- Pinna (auricle)
- The visible cartilaginous outer ear. It collects and funnels sound into the ear canal and aids sound localization, especially for high frequencies through spectral (pinna) cues.
- External auditory meatus
- The ear canal running from the concha to the tympanic membrane (~25 mm in adults). It channels sound, protects the eardrum, and provides a natural resonance that boosts gain near 2,700 Hz.
- Tympanic membrane
- The eardrum — a thin, cone-shaped membrane separating the outer and middle ear. It vibrates in response to sound and transmits that energy to the ossicular chain via the malleus.
- Ossicular chain
- The three middle-ear bones — malleus, incus, and stapes — that conduct vibration from the tympanic membrane to the oval window, providing impedance matching between air and cochlear fluid.
- Stapes
- The smallest bone in the body and the last ossicle; its footplate seats in the oval window and transmits vibration into the cochlear fluids. Stapes fixation causes conductive loss (otosclerosis).
- Impedance matching
- The middle ear's amplification (~30 dB) that overcomes the mismatch between air and cochlear fluid, mainly via the eardrum-to-oval-window area ratio (~17:1) and ossicular lever action.
- Eustachian tube
- The passage connecting the middle ear to the nasopharynx. It equalizes middle-ear pressure with ambient pressure; dysfunction causes negative pressure and Type C tympanograms or effusion.
- Cochlea
- The snail-shaped, fluid-filled inner-ear organ of hearing. It transduces mechanical vibration into neural signals and is tonotopically organized — high frequencies at the base, low at the apex.
- Organ of Corti
- The sensory epithelium on the basilar membrane containing inner and outer hair cells. It transduces basilar-membrane motion into neural activity in the auditory (VIIIth) nerve.
- Inner hair cells
- The primary sensory receptors of hearing; roughly one row of ~3,500 cells that synapse with ~90-95% of afferent auditory-nerve fibers and carry the main signal to the brain.
- Outer hair cells
- Three rows of motile cells that act as the cochlear amplifier, sharpening frequency tuning and boosting sensitivity by ~40-50 dB. Their motility generates otoacoustic emissions.
- Basilar membrane
- The membrane within the cochlea that vibrates as a traveling wave; its graded stiffness creates tonotopy — stiff/narrow base for high frequencies, floppy/wide apex for low frequencies.
- Tonotopic organization
- The orderly frequency-to-place mapping preserved from the cochlea through the central auditory pathways, with high frequencies at the cochlear base and low frequencies at the apex.
- Endocochlear potential
- The +80 mV resting potential of the scala media (endolymph), maintained by the stria vascularis. It powers hair-cell transduction; its loss reduces cochlear sensitivity.
- Endolymph
- The potassium-rich fluid filling the scala media (cochlear duct) and the membranous labyrinth. Its high K+ concentration drives hair-cell depolarization during transduction.
- Perilymph
- The sodium-rich fluid (similar to other extracellular fluids) filling the scala vestibuli and scala tympani, surrounding the membranous labyrinth and conducting the traveling wave.
- Auditory (VIIIth) nerve
- The vestibulocochlear nerve carrying afferent auditory signals from the cochlea to the cochlear nucleus. Retrocochlear lesions (e.g., vestibular schwannoma) affect its function.
- Central auditory pathway
- The ascending route from cochlear nucleus to superior olivary complex, lateral lemniscus, inferior colliculus, medial geniculate body, and auditory cortex; supports binaural and complex processing.
- Superior olivary complex
- The first brainstem site receiving binaural input; it computes interaural time and level differences for sound localization and mediates the acoustic reflex pathway.
- Vestibular system
- The balance organs of the inner ear — three semicircular canals (angular acceleration) and two otolith organs, the utricle and saccule (linear acceleration and gravity).
- Semicircular canals
- Three roughly orthogonal fluid-filled loops (anterior, posterior, horizontal) that sense angular (rotational) head acceleration via endolymph movement bending the cupula.
- Otolith organs
- The utricle and saccule, which sense linear acceleration and head tilt relative to gravity using calcium-carbonate crystals (otoconia) on a gelatinous macula.
- Frequency
- The number of cycles of a sound wave per second, measured in hertz (Hz); it corresponds to perceived pitch. The audiogram tests roughly 250-8,000 Hz.
