Archive for June, 2009

Graduate Audiology Jobs

Tuesday, June 30th, 2009

Being a graduate audiologist in 2009 you’ll be facing one of the toughest economic periods to enter the jobs market. BUT there is hope! Let me explain;

You’re at the beginning of your career with potentially more options at this stage of your career than later on the ladder. Every year a substantial portion of graduates takes the plunge and “take a break” or even do a “gap-year” abroad, some will follow the academic route, others may take up research and advance the knowledge field of audiology, the majority will take permanent or locum audiology jobs in public sector / NHS and a few will take up the private sector route.

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It boils down to options. You have a lot even though all may not be feasible at this point in time. Think them over, be open minded, consider your 40 year career plan ahead, the different phases and what will be you’re the initial best move and then… take that big step.

Regardless of your choice, we’re here to help and here to talk to. Should you consider taking up a perm or locum audiology job send us your CV by clicking here.

All the best!

The Audio Team

Barotrauma – Never mind the sharks, guard your ears!

Tuesday, June 30th, 2009

This morning I saw a very interesting case of Barotrauma whilst covering an ENT clinic. Mr Naui has been diving in a 10meter pool as part of his SCUBA training five days ago and whilst he was doing bounces (quick up and down movements at three meter depths) he suddenly experienced severe ear ache on the right. He suffered a significant decrease in his hearing, some vertigo and some mild tinnitus on the right.  He has seen his GP the next day that referred to the emergency ENT. His audiogram today looked like this:




Mr Naui reported that his hearing has subjectively improved since the incident and although the GP noted a tympanic perforation on Sunday, none was visible today. His vertigo also improved.


I discussed this patient with the ENT consultant who said Mr Naui clearly had cochlear damage (given the sensory-neural hearing loss,tinnitus and vertigo) likely caused by the a dislocation and rupture of the Reissner’s membrane and/or basilar membrane. He also said it could be inner ear decompression disease which is the result of a gas bubble forming in the inner ear. According to the consultant a fistula is unlikely as all his symptoms are improving and his hearing isn’t fluctuating. He prescribed Mr Naui steroids and antihistamine in an effort to decrease inflammatory changes and increase the delivery of oxygen. He will be reviewed in a few days but the consultant says his hearing loss is likely to remain significant at the high frequencies.


I then googled “Barotrauma” and came across this a very interesting summary of Barotrama of the middle and the inner ear


According to this article, Mr Naui certainly didn’t have inner ear decompression sickness (IEDS) as:

1)     its commonly seen after dives at extreme depths when divers use helium/oxygen mixture and Mr Naui was diving at only at 3 meter depths

2)     Mr Naui didn’t have any central neurological signs

3)     Inner ear decompression sickness patients needs recompression immediately.  The hearing can return to near normal levels if treated immediately.


I wonder if Mr Naui will pursue diving as a hobby after this incident.


Until next time,


Dezi Belle


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Prevent swimmers ear this summer

Tuesday, June 30th, 2009

With temperatures soaring like it as been the past few days, many of us will resort to swimming to cool us down. Here’s some handy hints by the experts on preventing swimmers ears.

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Swimmer’s Ear – Otitis Externa

Pediatric Basics

By Vincent Iannelli, M.D.

Children with swimmer’s ear (otitis externa) have inflammation in their external ear canal. It is usually caused by water irritating the skin inside the ear, which then becomes infected with a bacteria, or more rarely, a fungus.

Symptoms of Swimmer’s Ear

Ear pain is the most common symptom of swimmer’s ear. Unlike the pain of a middle ear infection (otitis media), which might follow a cold, the ear pain from swimmer’s ear is made worse by tugging on your child’s outer ear. Looking inside your child’s ear, your Pediatrician will likely see a red, swollen ear canal, with some discharge.

Diagnosis of Swimmer’s Ear

The diagnosis of swimmer’s ear is usually made when a child has the classic symptom of outer ear pain that is made worse by tugging on the child’s ear.Swimmer’s ear can be confused with a middle ear infection, especially when your pediatrician is not able to see your child’s ear drum.

Treatments for Swimmer’s Ear

Once your child has swimmer’s ear, it is not the time to put alcohol based ear drops, which are often used to prevent swimmer’s ear. They will likely burn and make your child’s ear feel even worse. Instead, swimmer’s ear is usually treated with antibiotic ear drops, either with or without added steroids (which some experts think can reduce inflammation and make symptoms go away faster).Common otic (ear) drops that are used to treat swimmer’s ear include:

  • Ciprodex*
  • Cipro HC*
  • Cortane-B*
  • Cortisporin*
  • Domeboro Otic
  • Floxin
  • Vosol
  • Vosol HC*

*antibiotic ear drops that include a steroid.Although expensive, Floxin, Ciprodex, and Cipro HC, are most commonly prescribed, as they have less side effects, can be used just twice a day, and may provide better coverage against the bacteria that cause swimmer’s ear.

