2022 Early Hearing Detection & Intervention Virtual Conference

March 13 - 15, 2022

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10/27/2019  |   8:00 AM - 10:00 AM   |  Impact of Ambient Noise on Hearing Screening   |  La Paz Room, Memorial Union

Impact of Ambient Noise on Hearing Screening

There is a trend toward point of care audiological testing that is performed outside of a sound proof booth. Such strategies are particularly suited to low resource environments, where audiological facilities are limited and care often must be provided in remote settings. The authors will review the ambient noise challenges of screening pure tone threshold exams in 1350 schoolchildren in rural Nicaragua. Optimal noise management was able only to reduce the pre-testing noise level to 48 dBA. Moreover, transient noise contamination during testing reached much high levels that affect test results. Strategies for reducing ambient noise effects will be discussed. Alternatives to pure tone testing include with speech in noise testing methodology, including digits in noise testing where a triplet of numbers in presented over a background noise level. Because this method utilizes background noise in the testing paradigm, it is presumed to be relatively impervious to ambient noise levels. We will discuss the utility of these methods in high ambient noise environments.

  • Describe the challenges of managing ambient noise in point of care hearing testing
  • Discuss the potential effects of ambient noise on speech in noise testing

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Presenters/Authors

Diana Lee (), Geisel School of Medicine at Dartmouth , Diana.Y.Lee.MED@dartmouth.edu;
Diana Lee is a student at Geisel School of Medicine at Dartmouth


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Isabelle Magro (), Giesel Medical School at Dartmouth, Isabelle.L.Magro.MED@Dartmouth.edu;
Fourth year Medical student in Otolaryngology


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Karen Mojica Alvarez (), Mayflower Medical Outreach, kmmojica@yahoo.com;
I am a Vice -president of Nicaraguan Association of Otolaryngology , Associate Professor at University of TrĂ³pico Seco and volunteer professor at the Lenin Hospital 2009-2014. I completed an M.D at National Autounomus University of Nicaragua, residency and research fellowship at Lenin Fonseca Hospital, Clinical Fellowship at University of Oklahoma and House Ear Institute. I have involved in projects related to the etiology, prevention and treatment of hearing loss in Nicaragua , in collaboration with World Health Organization, Panamerican Health Organization and CBM program. I am Co -founder of MAyflower Medical Outreach Nicaragua and representative Medical Director in Nicaragua since 2009 , this organization support training to Otolaryngology , audiologist and been involved with others NGO and Minister of Health in Nicaragua.


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James Saunders (), Dartmouth Hitchcock Medical Center, james.saunders@hitchcock.org;
Dr. James E. Saunders is a Professor of Otology / Neurotology at Dartmouth Hitchcock Medical Center. He completed an M.D. at University of Oklahoma, Residency Training and a Research Fellowship in Otolaryngology at Duke University Medical Center, and a Research and Clinical Fellowship at the House Ear Institute in Los Angeles. Dr. Saunders has many projects related to the etiology, prevention and treatment of hearing loss in the developing world including collaborations with the WHO and the Global Burden of Disease Project. He is past Coordinator for International Affairs and Chairman of the Humanitarian Efforts Committee for the AAO-HNSF. In 1999, he co-founded Mayflower Medical Outreach, an organization that supports and trains otolaryngologists and audiologists in Nicaragua. He currently serves as the co-chair for the Coalition for Global Hearing Health, an international multidisciplinary organization devoted to education and advocacy for hearing health services in low resource areas.


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