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Series Foreword | |
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Foreword | |
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Acknowledgments | |
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Preface | |
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The Normal Auditory Brainstem Response | |
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Introduction and Overview | |
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Historical Perspective | |
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How the Abr Fits with Other Auditory Evoked Potentials | |
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Overview of Applications of the Abr | |
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Scope of Patients Who Benefit From Abr Testing | |
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The Normal Abr | |
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Definition of the Abr | |
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The Normal Abr Waveform | |
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Neural Generators of the Abr | |
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Characteristics of A Normal Abr | |
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Absolute Latency | |
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Interwave Latency Intervals | |
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Interaural Latency Differences | |
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Latency-Intensity Functions | |
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Rate Changes | |
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Amplitude | |
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Waveform Morphology and Replicability | |
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Normative Data and Establishing Norms | |
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Acquisition of the Abr | |
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General Principles of Evoked Potential Measurement | |
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Evoked Versus Nonevoked Potentials | |
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Near-Field Versus Far-Field Recording | |
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Neural Synchrony | |
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Signal-to-Noise Ratio Enhancement With Signal Averaging and Time-Locking | |
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General Recording Considerations | |
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Test Environment | |
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Patient Considerations | |
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Instrumentation | |
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Stimulus Generators | |
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Transducers | |
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Trigger | |
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Electrodes | |
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Two-Channel Recordings | |
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One-Channel Recordings | |
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Electrode Application and Electrode Impedance | |
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Preamplifiers | |
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Common Mode Rejection | |
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Filters | |
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Signal Averager | |
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Display of Responses | |
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Artifact Rejection | |
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Data Analysis and Storage | |
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Calibration | |
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Specialized Techniques in Abr Acquisition | |
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Signal-to-Noise Estimation | |
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F[subscript SP] Averaging | |
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Maximum Length Sequences (MLS) | |
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Automated Identification of Waveforms | |
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Stimulus, Recording, and Patient Factors Influencing the ABR | |
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Effects of Stimulus Factors | |
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Stimulus Intensity | |
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Stimulus Rate | |
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Stimulus Polarity | |
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Rarefaction Stimuli | |
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Condensation Stimuli | |
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Alternating-Polarity Stimuli | |
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Polarity and Peripheral Hearing Loss | |
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Comparison of Rarefaction and Condensation Responses | |
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Stimulus Duration and Rise Time | |
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Stimulus Frequency | |
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Monaural Versus Binaural Recordings | |
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Effects of Recording Factors | |
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Electrode Montages | |
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Filter Settings | |
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Time Window | |
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One- Versus Two-Channel Recordings | |
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Number of Sweeps | |
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Effects of Patient Factors | |
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Age | |
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Gender | |
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Age and Gender | |
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Medication | |
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Attention | |
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Body Temperature | |
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Muscle Artifact | |
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Clinical Applications of the Auditory Brainstem Response | |
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Clinical Applications of the ABR in Neurological Testing | |
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Application and Procedure | |
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Who Should Be Tested? | |
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Test Procedures | |
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Identification of Wavel | |
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Use of Masking | |
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Effects of Cochlear Hearing Loss | |
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Wave V Latency | |
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Latency-Intensity Functions in Cochlear Hearing Losses | |
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High-Frequency Hearing Loss | |
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Asymmetric Hearing Loss | |
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Stimulus Polarity Interactions With Cochlear Hearing Loss | |
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Overcoming the Effects of Peripheral Hearing Loss | |
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Identification of Wavel | |
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Correction Factors | |
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Alternative Methods | |
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Effects of Conductive Hearing Loss | |
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Effects of Neurological Disorders | |
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Eighth Nerve Tumors and Other Neoplasms | |
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Normal Pure-Tone Thresholds and Abnormal ABRs | |
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Poor Pure-Tone Thresholds and Abnormal ABRs | |
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Neurofibromatosis | |
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Strategies in Interpretation of Results in Patients With Suspected Tumors | |
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Demyelinating and Other Neurological Diseases | |
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Other Neural Disorders Affecting the ABR | |
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Auditory Neuropathy | |
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Fourth Ventricle Hydroencephaly | |
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Vascular Abnormalities | |
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Head Injury | |
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Coma and Brain Death | |
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Use of the Abr in Intraoperative and Intensive Care Unit Monitoring | |
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Strengths and Limitations of the Abr in Neurological Applications | |
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Strengths of the Abr | |
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Limitations of the Abr in Neurological Applications | |
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Technical Errors | |
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Cross-Check Among Tests | |
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Clinical Application of the ABR in Estimating Hearing Sensitivity | |
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A Brief Historical Perspective | |