For mild cases of swimmer’s ear, you might ask your pediatrician if you can first try a solution of half strength white vinegar ear drops (half water/half white vinegar) twice a day — a common home remedy that some parents try.

Pain relievers, including acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) can also be used to to reduce your child’s pain until his ear drops start working.

If there is enough swelling, so that ear drops can’t get into your child’s ear, your pediatrician may place an ear wick inside his ear canal.

Prevention of Swimmer’s Ear

In general, you can prevent swimmer’s ear by keeping water out of your kids’ ears. Fortunately, that doesn’t mean that your kids can swim and enjoy the water. Instead, use an over-the-counter ear drying agent that contains isopropyl alcohol (rubbing alcohol), such as Auro-Dri or Swim Ear, or one with acetic acid and aluminum acetate (Star-Otic).If you like, you might also create your own homemade swimmer’s ear prevention solution by mixing equal parts of rubbing alcohol and white vinegar, and putting it in your child’s ears after he swims.

Although some experts think that earplugs are irritating and can lead to swimmer’s ear, you can also keep water out of your kids’ ears by using a barrier, like earplugs, including Mack’s AquaBlock Earplugs or their Pillow Soft silicone Earplugs. If your kids have a hard time keeping their earplugs in, consider also using the Aqua-Earband or Ear Band-It neoprene swimmer’s headband.

What You Need To Know

  • Swimmer’s ear is usually caused by an infection with the Pseudomonas aeruginosa or Staphylococcus aureus bacteria.
  • You can often prevent swimmer’s ear by keeping water out of your child’s ears.
  • Pools that are poorly maintained are more likely to spread swimmer’s ear.
  • Swimmer’s ear can be treated with prescription antibiotic drops, either with or without steroids.
  • Once your child is better, you should continue to use his ear drops for an additional two or three days, during which time he stays out of the water.
  • Ear wax may be protective against swimmer’s ear, so don’t aggressively remove wax from your child’s ear. Cleaning your child’s ears with a cotton-tip applicator may also put them more at risk for swimmer’s ear.
  • In addition to swimming, kids can be at risk for getting swimmer’s ear if they get water in their ears when bathing or showering.
  • Oral antibiotics are rarely needed to treat uncomplicated cases of swimmer’s ear.
  • Malignant otitis externa is a rare complication of swimmer’s ear.
  • Fungal infections and noninfectious disorders, including eczema, psoriasis, seborrheic dermatitis, and allergic contact dermatitis, can also cause otitis externa, and should be suspected in chronic cases of swimmer’s ear.


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Sizzling summer ears

Tuesday, June 30th, 2009

A guy walks into work, and both of his ears are all bandaged up.

The boss says, “What happened to your ears?”
He says, “Yesterday I was ironing a shirt when the phone rang and shhh! I accidentally answered the iron.”
The boss says, “Well, that explains one ear, but what happened to your other ear?”
He says, “Well, jeez, I had to call the doctor!”

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OAE’s to replace passwords?

Tuesday, June 9th, 2009

Scientists at the University of Southampton, UK are researching the possible use of OAE’s as part of biometrics. By stimulating the ear with clicks, they hope to capture the unique OAE of a person’s ear and use it as an identification tool. Here’s the article:

Biometrics Turns Your Ear Into Your Password

What is your mother’s maiden name? What was your high school mascot? What town were you born in? Who cares! Pretty soon, your body could be the only password you’ll ever need.


Image courtesy of U. Southampton

As the field of biometrics takes off, the securities that protect your identity – from your credit cards to your property – will increasingly focus on your own flesh and blood. And it’s not all fingerprint scanners and voice recognition. New technologies are allowing your identity to be confirmed (or revealed) from a greater distance, more quickly, and without necessarily asking your permission.

Take your ear. No, that’s not a van Gogh joke; it’s called otoacoustic emission (OAE), and it’s the center of one of the many fascinating frontiers in biometric technology. Every time an auditory stimulus strikes your ear, hair cells along the spiral-shaped cochlea (part of the inner ear) translate the vibrations into action potentials, which are relayed on to the temporal lobe in the brain. With the right stimulus – a series of clicks, for example – these hair cells make some noise of their own as they expand and contract: otoacoustic emission.

Everyone’s inner ear has a unique structure, sort of like your fingerprint. Subtle differences in the cochlea translate into subtle differences in the OAE it produces. Dr. Stephen Beeby, an engineer at the University of Southampton, UK, is leading a research project to capture these unique sounds and use them as part of biometrics. By stimulating the ear with clicks, he hopes to capture the unique OAE of a person’s ear and use it as an identification tool.