- Intensity
- The amount of acoustic energy in a sound, related to perceived loudness and expressed on the decibel scale; doubling distance from a point source reduces intensity by ~6 dB.
- Decibel (dB)
- A logarithmic ratio unit for sound: dB=20log10(P0P) for pressure. A 10× pressure increase equals 20 dB.
- dB SPL
- Sound pressure level referenced to 20μPa, the physical (absolute) decibel scale used to calibrate equipment and describe environmental sound.
- dB HL
- Hearing level — the audiometric scale referenced to average normal-hearing thresholds, so 0 dB HL is normal at each frequency. Audiograms are plotted in dB HL.
- dB SL
- Sensation level — decibels above an individual listener's own threshold for a stimulus. A presentation at 40 dB SL is 40 dB above that person's threshold.
- Acoustic impedance
- The opposition to the flow of acoustic energy through the middle-ear system, governed by mass, stiffness, and friction. Tympanometry measures changes in admittance (its reciprocal).
- Resonance
- The frequency at which a system vibrates most readily. Ear-canal resonance (~2,700 Hz) and middle-ear resonance shape the frequency response and natural amplification of the auditory system.
- Psychoacoustics
- The study of the relationship between physical sound properties and their perception — pitch, loudness, timbre, masking, and localization.
- Loudness
- The perceptual correlate of intensity; it grows nonlinearly with sound pressure. Recruitment is the abnormally rapid growth of loudness seen in cochlear hearing loss.
- Pitch
- The perceptual correlate of frequency, encoded by cochlear place (tonotopy) and the temporal firing pattern (phase locking) of auditory-nerve fibers.
- Temporal bone
- The skull bone housing the entire auditory and vestibular peripheral apparatus, including the external canal, middle-ear cavity, and the otic capsule of the inner ear.
- Conductive hearing loss
- Loss from an outer- or middle-ear problem blocking sound conduction. The audiogram shows normal bone conduction, reduced air conduction, and an air-bone gap.
- Sensorineural hearing loss
- Loss from cochlear (sensory) or auditory-nerve (neural) damage. Air and bone conduction are reduced together with no significant air-bone gap.
- Mixed hearing loss
- A combination of conductive and sensorineural components: both air and bone conduction are reduced, with an air-bone gap reflecting the conductive part.
- Presbycusis
- Age-related sensorineural hearing loss, typically bilateral, symmetric, and most pronounced in the high frequencies, often with disproportionate difficulty understanding speech in noise.
- Ototoxicity
- Damage to the cochlea or vestibular system from drugs such as aminoglycoside antibiotics, platinum-based chemotherapy (cisplatin), loop diuretics, and high-dose aspirin.
- Otosclerosis
- Abnormal bony remodeling of the otic capsule that fixes the stapes footplate, producing progressive conductive (sometimes mixed) loss, often with a Carhart notch at 2,000 Hz.
- Universal newborn hearing screening
- A program to screen every newborn's hearing before discharge, using OAEs and/or automated ABR to detect congenital hearing loss early; mandated in most U.S. states.
- EHDI
- Early Hearing Detection and Intervention — the public-health framework following the 1-3-6 benchmarks: screen by 1 month, diagnose by 3 months, enroll in intervention by 6 months.
- 1-3-6 guideline
- The EHDI benchmark: hearing screening by age 1 month, audiologic diagnosis by 3 months, and early intervention enrollment by 6 months for infants with hearing loss.
- Otoacoustic emissions screening
- A fast, non-invasive newborn screen that measures sounds produced by healthy outer hair cells; absent emissions flag possible loss but cannot detect neural (retrocochlear) problems.
- Automated ABR (AABR)
- An automated auditory brainstem response screen using a fixed level (often 35 dB nHL); it detects neural conduction problems including auditory neuropathy that OAEs miss.
- Auditory neuropathy spectrum disorder
- A condition with present OAEs but absent/abnormal ABR, reflecting normal outer-hair-cell function with disrupted neural transmission; why NICU infants are screened with AABR.
- Hearing conservation program
- An OSHA-required program triggered at an 85 dBA 8-hour TWA, including noise monitoring, audiometric testing, hearing protection, training, and recordkeeping.
- OSHA permissible exposure limit
- The OSHA limit of 90 dBA as an 8-hour time-weighted average, using a 5 dB exchange rate; the action level for a conservation program is 85 dBA.
