Introduction of Clinical Audiology Center

Hua Zhang, M. D.,

Beijing Tongren Hospital

Beijing Institute of Otolaryngology

 

Background北京同仁医院耳鼻咽喉头颈外科张华

 There are 27.80 million hearing-speech impaired people in China (2006)

0-6 age: 137,000: severe and profound hearing loss: (PTA≥81 dB HL) 0-3:83.9%，4-6: 67.36%

New born hearing loss: 23,000 annually.

Presbycusis: 73.58%，20.45 million totally, most of them with mild and moderate hearing loss.

But only 7-8% of them get intervention (hearing aids or cochlear implants) and rehabilitation.

 

Etiology of the hearing loss in China

Presbycusis

Otitis media

Infectious diseases

Ototoxic （main cause for children hearing loss）

Heritage

Noise induced

 

Difference among countries/regions

 

Mainland China：a few audiologists (even less speech pathologists) among 1,300,000,000 people. (but we have 20,335 ENTs.)

Hearing Impaired in China

Mainland：cochlear implantation/ hearing aids/rehabilitation are all paid by the patients’ own pockets.  Almost no hearing assistive devices in public places.

Currently: China got 205(2006)/400(2007) free CI and thousands of free hearing aids by donations and government.

All digital hearing aids for the children under 6 will get free in next decade

The economic develops very fast in last 3 decades in China. People need higher quality of life. They want to hear the world clearly.

So the audiology is a big potential market.

 

1998.11.18

Set up Clinical Audiology Center 

Belongs to Beijing TongRen Hospital (since 1886) and Beijing Institute of Otolaryngology (since 1958).

 

Organization

Beijing ENT Center

patients in 2007

167266 out-patient

20349 emergency cases

6082 operations

60％ of patients are non-local residents

2007: 124 Chinese articles（39 articles were published in core periodical ）

2007: 17 SCI articles

Hundreds of ENT departments, very few audiological ones throughout the country

 

Professionals

 Otologists

 Audiologists

 Rehabilitation/Speech therapists

 Special education

 Psychologists

 Engineers

 Social worker/society

 Family members

 Central/local government

 

Universal Newborn Hearing Screening
(UNHS) Network

Based in Beijing and 5 Provinces 

Biggest network in the country. Tested 165,000  (304 with severe hearing loss, 160 fitted with hearing aids, 28 received Cochlear implants) infants till 2007 

First time got the local epidemiological data of hearing loss for newborn infants

 

National Classes of UNHS

More than 500 ENTs/nurses/audiological technicians from 17 provinces trained in Beijing 

2 classes annually since 2004 

 

Ear Clinic

         20 specialists, 160-220 patients per day

 Otologists (Otoneurosurgeons)

 Otologists (microtosurgeons)

 Audiologists/technicians

 Specialists for tinnitus and vertigo

 Nurses

 

Dept. of physiological audiology

ERA (ECochG/ABR/ASSR)

OAEs

Speech audiometry

Central Auditory System tests

 

Diagnostic Audiometry

Pure tone （40-105 tests per day)

Behavioral audiometry for children

Acoustic Immittance

Recruitment tests

ENG

 

 

Clinic for Inner Ear Disorders

30 years

About 20 patients per day with vertigo

VNG, 7 per day

Dynamic Posturography, in the research

Subject visual vertical, in the process

Rotational Chair test

BPPV: diagnosis and treatment

Tinnitus

Ménière’s Disease

 

Hearing Aid Fitting

        First professional fitting center in China (1979)。

Binaural/Digital

Major brands

Real ear/Sound field/2 cc coupler/RECD

Ear mold making/Repair

 

Cochlear Implant Center

Otologists/Audiologists

Anatomists/Engineers

Aural Rehabilitation/Speech Pathologists

Psychologist/educationalists

Pediatricians/Social workers

More than 1000 (8000 in China) cochlear implants have been done in our hospital since 1996.

 

 

Aural Rehabilitation Consultation

Pre/post operative evaluation of CI

Parents’ consultation for hearing impaired children after fitting/operation

Follow-up/consultation

Attending social work, e.g. Ear Day

National Training Classes

 

TongRen Aural Rehabilitation Center

Dept. of Pediatrics and ENT have begun to set up the AR center since 1990s

Socialization and family involvement of the rehabilitation

Integrating short period of class training with long-term of family rehab.

Helping the children overcome the most difficult early stage.

Assessment: every four months

Scheduled parents’ seminars

 

Coop with WHO

1986: applied to set up WHO office of prevention of deafness and hearing impairment.

WHO Guidance.

1993: approved by the Beijing Municipal Government

3 national classes: 100 attendees for national network

2008: WHO coop center for prevention of hearing impairment

 

Prevention  of  deafness  into        community 

Regular community/kindergarten services: free consultation, free lectures, free auditory screening tests, free brochures

Noise measurement in subways, hearing check-up for workers Lectures in deaf schools and internship of audiology students

 

Audiological Education (staff training)

1993: China-Australia agreement.

1996: Set a first education project in China (Sino-Australian).

1997: 8 students studied in Australia.

1998: Certificated by Macquarie University 、 Capital University of Medical Science and Australian Hearing (AHS).

Audiological Education (bachelor/master)

1999: approved by Ministry of Education of China.

2000: began the program.

2001: bachelors graduation (5 years)/ began master training (3 years).

2001: training course for other developing countries.

2003: Master degree (7 years)

2005: Apply Au. D

 

Teaching in China

Courses of Audiology

Audiological Fundamental Sciences

Diagnostic Audiology (Hearing evaluation)

Pediatric Audiology

Amplification and Cochlear Implantation

Aural Rehabilitation        

Educational & Industrial Audiology

Psychology

 

Outcome

Trained 12 staff

60 graduated with Bachelor’s degree

6 with Master’s degree

We will help millions of hearing impaired

   people throughout  the mainland of China

 

Workshops on Cochlear Implant

 Anatomy

Workshops on Neonatal Hearing Screening

Continuing Education

23 workshops,

5,000 people,

59 institutes

 

R & D :
Gene for Deafness and Early Intervention

 

International Professional Tour

Good Partner with Governments and Media

Disabled Person’s Federations

 Health Ministry

Beijing Health Bureau

Universities

TVs,  newspapers and radios

 

Future >>>>>>

Economic developing in China

People like higher quality of life

They want to know the world more

China needs audiology!

Audiologists need China!