So What Happens During a Hearing Test Anyway?
When you arrive for your exam, you will be greeted by the front office staff and asked to fill out several forms, including those that record your personal information, medical history and verify your insurance. You will also receive a copy of a Notice of Privacy as mandated by law.
As your exam begins, your audiologist will review your personal information with you and will ask you some questions that are designed to discover the specific types of environments in which you may be experiencing some difficulty in hearing.
Next, the audiologist may look into your ears by using an otoscope. This instrument is used to examine the overall health of the ear canal and the ear drum, and whether or not there are obstructions in the canal. Sometimes the audiologist will have a video otoscope so you can see inside your ear as well!
The first test that is conducted is tympanometry. During this test all you need to do is hold still. This test is used evaluate the ear drum, and the function of the middle ear. This also allows us to perform two additional tests, which use the stapedial reflex, to evaluate the movement of the ossicles, 3 smallest bones found in the middle ear, and the nerve function of the auditory nerve.
Next is the pure tone hearing test. This is conducted in a in a soundproof booth. The audiologist will place headphones that are connected to an audiometer in your ears. The audiometer transmits a series of tones at a variety of volumes into your ears to determine the exact point or “threshold” at which you can hear various frequencies of sounds. When you hear a sound, you will be asked to push a button or raise your hand. Another type of pure tone testing uses a bone oscillator. This bypasses the outer and middle ear and stimulates the inner. This helps us identify the location of the loss and appropriate treatment. We are also able to use pure tone testing with children by using a variety of games and activities that test their hearing.
The next test is the speech test. During this test you will listen to a series of one and two syllable words at different volumes and be asked to repeat them. This will determine the level at which the patient can not only detect, but understand speech. It is important to know not only can you hear a sound, but how well can you combine those sounds to have meaning.
The results of your tests will be recorded on a graph called an audiogram, which the audiologist will review with you. The audiogram reflects you hearing loss in frequencies and decibels. With your permission, a copy of the audiogram and a report will be sent to your physician.
Specialty Hearing Tests:
Screen: A hearing screen is a simplified version of the pure tone testing. You will be seated in a sound proof room with headphones. The audiologist will present some sounds, where you will signal if you heard them. A hearing screen tells us if there is a loss, but does not tell us where problem is.
Speech in noise test: During these tests you will be asked to repeat words or sentences in competing noise. Many patients feel that they are OK in quiet, but struggle in competing noise situations. This test will determine how well you hear in noisy environments. We are also able to use this test pre and post fitting of hearing aids to measure their effectiveness in noise.
Tinnitus: With tinnitus testing, the audiologist will first present different sounds, to identify the pitch of the tinnitus. Next the audiologist will raise and lower the volume of that sound to find the loudness of the tinnitus. The last test presents a sound to find out if your tinnitus can be masked and how long that effect lasts. This test is often accompanied with a standardized tinnitus questionnaire and DPOAE testing.
DPOAE’s (Distortion Product Otoacoustic Emissions): This is a test of the outer hair cell function of the inner ear. A soft probe is placed in the ear that generates sound and records the responses made to that sound by the outer hair cells. OAE’s are one of the tests of choice for newborn hearing screening programs, because they don’t require voluntary responses. Although OAE testing is usually considered a pass fail test, it is frequency specific and is typically more sensitive to changes in hearing loss than an audiogram. Thus it is a valuable test and can show the beginning of hearing loss even though pure tone testing remains normal.
ABR (Auditory Brainstem Response): This test also doesn’t require the patient to respond, while it measures the brainwaves in response to sound. Unlike traditional ABR testing, our new equipment does not require sedation, the patient to be asleep, or immobility. A rapid click or tone is presented into the ear. Three electrodes, placed on the head then record the electrical nerve responses. ABR is also used as screen for acoustic tumors. It is slightly less sensitive in detecting acoustical tumors than an MRI, but it is a lot less expensive, making it a great screener for low risk patients.
Pediatric audiometry: We have many hearing games for children. These may range from teaching your child to drop or throw a block when they hear a sound to having hidden toys come to life when they hear a sound. Ideally we like to use a type of headphone, which allows us to test the ears individually, but we also have calibrated speakers for those children who won’t let anything in their ears. With a participating child this can be a very fun test to watch. Often we will recruit a parent or caregiver to help. If asked to participate, ignore any sounds. We want the child to react to the sound and not reacting to your reaction of the sound. We want you to be mildly distracting. This means entertain the child so they are not fussy, but so that they are eager to respond to other things.
Call today to schedule an appointment for your hearing test!