- NIOSH recommended exposure limit
- The NIOSH-recommended limit of 85 dBA as an 8-hour time-weighted average using a more protective 3 dB exchange rate.
- Exchange rate
- The increase in noise level that halves the allowable exposure time. OSHA uses 5 dB; NIOSH uses 3 dB, which is based on equal-energy principles.
- Noise-induced hearing loss
- Sensorineural loss from excessive noise, classically showing a 'noise notch' at 3,000-6,000 Hz (often 4,000 Hz) with recovery at 8,000 Hz; preventable with hearing protection.
- Standard threshold shift
- Under OSHA, an average shift of 10 dB or more at 2,000, 3,000, and 4,000 Hz in either ear relative to the baseline audiogram, triggering follow-up action.
- Hearing protection devices
- Earplugs and earmuffs rated by a Noise Reduction Rating (NRR) that attenuate noise reaching the ear; proper fit and consistent use are essential to real-world protection.
- Ototoxicity monitoring
- Serial audiologic testing (including high-frequency audiometry and OAEs) before and during treatment with ototoxic drugs to detect early changes and inform clinical decisions.
- Cerumen management
- Audiologist removal of impacted earwax (within scope of practice) via curette, irrigation, or suction, when it blocks the canal, testing, or device fitting and no contraindication exists.
- Tinnitus
- The perception of sound (ringing, buzzing) without an external source. It often accompanies hearing loss and noise exposure and is assessed by pitch/loudness matching and self-report measures.
- Risk indicators for hearing loss
- JCIH factors prompting monitoring even with a passed screen — NICU stay, family history, in-utero infections (CMV), craniofacial anomalies, syndromes, and ototoxic exposure.
- Pure-tone screening
- A pass/refer screen presenting tones at a fixed level (commonly 20 dB HL) at selected frequencies (1,000/2,000/4,000 Hz) to identify those needing full evaluation.
- School hearing screening
- Periodic pass/refer screening of school-age children to identify hearing loss affecting learning, typically at 20 dB HL across mid-to-high frequencies.
- Audiometric baseline
- The reference audiogram (obtained after a quiet period) against which future tests are compared in a conservation program to detect a standard threshold shift.
- Pure-tone audiometry
- The core behavioral test measuring hearing thresholds for pure tones by air and bone conduction, plotted on the audiogram in dB HL across 250-8,000 Hz.
- Air conduction
- Threshold testing through earphones or inserts; the signal travels the whole pathway (outer, middle, inner ear, nerve), so it reflects the total amount of hearing loss.
- Bone conduction
- Threshold testing via a bone oscillator on the mastoid/forehead that bypasses the outer and middle ear to stimulate the cochlea directly, isolating the sensorineural component.
- Air-bone gap
- The difference (in dB) between air- and bone-conduction thresholds at a frequency; a gap of ≥10 dB indicates a conductive component.
- Masking
- Presenting noise to the non-test ear to keep it from responding, preventing crossover when the test signal could be heard by the better ear (cross-hearing).
- Interaural attenuation
- The energy lost as sound crosses the skull to the other cochlea — roughly 40 dB for supra-aural earphones, 0 dB for bone conduction, and higher for inserts.
- Pure-tone average (PTA)
- The average of air-conduction thresholds at 500, 1,000, and 2,000 Hz; it summarizes hearing for the speech range and should agree closely with the SRT.
- Speech recognition threshold (SRT)
- The lowest level (dB HL) at which a listener correctly repeats ~50% of spondee words; it cross-checks the pure-tone average, which it should be within ~6-7 dB of.
- Word recognition score (WRS)
- The percentage of phonetically balanced monosyllabic words correctly repeated at a suprathreshold level; it gauges clarity/speech understanding, separate from sensitivity.
- Spondee words
- Two-syllable words with equal stress (e.g., 'baseball,' 'hotdog') used to establish the speech recognition threshold because their familiarity and energy make them easy to score.
- Speech detection threshold
- The lowest level at which a listener can just detect (not identify) the presence of speech, typically ~8-9 dB better than the SRT; used when SRT can't be obtained.
- Most comfortable loudness level
- The intensity at which speech is judged most comfortable; often used as a presentation level for word-recognition testing and device fitting decisions.
- Uncomfortable loudness level (UCL/LDL)
- The level at which sound becomes uncomfortably loud; it sets the upper limit of the dynamic range and guides hearing-aid output limiting (MPO).