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What Auditory Evoked Potentials Test | |
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When to Use the Abr to Estimate Auditory Function | |
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Clicks Versus Frequency-Specific Stimuli | |
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Types of Frequency-Specific Stimuli | |
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Tonebursts | |
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Stimulus Polarity Effects With Tonebursts | |
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High-Frequency Tonebursts | |
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Masking Noise With Clicks and Tonebursts | |
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High-Pass Masking of Clicks | |
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High-Pass Masking and Tonebursts | |
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Tonebursts in Notched Noise | |
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Procedures in Using the Abr to Estimate Hearing Sensitivity | |
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Test Protocols For Infants and Children | |
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ABR to Air-Conducted Clicks | |
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ABRs to 500-Hz Tonebursts | |
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ABR to Bone-Conducted Clicks | |
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Modifications to Improve Test Efficiency | |
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Test Protocol for Older Children and Adults Using the 40-Hz Response | |
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Steady State Responses | |
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SN[subscript 10] Response | |
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Use of Masking | |
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Relation of Responses to Behavioral Thresholds | |
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Cautions and Considerations | |
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Neural Integrity | |
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Collapsing Ear Canals | |
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Middle Ear Function and Otoacoustic Emissions | |
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The ABR Is Not a Hearing Test | |
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Technical Errors | |
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Testing Infants and Children With Physiological Measures | |
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Physiological Techniques in Pediatric Audiology | |
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Immittance and Middle Ear Muscle Reflexes | |
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Evoked Otoacoustic Emissions | |
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Auditory Evoked Potentials | |
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Auditory Brainstem Response | |
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Who Should Be Tested? | |
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Estimating Auditory Sensitivity in Infants and Children | |
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Examining Auditory Pathway Integrity | |
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Middle Latency and Late Potentials | |
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Strengths and Limitations of Auditory Evoked Potentials in Pediatric Applications | |
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Strengths | |
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Limitations | |
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Newborn Hearing Screening Using the ABR | |
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Abr Screening Methods | |
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Retrospective Studies of Abr Testing in Newborns | |
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Special Considerations in Recording ABRs in Infants | |
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Electrode Montages | |
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Number of Recording Channels | |
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Filter Characteristics | |
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Bone-Conduction ABRs in Infants | |
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Waveform Interpretation and Normative Data | |
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Ear and Gender Differences in the ABR | |
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Relation Between ABR Thresholds and Behavioral Thresholds | |
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Auditory Neuropathy in Infants and Young Children | |
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Case Studies and Report Writing | |
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ABR Case Studies | |
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Case Study 1: Unilateral Cochlear Hearing Loss and A Normal ABR | |
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Case Study 2: High-Frequency Asymmetric Cochlear Hearing Loss | |
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Case Study 3: Cochlear Hearing Loss With A Negative Summating Potential | |
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Case Study 4: Adult with Hearing Within Normal Limits and an Elghth Nerve Tumor | |
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Case Study 5: Adult with Asymmetric Hearing Loss and an Eighth Nerve Tumor | |
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Case Study 6: Adult with Asymmetric Hearing Loss and an Eighth Nerve Tumor | |
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Case Study 7: Adult with an Eighth Nerve Tumor and an Abnormal Abr Rate Effect | |
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Case Study 8: Severe Unilateral Hearing Loss and A Vestibular Schwannoma | |
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Case Study 9: Adult with Meningioma | |
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Case Study 10: Adult with Brainstem Gliomas | |
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Case Study 11: Infant with Normal Hearing | |
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Case Study 12: Child With A Bilateral Conductive Hearing Loss | |
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Case Study 13: Child with Unilateral Atresia | |
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Case Study 14: Child with A Moderate Sensory Hearing Loss | |
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Case Study 15: Child With A Unilateral Sensory Hearing Loss | |
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Case Study 16: Adult with an Auditory Neuropathy | |
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Case Study 17: Infant with an Auditory Neuropathy | |
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Case Study 18: Collapsed Ear Canal That Mimics A Retrocochlear Lesion | |
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Case Study 19: Postauricular Muscle Artifact | |
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Case Study 20: Technical Error in Electrode Connection | |
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Reporting ABR Test Results | |
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Abr Testing for Estimation of Peripheral Hearing Sensitivity | |
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Sample Infant/Child Report--Consistent With Normal Peripheral Sensitivity | |
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Sample Infant/Child Report--Consistent With Moderate Conductive Hearing Loss | |
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Sample Infant/Child Report--Consistent With Mild to Moderate Cochlear Hearing Loss | |
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Abr Testing for Otoneurological Evaluation | |
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Sample Adult Report--Normal Peripheral Hearing and Normal ABR | |
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Sample Adult Report--ABR Consistent With Bilateral Moderately Severe High-Frequency Peripheral Hearing Loss | |
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Sample Adult Report--Abnormal ABR Consistent With Eighth Nerve/Brainstem Lesion | |
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ABR Laboratory Exercises and Protocol Practice | |
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Laboratory Exercises | |
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Normal Auditory Brainstem Response | |
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Effects of Stimulus Intensity | |
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Effects of Stimulus Polarity | |
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Effects of Presentation Rate | |
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Comparison of Electrode Montages | |
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Effects of Filter Settings | |
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500-Hz Toneburst ABR | |
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Bone-Conduction ABR | |
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40-Hz Response Using a 500-Hz Toneburst | |
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Protocol Practice | |
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Neurological Application | |
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Estimation of Hearing Sensitivity in Infants | |
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Estimation of Hearing Sensitivity in Older Children or Adults | |
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Skill Checklist | |
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Glossary | |
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References | |
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Index | |