Lesson 1Audiogram configurations and diagnostic reasoning: high-frequency sloping sensorineural loss typical of noise-induced hearing loss vs flat or mixed lossesExamines common adult audiogram patterns, emphasising high-frequency sloping sensorineural loss from noise exposure versus flat or mixed losses, and how these inform diagnosis, prognosis, and management in noisy Nigerian environments.
Reading and describing audiogram shapesNoise-induced high-frequency sloping lossAge-related versus noise-related patternsIdentifying mixed and conductive componentsImplications for counselling and treatmentLesson 2External and middle ear exam: otoscopy findings to rule out wax, tympanic membrane pathology; when to perform tympanometry in adultsCovers adult otoscopic and middle ear assessment, including recognition of cerumen, tympanic membrane pathology, and when tympanometry is indicated, with emphasis on documentation and implications for further testing in local clinics.
Systematic adult otoscopy techniqueCommon cerumen and canal findingsRecognising tympanic membrane pathologyIndications for tympanometry in adultsImpact on audiologic test planningLesson 3Objective tests: OAEs for cochlear outer hair cell function, when to order ABR/EP for retrocochlear concernsReviews objective tests for adult assessment, focusing on OAEs for cochlear status and indications for ABR or other evoked potentials when retrocochlear pathology or nonorganic hearing loss is suspected in Nigerian patients.
OAE types and clinical applicationsInterpreting absent or reduced OAEsWhen to order diagnostic ABR testingABR patterns in retrocochlear diseaseObjective tests in difficult-to-test adultsLesson 4When to refer for medical imaging or ENT: asymmetric loss, severe unilateral tinnitus, or abnormal neurologic signsClarifies when adults with hearing loss or tinnitus should be referred for ENT or imaging, focusing on asymmetric loss, unilateral tinnitus, neurologic signs, and red-flag histories suggesting serious pathology in accessible Nigerian services.
Audiometric criteria for ENT referralRed-flag tinnitus and unilateral symptomsNeurologic and vestibular warning signsWhen to request MRI or CT imagingCoordinating care and reporting findingsLesson 5Comprehensive adult audiologic history: noise exposure, ototoxic medications, gradual vs sudden onset, communication situations, tinnitus characteristics, medical comorbiditiesGuides collection of thorough adult audiologic history, including noise exposure, ototoxic drugs, onset pattern, communication challenges, tinnitus features, and comorbidities, to support accurate diagnosis and tailored management in Nigeria.
Characterising onset and progressionOccupational and recreational noise historyMedication, illness, and ototoxic riskCommunication and listening situation reviewTinnitus description and impact inquiryLesson 6Key evidence-based resources and clinical practice guidelines for adult audiologic managementOutlines key evidence-based guidelines and consensus statements shaping adult audiologic assessment and management, emphasising how to locate, interpret, and apply them to everyday clinical decisions for adults with hearing loss and tinnitus.
Major audiology and ENT guideline sourcesKey adult hearing assessment recommendationsBest practices for adult hearing aid fittingGuideline use in tinnitus assessmentKeeping current with evolving evidenceLesson 7Workplace accommodations and communication strategies: meeting strategies, assistive listening devices (FM/remote mic), legal/occupational considerations for office workersCovers workplace communication needs of office workers with hearing loss, including meeting strategies, remote microphone systems, reasonable accommodations, and legal protections under disability and employment regulations in Nigeria.
Assessing workplace listening demandsEnvironmental and meeting modificationsRemote microphone and FM system optionsTraining communication partners at workLegal and occupational rights overviewLesson 8Diagnostic audiometry: pure-tone air and bone conduction testing, masking principles, interpretation of air-bone gapsProvides structured approach to adult diagnostic audiometry, including pure-tone air and bone conduction, masking principles, and interpretation of air-bone gaps to distinguish sensorineural from conductive components in routine practice.
Pure-tone air conduction proceduresBone conduction and vibrotactile responsesWhen and how to apply maskingInterpreting air-bone gaps accuratelyQuality control and retest criteriaLesson 9Follow-up plan: hearing aid trials, rehabilitation, auditory training, monitoring progression and counselling for preventive hearing conservationDescribes designing individualised follow-up plan, including hearing aid trials, auditory training, counselling, and monitoring progression, with strategies for preventive hearing conservation and long-term patient engagement in Nigeria.
Structuring hearing aid trial periodsScheduling and content of follow-up visitsAuditory training and communication rehabMonitoring thresholds and functional outcomesPreventive hearing conservation counsellingLesson 10Red flags for urgent medical referral in adults: sudden sensorineural hearing loss, asymmetric loss, focal neurological signs, fluctuating symptomsDetails clinical warning signs requiring urgent medical referral, including sudden sensorineural loss, asymmetry, neurologic findings, and fluctuating symptoms, with timelines, documentation tips, and patient counselling points.
Criteria for sudden sensorineural lossRecognising clinically significant asymmetryFocal neurologic and vestibular signsFluctuating hearing and episodic symptomsUrgent referral pathways and counsellingLesson 11Tinnitus assessment: tinnitus history, psychoacoustic measures, Tinnitus Handicap Inventory and counselling approachesExplores comprehensive tinnitus assessment in adults, including detailed history, psychoacoustic measures, validated questionnaires like Tinnitus Handicap Inventory, and how results guide counselling and management planning.
Key elements of tinnitus case historyPitch and loudness matching methodsMinimum masking level and residual inhibitionUsing Tinnitus Handicap Inventory scoresLinking assessment to care planningLesson 12Management options: hearing aid candidacy, selection criteria, verification (real-ear measures), and fitting protocolsDetails adult hearing aid candidacy, selection, verification, and fitting, including needs assessment, technology matching, real-ear measures, and counselling to support realistic expectations and device adoption in Nigeria.
Determining candidacy and motivationSelecting style and technology levelPrescriptive targets and fitting formulasReal-ear verification and fine-tuningOrientation and expectation counsellingLesson 13Tinnitus management: sound therapy, counselling (CBT principles), referral options, and hearing aid-based tinnitus approachesReviews tinnitus management strategies for adults, including sound therapy options, CBT-informed counselling, hearing aid-based approaches, and criteria for referral to psychology, ENT, or multidisciplinary tinnitus clinics.
Education and reassurance techniquesSound therapy and sound enrichmentCBT principles in tinnitus counsellingHearing aids with tinnitus featuresReferral to specialised tinnitus servicesLesson 14Differential diagnoses: noise-induced hearing loss profile, age-related changes, ototoxicity, Meniere’s disease indicators, conductive componentsDiscusses differential diagnosis of adult hearing loss, contrasting noise-induced profiles, age-related changes, ototoxicity, Meniere’s indicators, and conductive components, and how test findings guide medical referral.
Noise-induced versus presbycusis patternsOtotoxicity history and audiometric signsFeatures suggestive of Meniere’s diseaseIdentifying conductive and mixed lossesIntegrating data for differential reasoningLesson 15Speech audiometry: speech reception threshold (SRT), word recognition scores (WRS), supra-threshold testing and significance for real-world communicationExplains speech audiometry procedures and interpretation, including SRT, word recognition scores, and supra-threshold tests, and how these relate to real-world communication, counselling, and hearing aid expectations.
Speech reception threshold proceduresWord recognition test selectionInterpreting WRS and rollover patternsSupra-threshold and speech-in-noise testsLinking results to communication needs