- Dynamic range
- The span between threshold (SRT) and the uncomfortable loudness level; a narrowed dynamic range, common in cochlear loss with recruitment, complicates amplification.
- Performance-intensity function
- A plot of word-recognition score versus presentation level; rollover (a drop in score at high levels) suggests a retrocochlear (VIIIth-nerve) site of lesion.
- Rollover
- A decrease in word-recognition score at high presentation levels after a peak; a rollover index above ~0.45 raises suspicion of a retrocochlear lesion.
- Immittance audiometry
- A battery (tympanometry plus acoustic reflexes) assessing middle-ear status objectively by measuring sound energy flow as ear-canal pressure is varied.
- Tympanometry
- An objective test of middle-ear function that plots admittance as ear-canal pressure sweeps from positive to negative, yielding a tympanogram type.
- Type A tympanogram
- A normal tympanogram with a peak admittance near 0 daPa and normal compliance, indicating normal middle-ear pressure and mobility.
- Type As tympanogram
- A shallow (low-amplitude) tympanogram with a normal-pressure peak, indicating a stiff/fixed system such as otosclerosis or a thickened tympanic membrane.
- Type Ad tympanogram
- A deep (high-amplitude) tympanogram with a normal-pressure peak, indicating a hypermobile system such as ossicular discontinuity or a monomeric eardrum.
- Type B tympanogram
- A flat tympanogram with no clear peak. With normal canal volume it suggests effusion/fluid; with large volume it suggests a perforation or patent PE tube.
- Type C tympanogram
- A tympanogram with a peak at significantly negative pressure (more negative than ~ −150 daPa), indicating Eustachian-tube dysfunction with negative middle-ear pressure.
- Equivalent ear-canal volume
- The estimated volume of air between the probe tip and eardrum; an abnormally large value with a flat tympanogram suggests perforation or an open ventilation tube.
- Acoustic reflex
- The reflexive contraction of the stapedius muscle to loud sound, with thresholds normally near 70-100 dB HL (about 85 dB SL above threshold); its presence, absence, decay, and ipsi/contra thresholds help localize lesions in the auditory pathway.
- Acoustic reflex threshold
- The lowest level eliciting a measurable stapedial reflex; elevated or absent reflexes point to conductive loss, significant cochlear loss, or retrocochlear/facial-nerve involvement.
- Acoustic reflex decay
- Sustained 10-second stimulation (usually 500/1,000 Hz at 10 dB above reflex threshold); reflex amplitude falling to half within 5 seconds suggests a retrocochlear lesion.
- Wideband acoustic immittance
- A newer immittance method measuring middle-ear energy absorbance across a broad frequency range, offering more detailed information than single-frequency tympanometry.
- Otoacoustic emissions (OAEs)
- Low-level sounds generated by healthy outer hair cells, recorded in the ear canal; they objectively confirm cochlear (outer-hair-cell) function and are absent with >~30-40 dB loss.
- Transient-evoked OAEs (TEOAEs)
- OAEs elicited by brief clicks, providing a broadband check of outer-hair-cell function; widely used in newborn screening for a pass/refer outcome.
- Distortion-product OAEs (DPOAEs)
- OAEs evoked by two simultaneous tones (f1, f2); the cochlea generates a distortion product (often 2f1−f2), allowing frequency-specific outer-hair-cell assessment to higher frequencies.
- Auditory brainstem response (ABR)
- An auditory evoked potential reflecting synchronous neural firing from the VIIIth nerve through the brainstem, used for threshold estimation and neurodiagnostic site-of-lesion testing.
- Wave V
- The most robust and latest ABR peak, generated near the lateral lemniscus/inferior colliculus; its presence at low levels is the key marker for ABR threshold estimation.
- ABR threshold estimation
- Lowering stimulus level until Wave V disappears to estimate hearing thresholds objectively, essential for infants and difficult-to-test patients (the EHDI diagnostic tool).
- Neurodiagnostic ABR
- High-level ABR analyzing absolute and interaural Wave-V latencies and interwave intervals (I-III, III-V, I-V) to screen for retrocochlear pathology such as vestibular schwannoma.
- Auditory steady-state response (ASSR)
- An evoked potential to modulated tones that yields frequency-specific, automated threshold estimates; complements ABR, especially for severe-to-profound losses.