If supersensitive microphones capable of sensing an OAE were built into your cell phone, your identity could be confirmed from afar. This way, your bank or cell phone company could know for sure that you were you, and not that guy who found your credit card on the sidewalk. If the technology is perfected and fully implemented, your cochlear-ID could secure every phone purchase you make. It could also shut down your cell phone or mp3-player the moment they touch foreign ears. Just in case that German guy who stole my iPod is reading: your days are numbered, mein freund.

Introducing new biometric techniques is no easy task. The researchers will have to show that OAE signals do not change over time, thereby providing a consistent biometric ever an individual’s lifetime. They will also need to prove that their technology has a low rate of false-match mistakes before its widespread use. There are still some bugs to work out. Excessive wax or ear infections can also muddle the signal, and apparently alcohol also dampens the sound of the OAE. That could make that late-night pizza delivery harder than you thought.

Audiologists have even suggested that they can distinguish gender, and even ethnic groups, by looking at OAE signals. This broadens the scope of how this technology could eventually be used; it also raises the whole host of ethical questions that surround biometric technology. How many aspect of our identity do we want to reveal with the sound of a click? I suppose you could always thwart your would-be identifier with speaker phone.

The research is funded through mid-2010, so we should be seeing their final product – bugs worked out – by then. Researchers hope to sell their microphones and software to electronics companies, and you shouldn’t be surprised to see this technology hitting the market soon after. So if you’re always forgetting your passwords, you might be able to – ahem – lend an ear instead. 


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London Audiology Jobs

Tuesday, June 9th, 2009

We have a few locum positions going and it is not always possible to get the right candidate at the right moment. If you’re not desperately looking but want to stay in the loop of available audiology jobs… maybe for something more ongoing or a position closer to home, a paediatric opportunity and even cochlear implant jobs.

Click here and send us your CV. We’ll keep you posted on exciting job opportunities.

Have a cracking week!

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Unusual Middle Ear Mischief

Tuesday, June 9th, 2009

This morning I’ve seen an interesting case of a chap with middle-ear trauma. He had a perforated eardrum in December last year and came for a follow-up today. He was somewhat reluctant to tell me what happened (understandably, if it was self-inflicted!) Apparently he was cleaning his left ear with an ear bud when his telephone rung. Oooooops….. He says the person on the other end quite possibly ended up with noise trauma!

Interestingly enough, his audiogram in December indicated a mixed hearing loss and today, with the perforation closed up, the audio indicates a significant sensory-neural dip at 2kHz (down to 50dB!). The conductive component has disappeared altogether. I had a chat with the ENT consultant who says this is quite interesting and is sending the patient for a MRI scan. He wondered if the guy hasn’t had a loss prior to the trauma. In the absence of other symptoms, the ENT doesn’t feel the need to explore the middle ear as such, but the sensory-neural component certainly is interesting (and could benefit from a hearing aid!).

This is just reiterating the golden rule: “nothing smaller that your elbow in your ears please!”

Dezi Belle

P.s. I’ve managed to locate an interesting article of two similar case studies:

Penetrating middle ear trauma: a report of 2 cases


Penetrating middle ear injury can result in heaving loss, vertigo, and facial nerve injury. We describe the cases of 2 children with penetrating trauma to the right ear that resulted in ossicular chain disruption; one injury was caused by cotton-tipped swabs and the other by a wooden matchstick. Symptoms in both children included hearing loss and otalgia, in addition, one child experienced ataxia and the other vertigo. Physical examination in both cases revealed a perforation in the posterosuperior quadrant of the tympanic membrane and visible ossicles. Audiometry identified a moderate conductive hearing loss in one child and a mild sensorineural hearing loss in the other. Both children underwent middle ear exploration and reduction of a subluxed stapes. We discuss the diagnosis, causes, and management of penetrating middle ear trauma. To reduce the morbidity, associated with these traumas, otologic surgeons should act promptly and be versatile in choosing methods of repairing ossicular chain injuries.

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One ear… hmmm

Friday, June 5th, 2009

Three blondes were trying out at the FBI. The interviewer said, “I’m going to hold a picture up for five seconds. Look at it, and when I put it away, tell me what you saw.”

He held it up

The first blonde said, “I saw a man with one ear.”
The interviewer said, “well, that’s partially right…you see, it is a side profile so all you’d see is one ear.”

The second blonde said, “I saw a man with one eye.”
The interviewer said, “well, that’s partially right…you see it is a side profile so all you’d see is one eye.”

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The third blonde said, “Well, I’m not sure, but he has contacts.”

The interviewer was stunned and said, “hang on a second.” He went to the back room, checked the deatils of the man who modeled for the picture. He came back out and said, “You’re absolutely right, he did have contacts. How did you know?”

The third blonde said, “Well, I figured he couldn’t wear glasses since he only had one ear.”

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