Audiology Division

Overview

The Audiology division started at KFUH as one clinic under the ENT department in 1982, with one audiology physician and a limited basic equipment. It was the first in the whole kingdom at that time. The main scope of practice was to conduct basic hearing evaluation for patients who were referred mainly from ENT department.

Over the past 40 years, the division has evolved and today it provides many and varied services in addition to the general auditory assessment clinic, including newborn hearing screening clinics, ABR clinics, cochlear implant clinics, BAHA & hearing aids clinic, tinnitus clinic, and vestibular clinics . The unit includes 4 audiovestibular, 3 audiologists and 1 nurse.
The main aim of the audiology division is to provide services to investigate, diagnose and manage hearing, balance and communication disorders in adults and children from birth onwards. This has a dramatic positive effect on patients’ wellbeing and their quality of life.
The common presenting symptoms of hearing and balance disorders include: hearing impairment, difficulty in understanding words, repeated requests to speak more slowly and clearly and loudly, tinnitus, vertigo, imbalance, speech delay or delayed milestones in children.
In addition, physicians in this specialty seek to identify other pathologies which may have an impact on the patient’s health or wellbeing and institute treatment and advice about their prevention or further progression.
Audiovestibular symptoms can be both peripheral otological and central nervous system in origin. They include disorders which are:

•  inherited
•  infectious
•  inflammatory
•  vascular
•  traumatic
•  metabolic
•  neurodegenerative

 Patient Care

The division receives referrals from other clinical departments in the hospital as well as other hospitals in the Eastern Province.

The division runs 33 outpatient clinics per week, including the following:

 General Audiology Clinics (10 clinics / Daily a.m. & p.m.)

• This clinic receives referral from ENT department as well as other clinical departments in the hospital and other educational and health institutions in the Eastern Province.
•  It provides comprehensive audiological evaluation using different types of procedures to evaluate hearing in patients of all age groups.

 Newborn Hearing Screening( 2 clinics / Wednesday & Thursday p.m.)

•  This is a nurse led clinic that implements Automated Auditory Brainstem Response testing (AABR).
•  In this clinic all newborns who failed the initial newborn hearing screening that is routinely done in KFHU nursery - before the newborn discharge- will be rescreened maximum by the age of 1 month.
•  Any newborn who failed the screening in this clinic, will have a direct access to specialized ABR clinic (NHS- ABR).

 ABR clinics( 5 clinics / Sunday, Monday, Wednesday, Thursday a.m.)

•  The auditory Brainstem Response (ABR) is an objective test to assess the central hearing pathways from the cochlea along the auditory nerve all the way to the brain stem. It is used to assess hearing thresholds of young children, as well as the functionality of the auditory neural pathway. At the end of the session, appropriate hearing aids or radiological investigation will be requested as indicated.
•  The audiology division has:

              o 1 ABR clinic that provides a direct access to patients who failed the newborn hearing screening (NHS- ABR).
             o 2 ABR clinics that provide a direct access to cochlear implant candidates (CI-ABR).
             o 2 ABR clinics that provide services to referrals from other clinical departments or other health institutions in the Eastern Province (General-ABR)

 Cochlear implant clinics:

A. Preoperative Hearing assessment clinic (3 clinics / Monday p.m., Tuesday a.m., Wednesday a.m.)

•  In these clinics, patients who are diagnosed with hearing loss will have various tests of hearing including unaided audiogram, aided audiogram, OAE, Tympanometry, acoustic reflexes.
•  In addition, trial of hearing aid is used to assess its potential benefit.
•  Patients who do not show the expected benefit from hearing aids are discussed jointly in the cochlear implant committee that includes otologist, Audiologist and speech-pathologist.
•  If the patient is a candidate, the cochlear implant surgery will be scheduled to the patient by the otologist.

B.Postoperative Cochlear Implant clinic  Fitting and Switch on Clinic (1 clinic / Tuesday a.m.)

•  2-4 weeks after cochlear implant surgery, the patient will have an appointment in this clinic to fit the external cochlear implant device and to do switch on and adjustment of the sound processor and to give information to the patient/or family on the proper care and use of the device.
•  Later on, the patient will be given a follow up appointments in the cochlear implant programming clinic to make further adjustment & programming of the sound processor.

. Cochlear Implant Programming Clinic( 5 clinics / Sunday p.m., Tuesday a.m. & p.m., Wednesday a.m. & p.m.)

•  For maximum benefits, cochlear implant recipients are seen regularly at scheduled intervals to assess their hearing performance and benefit from cochlear implant and to readjust and fine tune their devices. Follow up in this clinic is mandatory throughout their lifetime.

 BAHA & Hearing Aids (1 clinic / Thursday p.m.)

•  The clinic provides prescription of appropriate hearing aids according to type and degree of hearing impairment and to measure the efficiency and actual performance of hearing aids for patients (pediatrics, adults or geriatrics).
•  Detect candidates for Bone Anchored hearing aids
•  Fit and program the BAHA device after surgery (follow up throughout lifetime).

 Tinnitus (1 clinic / Monday a.m.)