- Electrocochleography (ECochG)
- Recording of early cochlear/VIIIth-nerve potentials (cochlear microphonic, summating potential, action potential); an elevated SP/AP ratio supports endolymphatic hydrops/Ménière disease.
- Cochlear microphonic
- An AC receptor potential mirroring the stimulus waveform, generated mainly by outer hair cells; its presence with absent ABR is a hallmark of auditory neuropathy.
- Visual reinforcement audiometry (VRA)
- A behavioral pediatric method (~6 months-2.5 years) that conditions an infant to turn toward sound, rewarding correct head-turns with an animated visual reinforcer.
- Conditioned play audiometry (CPA)
- A behavioral method for toddlers/preschoolers (~2.5-5 years) who perform a play task (e.g., drop a block) each time a tone is heard, yielding ear- and frequency-specific thresholds.
- Behavioral observation audiometry (BOA)
- Observing unconditioned reflexive responses (startle, eye-widening, cessation of activity) to sound in very young infants; least reliable, now largely supplemented by physiologic tests.
- Audiogram
- The graph plotting hearing thresholds (dB HL on the y-axis, increasing downward) against frequency (Hz on the x-axis), with standard symbols for right/left and air/bone.
- Audiogram symbols
- O = right air conduction, X = left air conduction, < = right bone (unmasked), > = left bone; brackets/[ ] and triangles indicate masked thresholds; arrows mean no response.
- Degree of hearing loss
- Severity by threshold: normal (≤25 dB), mild (26-40), moderate (41-55), moderately severe (56-70), severe (71-90), and profound (>90 dB HL).
- Configuration of hearing loss
- The shape of the audiogram across frequency — flat, sloping (worse highs), rising (worse lows), cookie-bite (mid-frequency), or notched (noise/ototoxic).
- Cross-hearing
- When a signal presented to the test ear is loud enough to be perceived by the non-test cochlea; masking the non-test ear prevents this artifact (the 'shadow curve').
- Stenger test
- A test for unilateral nonorganic (functional) loss using simultaneous tones in both ears; a positive Stenger reveals exaggerated thresholds in the 'poorer' ear.
- Vestibular assessment
- A battery (VNG/ENG, rotary chair, VEMP, vHIT, posturography) evaluating the peripheral and central balance systems and the vestibulo-ocular reflex.
- Videonystagmography (VNG)
- A battery using video goggles to record eye movements during oculomotor, positional, and caloric testing to identify peripheral vs central vestibular dysfunction.
- Electronystagmography (ENG)
- Eye-movement recording via electrodes around the eyes (corneo-retinal potential) during the same battery as VNG; VNG has largely replaced it for most patients.
- Caloric testing
- Irrigating each ear with warm and cool stimuli to assess the horizontal canal; a side-to-side difference (unilateral weakness) localizes a peripheral vestibular deficit.
- Rotary chair testing
- Rotating the patient in darkness to test the horizontal vestibulo-ocular reflex across frequencies; valuable for bilateral vestibular loss and pediatric assessment.
- Vestibular evoked myogenic potentials (VEMP)
- Reflexive muscle responses to loud sound/vibration assessing otolith pathways: cervical VEMP tests the saccule/inferior nerve, ocular VEMP the utricle/superior nerve.
- Video head impulse test (vHIT)
- A bedside test recording eye and head velocity during rapid head thrusts to measure VOR gain and detect corrective (catch-up) saccades for each semicircular canal.
- Dix-Hallpike maneuver
- A positional test that provokes torsional/up-beating nystagmus to diagnose posterior-canal benign paroxysmal positional vertigo (BPPV).
- Posturography
- Computerized dynamic posturography measures postural sway under varied visual/support conditions to assess how a patient uses sensory inputs for balance.
- Otoscopy
- Visual inspection of the ear canal and tympanic membrane before testing, to identify cerumen, foreign bodies, perforations, or pathology and to clear the canal for accurate results.
- Speech-in-noise testing
- Tests (e.g., QuickSIN) measuring the signal-to-noise ratio needed to understand speech in background noise — a real-world complaint not captured by quiet-room WRS.
- Auditory processing disorder
- A deficit in the central processing of auditory information despite normal peripheral hearing, assessed with dichotic, temporal, and degraded-speech tests.
- Tinnitus assessment
- Quantifying tinnitus via pitch matching, loudness matching, minimum masking level, and residual inhibition, alongside validated questionnaires (e.g., the Tinnitus Handicap Inventory).
