#  Advanced Audiologic Diagnosis and Referral: Ordering Imaging, Laboratory Testing, and Cultures

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**Presentation Date:** 04 October 2026

**Duration:** 2:50:12

**Return to:** [AuDacity Archive](https://audiologist.org/audacity-archive)

Audiologic evaluation often reveals clinical findings that warrant diagnostic investigation beyond the audiogram. As state scope-of-practice laws evolve, audiologists may have greater authority to order imaging, laboratory testing, and cultures as part of a comprehensive evaluation of patients with hearing and balance disorders. Using Maryland’s 2024 law as a working model, this course will examine the current scope-of-practice landscape and the clinical responsibilities associated with this expanded authority.

Participants will explore the audiometric and clinical findings that may warrant additional diagnostic testing, including appropriate imaging modalities and protocols for common otologic and vestibular presentations. The course will also review relevant laboratory studies for sudden sensorineural hearing loss, autoimmune inner ear disease, and vestibular disorders, as well as indications and proper techniques for obtaining diagnostic cultures. Special attention will be given to recognizing red flags for malignant otitis externa and other conditions requiring urgent medical referral. Practical guidance will be provided for establishing relationships with imaging centers and laboratories and developing effective processes for documentation, results management, patient follow-up, and referral.

**Attendees will be able to:**

1. Describe the current scope of practice landscape for audiologist-ordered imaging, bloodwork, and cultures, using Maryland's 2024 law as a working model.
2. Identify the audiometric and clinical findings that warrant a referral for imaging, lab work, or cultures in patients with hearing or balance complaints.
3. Differentiate appropriate imaging modalities and protocols (MRI vs. CT) for common otologic and vestibular presentations.
4. List the relevant laboratory tests for diagnostic workup of sudden sensorineural hearing loss, autoimmune inner ear disease, and vestibular disorders.
5. Describe indications and proper technique for obtaining diagnostic cultures in otologic disease, including recognizing red flags for malignant otitis externa.
6. Outline the practical steps for establishing ordering relationships with imaging centers and laboratories, including documentation, follow-up, and referral pathways.

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**Speakers:**

- Jana Brown, Au.D.
- Alicia Spoor, Au.D.