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At the National Intrepid Center of Excellence (NICoE), audiologists work collaboratively to treat service members with traumatic brain injury (TBI). Auditory symptoms, such as hearing loss, tinnitus, auditory processing disorder and vestibular migraines, can impair a service member's ability to communicate effectively in both personal and professional settings. Given the impact of hearing impairments on situational awareness ─ a critical component of return-to-duty standards ─ it is imperative that patients receive comprehensive audiological care.
TBI patients often present with complex issues that may not be readily identified through standard testing, so effective communication is at the heart of NICoE’s practice. While many patients evaluated at the NICoE exhibit normal hearing thresholds, audiologists commonly observe underlying auditory disorders. Tinnitus, characterized by ringing, buzzing or hissing sounds in the ears, is a frequent complaint. As there is no definitive test for tinnitus, audiologists rely on patient self-reports. While pitch matching and masking assessments can be used to characterize the tinnitus, they do not provide a diagnosis.
Dr. Melissa Kokx-Ryan, an audiologist at the NICoE, emphasizes the value of the collaborative environment: “It’s really nice to not work in a silo. From a TBI care standpoint, we’re unique in that I can go next door and talk to the speech language pathologist or go down the hall and talk to the neuropsychologist about a patient.”
Some TBI patients experience hidden hearing loss, which is characterized by abnormalities in the auditory system that are not reflected in a standard audiogram. An example of this is auditory processing disorder, in which the patient's ears detect sounds normally, but the neural processing of auditory information is disrupted.
NICoE audiologist Joanna Pearson highlights the importance of interprofessional communication to address hidden hearing loss: "It’s important to communicate with the team because having that other piece of information of ‘All right, the hearing seems normal, but what does the speech language pathology show? What does neuropsychology show?’ helps put the puzzle together.’" Determining the precise nature of the underlying problem, whether it is auditory, attentional or otherwise, guides the development of an appropriate management strategy.
Regardless of the specific auditory complaint, audiologists work with other NICoE providers as needed to develop and implement individualized treatment plans for each patient.
About the NICoE
The National Intrepid Center of Excellence provides state-of-the-art medical, neurological, rehabilitative, behavioral health, advanced imaging and diagnostics, education and complementary services to service members to facilitate recovery and return to military service. As a Center of Excellence, the NICoE leads and innovates in the delivery of patient-centered care, conducts research to establish protocols for TBI treatment and shares staff expertise through professional training and education.
| Date Taken: | 07.14.2025 |
| Date Posted: | 07.21.2025 10:15 |
| Story ID: | 542742 |
| Location: | BETHESDA, MARYLAND, US |
| Hometown: | BETHESDA, MARYLAND, US |
| Web Views: | 19 |
| Downloads: | 0 |
This work, Teamwork on display: audiology at the NICoE, by Ben Lasky, identified by DVIDS, must comply with the restrictions shown on https://www.dvidshub.net/about/copyright.
