I. General examination of the ear canal and TM

• A. Confirm adequate acoustic / physical access to EAM and TM

  • 1. Audiological diagnostic procedures
  • 2 Hearing instrument - related procedures

• B. Correlate otoscopic and audiometric findings

• C. Identify and monitor pathology for physician referral

  • 1. Pinna
  • 2. Concha
  • 3. Canal
  • 4. Tympanic Membrane
  • 5. Middle Ear
  • 6. Eustachian Tube

II. Physician communication / Telemedicine

• A. Demonstration of conditions requiring medical attention

• B. Description of conditions of clinical interest

• C. Tracking treatment outcomes via audiologic and VO findings

• D. Remote on-line and off-line consultation to ENT physician

  • 1. EARS PROJECT, U. of Maine

  III. Hearing instrument selection and fitting applications

  • A. Ear selection for monaural fitting

  • B. Instrument morphology predetermination

  • C. Otoblock / REM probe placement

  • D. Impression material / technique determination

  • E. Impression detailing information

  • F. Patient counseling

    • 1. Insertion
    • 2. Removal
    • 3. Operation
    • 4. Hygiene
    • 5. Cosmetic assessment

  • G. Identification of loci of contusion, abrasion or contact points of irritation

    • 1. Direction for remediation
    • 2. Verification of outcome

  • H. Visual diagnosis of instrument malfunction

  IV. Patient education

  • A. Conditions influencing audiological findings and recommendations

    • 1. Otic pathology requiring referral
    • 2. Otic pathology or anomalies influencing hearing aid morphology or ear of fitting selection
    • 3. Cerumen accumulation requiring treatment or referral

  • B. Hearing aid orientation

    • 1. Usage and operation
    • 2. Hygiene

  V. Professional image enhancement

  • A. With patients

  • B. With physicians

    • 1. Referring
    • 2. Non-referring

  VI. Knowledge base / Skill growth

  • A. Otic pathology and anomalies

  • B. Normal anatomic variations

  • C. Improved hearing aid morphology selection / modification

  • D. Cerumen management techniques

  VII. Cerumen management

  • A. Assessment

    • 1. Degree of obstruction: 0 to +3
    • 2. Location in canal
    • 3. Texture

  • B. Management

    • 1. Referred
      • a. Demonstrate
      • b. Document
      • c. Refer
      • d. Confirm
      • e. Self-Care / follow-up
    • 2. Direct
      • a.Irrigation
      • b.Suction
      • c.Curettage
      • d.VO Curettage