- Loudness discomfort level testing
- Measuring the level at which sound becomes uncomfortable, to characterize reduced sound tolerance (hyperacusis) and to set device output limits.
- Calibration
- Verifying that audiometric equipment delivers correct frequency and intensity to ANSI standards; biological and electroacoustic checks ensure valid, reproducible thresholds.
- Insert earphones
- Foam-tip earphones offering higher interaural attenuation (reducing masking needs), better infection control, and reduced collapsing-canal artifact versus supra-aural phones.
- Bone-conduction occlusion effect
- An apparent improvement in low-frequency bone thresholds when the non-test ear is occluded by a masking earphone; clinicians account for it during masked bone testing.
- Carhart notch
- A characteristic dip in bone-conduction thresholds around 2,000 Hz seen in otosclerosis; it is a mechanical artifact that typically resolves after successful stapes surgery.
- Cochlear dead region
- A cochlear area with non-functioning inner hair cells/neurons; identified with the TEN test, it informs whether amplifying those frequencies helps or harms speech understanding.
- Acoustic reflex pattern analysis
- Comparing ipsilateral and contralateral reflexes across ears to localize lesions to the middle ear, cochlea, VIIIth nerve, brainstem, or facial nerve.
- Real-ear-to-coupler difference
- (RECD) The measured difference between a real ear and a 2-cc coupler; used to individualize fitting, especially for children with small ear canals, without behavioral measures.
- Self-report outcome measures
- Validated questionnaires (e.g., APHAB, COSI, HHIE) capturing patient-perceived hearing difficulty and benefit to integrate function with audiometric data.
- Sensation level for testing
- Presenting speech-recognition material at a fixed level above the SRT (often 30-40 dB SL) to reach the plateau of the performance-intensity function for the best score.
- Hearing aid
- An electronic device that amplifies and shapes sound to compensate for hearing loss; core components are a microphone, amplifier/digital processor, receiver, and battery.
- Behind-the-ear (BTE)
- A hearing-aid style with the components in a case behind the ear coupled to the canal by tubing and an earmold; versatile and suitable for a wide range of losses, including severe.
- Receiver-in-canal (RIC)
- A BTE variant placing the receiver in the ear canal connected by a thin wire; offers a discreet fit, open coupling, and reduced occlusion for mild-to-moderate losses.
- In-the-ear (ITE)
- A custom hearing aid filling the concha; larger than canal styles, easier to handle, and able to house more features and a larger battery.
- Completely-in-canal (CIC)
- A small custom aid seated deep in the canal for cosmetic discretion; limited gain/output and features, best for mild-to-moderate losses.
- Microphone
- The hearing-aid input transducer converting acoustic sound to an electrical signal; directional microphone arrays improve the signal-to-noise ratio in noise.
- Receiver (hearing aid)
- The output transducer (a miniature loudspeaker) that converts the amplified electrical signal back to sound delivered to the ear canal.
- Earmold
- The custom-fit piece coupling a BTE to the ear; its style and venting affect retention, acoustics, occlusion, and feedback, and can shape the frequency response.
- Venting
- A bore drilled in an earmold/dome that lets low-frequency sound and pressure escape, reducing the occlusion effect at the cost of more potential feedback and less low-frequency gain.
- Occlusion effect
- The hollow, 'in-a-barrel' perception of one's own voice when the ear canal is blocked by a mold; minimized with venting or open fittings.
- Open fitting
- A non-occluding coupling (open dome) that leaves the canal largely open, ideal for normal/near-normal low-frequency hearing; reduces occlusion but limits low-frequency gain.
- Prescriptive fitting target
- A validated formula (e.g., NAL-NL2 for adults, DSL v5.0 for children) prescribing gain and output by frequency for the patient's audiogram and age.
- NAL-NL2
- A prescriptive formula from the National Acoustic Laboratories aimed at maximizing speech intelligibility while keeping overall loudness comfortable, common for adults.
- DSL v5.0
- The Desired Sensation Level formula, often preferred for children; it targets audibility across a wide input range and is paired with RECD-based fitting.
- Real-ear measurement
- (REM/probe-microphone) Measuring actual sound levels in the patient's ear canal to verify a hearing aid meets prescriptive targets across frequencies — the fitting gold standard.
