presented of ear canal atresia or anotia as well as severe ear canal stenosis.


2) Patient with revealed of excessive earwax.

3) Patient with active otitis media.

4) Patient with complaint of earpain or diagnosed with otitis externa.

5) Patient did not want to wear insert phone especially pediatric case. In some pediatric cases, they feel comfortable as fit with earphone even though we learn that insert phone is the comfortable transducer for most pediatric cases.

Please choose the insert phone if you face the situation below:

1) All cases with normal structure of outer ear.

2) Patient with presented of collapsing ear canal especially in elderly cases.


COLLAPSING EAR CANAL
3) Patient with small or abnormal structure of head that prevent us to use headphone as a transducer.

4) Pediatric cases as the insert phone give greater subject comfort.




Please choose the free field if:

1) Patient reluctant to use both headphone and insert phone especially non cooperative children.

2) To get the aided thresholds for the patient with hearing aids or cochlear implants.

3) Sometimes is good to condition the child using the free field first in order to show the parents how to get their children's hearing thresholds. 





 

References: 
1) Gelfand, S. (2009). Essentials of Audiology. (3rd Edition). New York, NY: Thieme. 
2) Katz, J., Medwetsky, L., Burkard, R. & Hood, L. (2009).Handbook of Clinical Audiology (6thEdition).Baltimore, MD: Lippincott, Williams and Wilkins.
3) http://www.rcsullivan.com/www/ears.htm#13.10

 








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