ENT Module

Audiogram documentation

The audiogram entry interface records a full diagnostic audiological assessment:

PURE TONE AUDIOMETRY

For each ear (right and left):

• Air conduction thresholds: 250, 500, 1000, 2000, 4000, 8000 Hz (dB HL)
• Bone conduction thresholds: 500, 1000, 2000, 4000 Hz (dB HL)
• Masked and unmasked values recorded separately

SPEECH AUDIOMETRY

• Speech Reception Threshold (SRT)
• Word Recognition Score (WRS) at 40dB SL

TYMPANOMETRY

• Type A (normal compliance), Type B (flat — effusion/perforation), Type C (negative pressure)
• Peak pressure (daPa), static compliance (ml), ear canal volume

OAE (OTOACOUSTIC EMISSIONS)

• DPOAE (Distortion Product): present/absent per frequency
• TEOAE (Transient Evoked): pass/refer result

CLASSIFICATION (ASHA criteria):

Normal: ≤25 dB HL

Mild: 26–40 dB HL

Moderate: 41–55 dB HL

Moderately severe: 56–70 dB HL

Severe: 71–90 dB HL

Profound: >90 dB HL

Type:

Conductive — air-bone gap >10 dB, normal bone conduction

Sensorineural — bone conduction elevated equally with air

Mixed — both components present

The audiogram is plotted as a standard ANSI audiogram chart (red circles = right air, blue X = left air, < = right bone, > = left bone). Previous audiograms are overlaid for comparison.

Newborn hearing screening pathway

Egypt's national newborn hearing screening programme uses OAE before hospital discharge. Clinit tracks the complete post-referral pathway.

STEP 1: REFERRAL REGISTRATION

When a child presents with a "refer" OAE result, register in the ENT module:

• Screening date and result (OAE fail / AABR refer)
• Referring hospital and ward
• Target dates: diagnostic ABR within 3 months of birth (WHO guideline)
• Assigned audiologist

STEP 2: DIAGNOSTIC TESTING

ABR (Auditory Brainstem Response):

• Click ABR: thresholds at 500, 1000, 2000, 4000 Hz (each ear)
• Tone-burst ABR: frequency-specific thresholds for hearing aid fitting
• Wave morphology: V wave present/absent, latency (ms)

ASSR (Auditory Steady-State Response):

• Frequency-specific thresholds at 500, 1000, 2000, 4000 Hz
• Used when ABR thresholds are >70 dB to estimate amplification targets

STEP 3: DIAGNOSIS ENTRY

• Degree (mild/moderate/moderately severe/severe/profound per ear)
• Type (conductive/sensorineural/mixed)
• Laterality (unilateral/bilateral)
• Probable aetiology: genetic, CMV, hyperbilirubinemia, meningitis, noise-induced, unknown

STEP 4: INTERVENTION RECORD

• Hearing aid: make, model, fitting date, NAL-NL2 or DSL target, ear mould details
• FM system: type, fitting date
• Cochlear implant candidacy: assessment date, decision, surgery date if applicable
• BAHA: brand, implant type

STEP 5: SPEECH AND LANGUAGE MILESTONES (0–12 months)

Auditory milestones linked to the pathway — AI flags deviation from expected trajectory and suggests re-referral or intervention escalation.

Alert timeline: the pathway record shows days elapsed since birth. Colour-coded urgency: green (within targets), amber (approaching deadline), red (milestone missed).