- Verification
- Objectively confirming a device performs as intended — e.g., REM matching prescriptive targets and electroacoustic analysis — done before the patient relies on it.
- Validation
- Confirming real-world benefit and patient satisfaction using outcome measures (self-report questionnaires, aided speech testing) after the fitting.
- Electroacoustic analysis
- Test-box measurement of a hearing aid's gain, output (OSPL90), frequency response, distortion, and noise against ANSI specifications for quality control.
- Compression
- Nonlinear amplification (WDRC) that gives more gain to soft sounds and less to loud, packing a wide range of inputs into the listener's reduced dynamic range.
- Maximum power output
- (OSPL90/MPO) The highest sound level a hearing aid can produce; it is set below the patient's uncomfortable loudness level to protect against overly loud sounds.
- Directional microphones
- Multi-microphone arrays that emphasize sounds from the front and attenuate those from behind/sides, improving speech understanding in noise.
- Feedback management
- Algorithms that suppress the whistling caused by amplified sound leaking back to the microphone, allowing more gain and more open fittings.
- Telecoil
- A small induction coil in a hearing aid that picks up magnetic signals from telephones and hearing loops, delivering clearer sound by bypassing room acoustics.
- Cochlear implant
- A surgically implanted device that bypasses damaged hair cells and electrically stimulates the auditory nerve via an electrode array for severe-to-profound sensorineural loss.
- Cochlear implant components
- An external microphone/sound processor and transmitting coil, plus an internal receiver-stimulator and intracochlear electrode array that stimulates auditory-nerve fibers tonotopically.
- Cochlear implant candidacy
- Determined by severe-to-profound sensorineural loss with limited aided word recognition; criteria have broadened to include children under 12 months and asymmetric/single-sided deafness.
- Bone-anchored hearing device
- An osseointegrated implant that transmits sound via direct bone conduction, indicated for conductive/mixed loss, chronic ear disease, or single-sided deafness.
- Bimodal hearing
- Using a cochlear implant in one ear and a hearing aid in the other to combine electric and acoustic hearing for better localization and speech in noise.
- Assistive listening device
- (ALD) Equipment improving access beyond hearing aids — remote-microphone (FM/DM) systems, loops, infrared, captioning, and alerting devices.
- FM/DM system
- A remote-microphone system placing the talker's mic near the source and streaming wirelessly to the listener, dramatically improving the signal-to-noise ratio at distance and in noise.
- Hearing loop
- (Induction loop) A wire encircling a room that transmits an audio signal magnetically to telecoil-equipped hearing aids/implants, delivering clear sound directly to the user.
- Aural rehabilitation
- A patient-centered program — amplification, auditory training, communication-strategy instruction, and counseling — to reduce the impact of hearing loss on daily life.
- Auditory training
- Structured listening practice to improve perception of speech and sound, especially for new cochlear-implant users and listening in noise.
- Communication strategies
- Techniques taught to patients and partners — facing the talker, reducing background noise, asking for rephrasing, anticipatory and repair strategies — to ease conversation.
- Speechreading
- Using visual cues from lips, face, and gestures to supplement degraded auditory speech information; trained as part of aural rehabilitation.
- Counseling (audiology)
- Informational and emotional support helping patients and families accept hearing loss, set realistic expectations, build motivation, and adjust psychosocially.
- Tinnitus management
- Evidence-based approaches including sound therapy, hearing aids, cognitive-behavioral elements, and Tinnitus Retraining Therapy (TRT) combining sound enrichment with directive counseling.
- Tinnitus Retraining Therapy
- (TRT) A management approach pairing low-level sound enrichment with directive counseling to promote habituation of the tinnitus signal and its emotional reaction.
- Sound therapy
- Using low-level background or masking sound to reduce tinnitus prominence and promote habituation, often delivered through hearing aids or dedicated generators.
- Pediatric (re)habilitation
- Family-centered intervention promoting listening and spoken-language or signed development, early amplification/implantation, and coordination with early-intervention and education teams.
- LSL (listening and spoken language)
- An intervention approach developing spoken language through listening for children with hearing loss, relying on early, well-fit amplification and family coaching.
- Frequency lowering
- A hearing-aid feature shifting/compressing high-frequency energy into lower regions where hearing is better, improving audibility of cues like /s/ for steep high-frequency losses.