 One of the newest specialized clinics in the Audiology Unit to diagnose tinnitus and its causes.
 This clinic provides the latest treatment & rehabilitation methods for patients suffering from tinnitus

 Vestibular Clinics (5 clinics / Sunday a.m. & p.m., Monday p.m., Tuesday a.m. & p.m.)

 The vestibular clinic provides the assessments as a one stop clinic. This involves taking a detailed history of the patients’ problems, clinical examination and carrying specialized hearing and balance assessment including VNG, caloric & VEMP testing.

•  In addition, rehabilitation such as repositioning maneuver is carried out when indicated to treat BPPV in the same visit.
•  At the end of the session, appropriate blood or radiological investigation will be requested as indicated.
•  As indicated, some patients will be referred to other clinical departments e.g. neurology, neurosurgery & cardiology.

Activities

The Audiology Unit, in collaboration with the Cochlear Implant Unit, organized several specific workshops and campaigns, including the following:

• 21 March, 2016
The first meeting for cochlear implant patients, AlKhobar, KSA.

• 6 Nov 2016
1st Audiology Workshop on Cochlear Implants: Clinical Orientation on Selection and Fitting of Cochlear Implant Patients, AlKhobar, KSA.

• 1&2 Nov 2017
2nd Audiology course on cochlear implants: tools of diagnosis and management, AlKhobar, KSA.

• 10-11 Nov 2018
3rd Audiology course on cochlear implants. Overview on objective measures, Alkhobar, KSA.

• 21 March, 2019
Awareness campaign for hearing loss and cochlear implantation in children under the title "My Life with a Voice", Al-Rashid Mall, Al-Khobar.

• 30-31 Oct 2019
4th Audiology course on cochlear implants: management of pediatric cochlear implant patients. AlKhobar, KSA.

 Accomplishments 

 Educational Achievements

•  The unit participates in the various educational programs for students of the Saudi Board of Ear, Nose and Throat, family and community medicine, in addition to the fourth and sixth year medical students attending IAU college of Medicine.
•  Development of program for acceptance and education of hearing impaired students in Faculty of Arts in 2013-2014.
•  Development of Arabic word recognition material.
•  The audiology unit receives training requests for new Audiology graduates, who remain in the unit from 6 to 12 months, where the following are done:

1. Organizing their presence in the unit to ensure mastery of multi-skills and examining different conditions.
2.  Not allowing them to provide medical services directly to patients without the presence of a doctor or specialist.
3. Evaluating them periodically and giving them constructive notes to improve their scientific and practical level.

 Research Achievements

Members in Audiology team have many research publications in different national and international Scientific journals in addition to participation in many international and local scientific conferences.

 Newborn screening program

•  The newborn hearing screening program began in the hospital in 2012, with the aim of early detection of deafness cases and referring them to audiology unit, where additional diagnostic tests and prescriptions for hearing aids or referring to the cochlear implant program when indicated.
•  A protocol has been put in place that regulates the referral of all newborns who did not pass the initial screening in the hospital's newborn nursery, where they are going to have a second screening in the audiology unit NHS screening clinics.
•  Those who did not pass the second screening will have a direct access for diagnostic testing in a designated ABR clinic (NHS-ABR). The first diagnostic ABR is carried out at the age of 3 months and if necessary it will be repeated at the age of 6 months and 9 months. This is to ensure the level of hearing impairment is established before the prescription of any hearing aids or the transfer to the cochlear implant clinic if indicated.
•  In 2018, the Audiology Unit, through cooperation with the IT Department, initiated the creation of a new entry in the QuardaMed system that enables nurses in the hospital's nursery to record the results of the hearing screening for each newborn.
•  A form showing the result of the screening is given to the parents’ of any newborn upon discharge from the hospital, explaining the result of the first screening and any further measures that need to be taken.
•  Currently, the unit is working in creating a new entry that enables recording of the result of the second newborn hearing screening that is carried out in Audiology hearing screening clinic.

 The Audiology Unit has performed some regulatory procedures in its outpatient clinic since March 2018, including the following:

•  Patient admission to clinics according to the time recorded in the appointment sheet, which had a good effect in reducing patients' waiting time to enter the clinic and reducing overcrowding in the patients’ waiting area.
•  To increase patients’ capacity, the unit advanced clinics’ starting time from 9:00 am to 8:00 am on Sunday, Tuesday and Wednesday every week.

 Staff Members

• Dr. Nithreen Abdulsalam.MD, MSc, PhD. Audiovestibular Consultant, Assistant professor.
• Dr. Mahmoud Mahrous. MD, MSc, PhD. Audiovestibular Consultant.
• Dr. Amal Alshaikh.MD, MSc, PhD. Audiovestibular Consultant, Assistant professor
•  Dr. Ibrahim Busaad.MD, MSc
• Mrs. Rasha Alsaffar. BSc, MSc. Audiologist
•  Mrs. Samar Alaswad. BSc. Audiologist
•  Mrs. Hala Alrwali. BSc. Audiologist
• Mrs. Nadeen Algeryafi. BSc. Nurse