Audiological Medicine

Audiological medicine provides diagnosis and management of patients with disorders of hearing and balance.

Audiological problems can also include tinnitus and auditory processing disorders.

At Great Ormond Street Hospital, we see patients as young as newborns right through to the late teenage years, and accept referrals from within the hospital and from external consultants. The team of audiologists, clinical scientists and audiovestibular physicians provide an integrated service.

A range of technology is used to assist patients with hearing deficits including digital hearing aids, bone anchored hearing aids, cochlear implants and vibrotactile aids. We provide a routine service for the fitting of digital hearing aids.

In addition, we have developed a number of protocols and contributed to the formulation of several national guidelines for the management of children with the following conditions:

  • auditory neuropathy/auditory dys-synchrony (designated as a national centre)

  • auditory processing disorders

  • balance disorders in children

  • bone anchored hearing aids

  • management of patients with ototoxicity

Paediatric hearing assessments

The Audiological department offer a range of tests for children attending the hospital.

Subjective hearing tests

Distraction test

The distraction test is ideally used for babies who are developmentally six to eight months old (although it can be used from six months to 24 months of age by experienced testers), and assesses the ability of the baby to hear a sound then turn to locate it.

Visual reinforced audiometry (VRA)

This test is suitable for infants from six months to two years old. This is a powerful technique that can be used to determine frequency and ear specific hearing thresholds.

Play audiometry

Play audiometry is suitable for pre-school children of 20 months to five years old (developmentally). The child must be able to understand simple instructions and commands.

Pure tone audiometry (PTA)

Children of school age upwards are generally able to manage this test. Tones of varying frequency and intensity are played through headphones or insert phones. The child must press a hand held button for as long as they can hear a sound.

Objective hearing tests

Otoacousic emissions (OAE)

Sound is presented into the ear canal via a probe. The sound wave passes through the ear drum and middle ear then into the cochlear. This stimulates the hair cells in the cochlear causing the outer hair cells to twitch in response creating an echo.

Auditory Brainstem Response (ABR)

Clicks or tones of varying intensities are presented via probes placed in the ear canal. Electrodes are attached to the mastoids behind each ear and one to the upper forehead.

Middle ear tests

Tympanometry

This test measures the stiffness of the ear drum by applying a positive and negative pressure in the ear canal. Maximum compliance will occur when the pressure in the canal equals the pressure in the middle ear.

Stapedial Reflex

When a loud sound is presented to the ear, a protective mechanism is triggered that tightens the small bones (ossicles) that connect the ear drum to the cochlear and reduce the sensitivity of hearing.

Meet the team

Consultant AudioVestibular Physicians

Dr Raouf Chorbachi 
Consultant AudioVestibular Physician
Special interests: cleft lip and palate.

Dr Tony Sirimanna MB BS; MS; FRCS(Ed); DLO(RCS-UK); MSc; FRCP  
Consultant AudioVestibular Physician
Special interests: aetiology of hearing loss, central auditory processing disorders, newborn hearing screening, bone anchored hearing aids and auditory neuropathy.
Additional information: Lead Clinician for Audiology, Audiological Medicine & Cochlear Implant.

Dr Ewa Raglan 
Consultant AudioVestibular Physician
Special interests: balance and vestibular system.

Dr Kaukab Rajput 
Consultant AudioVestibular Physician
Special interests: cochlear implants, ototoxicity in patients undergoing chemotherapy and auditory neuropathy/dys-synchrony.

Audiologists

Brindha Anandanadarajah 
Audiologist

Shahnaz Rani 
Audiologist
Special interest: bone anchored hearing aids (BAHA).

Refer a patient  

Please visit the refer a patient section for further information on how to refer your child/patient to Great Ormond Street Hospital for Children.