- Loudness-discomfort-based output
- Setting a hearing aid's maximum output just below the patient's uncomfortable loudness level so amplified sound stays audible but never painfully loud.
- Hearing aid orientation
- Teaching the new user insertion/removal, battery handling, cleaning, controls, and realistic adaptation expectations to support successful, consistent use.
- Remote microphone benefit
- The large signal-to-noise-ratio improvement from placing a microphone near the talker; the single most effective intervention for understanding speech at a distance and in noise.
- Dome (hearing aid)
- The soft tip on a RIC/receiver coupling the device to the canal; open, closed, or power domes are chosen to balance audibility, occlusion, and feedback.
- Treatment plan
- An individualized plan integrating assessment results and patient preferences into short- and long-term goals for amplification and rehabilitation, revised with outcome data.
- Verification before validation
- Best practice sequencing: first verify the device meets electroacoustic/REM targets, then validate functional benefit with the patient before finalizing the fitting.
- Single-sided deafness management
- Options for one profoundly deaf ear with normal hearing in the other: CROS hearing aids, bone-conduction devices, or a cochlear implant in the deaf ear.
- CROS hearing aid
- (Contralateral Routing of Signal) Routes sound from a non-usable ear to the better ear, helping patients with single-sided deafness hear from their poorer side.
- ASHA Code of Ethics
- The ethical framework for audiologists/SLPs built on four principles: responsibility to persons served, to achieving/maintaining competence, to the public, and to professional relationships.
- Principle of Ethics I
- The ASHA principle that practitioners hold paramount the welfare of persons served professionally and treat participants in research and teaching with honesty and compassion.
- Scope of practice (audiology)
- The ASHA-defined range of audiology activities — prevention, identification, assessment, and (re)habilitation of auditory and vestibular disorders — within which a clinician must work.
- Certificate of Clinical Competence (CCC-A)
- ASHA's credential for audiologists, requiring a qualifying degree, supervised clinical experience, and a passing score on the Praxis Audiology (5343) examination.
- Informed consent
- The process of giving patients adequate information about procedures, risks, benefits, and alternatives so they can voluntarily agree before evaluation or treatment.
- Confidentiality
- The ethical and legal duty (reinforced by HIPAA) to protect patient health information and disclose it only with consent or as permitted by law.
- HIPAA
- The Health Insurance Portability and Accountability Act, which sets federal standards for protecting the privacy and security of patients' protected health information.
- Evidence-based practice
- Integrating the best available external research evidence with clinical expertise and patient values/preferences to guide audiologic decisions.
- Cultural competence
- Delivering services responsive to patients' cultural and linguistic backgrounds, using qualified interpreters and culturally appropriate, valid assessment and counseling.
- Documentation
- Accurate, timely recordkeeping of history, procedures, results, recommendations, and communications, supporting continuity of care, billing, and legal accountability.
- Scope-of-competence referral
- The ethical duty to refer when a patient's needs fall outside one's competence or scope, ensuring care is provided by an appropriately qualified professional.
- Infection control
- Standard precautions — hand hygiene, gloves, and disinfection/sterilization of probes, tips, and surfaces — to prevent cross-contamination during otologic procedures.
- Conflict of interest
- A situation where personal or financial interests could improperly influence professional judgment (e.g., dispensing); ethics require disclosure and prioritizing patient welfare.
- Supervision (audiology)
- Oversight of students, externs, and support personnel consistent with ASHA standards and state rules; the supervising audiologist retains responsibility for patient care.
- IDEA
- The Individuals with Disabilities Education Act, ensuring children with disabilities (including hearing loss) receive a free appropriate public education with an IEP/IFSP.
- ADA
- The Americans with Disabilities Act, prohibiting disability discrimination and requiring effective communication access and reasonable accommodations for people with hearing loss.
- Interprofessional practice
- Collaboration among audiologists, physicians, educators, SLPs, and others, sharing information (with consent) to coordinate patient-centered care.
- Professional liability
- Accountability for one's clinical actions; practicing within scope, maintaining competence, and documenting properly reduce malpractice/negligence risk.
- Research ethics (IRB)
- Standards protecting human research participants — Institutional Review Board oversight, informed consent, and minimizing harm — that audiologists conducting research must follow.
- Continuing education
- Ongoing professional development required to maintain ASHA certification and state licensure, ensuring competence keeps pace with evolving evidence and technology.