The initial hearing evaluation will focus on identifying your specific needs so together we can determine the best treatment options. We typically allow a full hour for this appointment so we can discuss your concerns before and after testing. We will review your medical history including your medications, your exposure to noise or music, your family history, and your current lifestyle. Your ears will be checked for cerumen (wax) buildup, and minor blockages can be cleared by the audiologist. Patients with significant wax impactions will be referred to a physician for ear cleaning before testing can be completed.
Middle Ear Tests include tympanometry and acoustic reflex measures to check the pressure in the middle ear, movement of the eardrum and the three bones (ossicles) in the middle ear, and reflexes from the middle ear muscles. Eustachian tube dysfunction can lead to negative pressure or fluid in the middle ear, requiring medical or surgical treatment. Damage to the ossicles can result from a head injury, chronic middle ear disease, or a condition called Otosclerosis in which the bone hardens and restricts flow of sound to the inner ear (cochlea).
Otoacoustic Emissions testing (OAE) is a very sensitive test of the outer hair cells in the cochlea. While this is not a true hearing test, it may be used to test infants and small children who cannot respond to tones. Robust responses on this test are consistent with normal inner ear function.
The hearing evaluation consists of pure tone testing and speech testing. The pure tone test will measure the softest sounds you can hear, using tones ranging from low to high pitches. Using a graph we can classify your hearing as being normal or in the mild to profound range, depending on how loud the tones need to be for you to barely hear them. Speech recognition testing will tell us how clear words sound to you when they are comfortably loud and there is no competing noise.
If you report difficulty hearing in noise, we may test your ability to understand sentences with competing background noise, using a recorded Speech in Noise test. We may also use the Dichotic Digits Test to determine how well your brain integrates information coming from both ears, using a recorded test with different numbers presented simultaneously to each ear.
We hear with the ears but understand with the brain. In addition to our full service diagnostic hearing exams, we incorporate cognitive screenings into our test battery. This will not only give you valuable information regarding your cognitive state, but also allow us to track cognition over time.
Once testing is complete, we will discuss your results and determine the best options for you. The health of your ear is our primary concern, so if there is any indication that you need medical or surgical treatment, we will refer you to a physician for management. Otherwise we will discuss other ways to help you, including hearing aids, hearing protection, or tinnitus management.