The First Step In A Hearing Evaluation Is Otoscopy.
Otoscopy is when a light is used to evaluate the outer ear canal and eardrum, assessing for skin changes, accumulated wax, and to examine the eardrum to ensure it is healthy. This procedure is typically very quick and requires the patient to sit still. Your audiologist will be looking for different landmarks on the eardrum. Should the outer ear canal have too much wax, or cerumen, you may need to have it cleaned before the rest of the hearing evaluation.
Following otoscopy, your audiologist may perform tympanometry. Tympanometry is an assessment of the middle ear space and checks for excessive negative pressure, which may occur if you have allergies or a cold, or fluid behind the eardrum, an indication of possible ear infection. This testing also requires the patient to sit still and not speak for the duration of the test, but don’t worry-it only takes a minute or two! During tympanometry a probe is inserted into the ear and air pressure is varied. It may feel like you are going up in a airplane, or you may hear a “hum”. Both are totally normal responses to the pressure. The varied air pressure examines the movement of the eardrum and the bones of the middle ear, and how well your ear can equalize pressure. These components help your audiologist determine a diagnosis and treatment options to provide you with the best care.
Pure Tone Audiometry
Pure tone audiometry is the evaluation of the softest sounds an individual can hear, or what is called the hearing threshold. Headphones or inserts will be placed on/in your ears, and you will be given a button to press when you hear the beeps. Your hearing threshold across a variety of frequencies will help your audiologist your diagnosis, and how to best help your hearing. In addition to testing through headphones, your audiologist will also place a headband, called a bone conduction vibrator, on your head to test the threshold of hearing for your inner ear, or cochlea.
Word Recognition Testing
Word recognition testing is another part of the audiometric evaluation that allows audiologists to determine how well an individual will do with hearing aids and to assist with diagnosis. With this testing, the audiologist will either ask you to repeat back the words you hear either through a recording or through monitored live voice. Each ear will be isolated to determine how clearly an individual can distinguish words. The scores from this test allow the audiologist to determine the degree of hearing loss and how the individual will likely do with a hearing aid, when speech is able to be amplified. The clarity of speech of speech is important in determining if an individual will succeed with hearing aids.
Understanding speech in background noise is a common complaint of many individuals. The quick speech in noise test (qsin) is an assessment of how well an individual is able to understand speech in background noise. A threshold is determined for the level at which the individual can accurately understand speech in noise and a score is generated. Qsin may be performed both before and after hearing aids are fit to ensure hearing aids are providing appropriate gain and improvement. Qsin is an essential tool that allows audiologists to determine which hearing aid features or assistive listening devices will best help an individual.
Play audiometry allows pediatric audiologists to evaluate the hearing of the youngest patients typically between ages 2-5. Around 5 years of age, many children can perform traditional hearing testing in the booth. Before that age, audiologists can create games, such as placing a peg in a hole or putting a block in a bucket, every time the child is able to hear a tone or speech. Many children enjoy play audiometry and view it as a game. Play audiometry allows the audiologist to determine the hearing threshold of the child and the type of hearing loss. For children under the age of 2 there are different tests used to evaluate hearing.
Otoacoustic emissions, or OAEs, are a part of the evaluation that assesses the inner ear, or cochlea. This test is used to evaluate babies through adults. The cochlea has hair cells that are important for sending the sound signal to the brain. Like some of the other tests, this test requires the patient to sit still and does not require a response. The audiologist will insert a probe into the ear and you may or may not hear some sounds. When the sound is able to be heard by the cochlea, the sound causes a vibration that is able to be measured by the probe. There are many different types and causes of hearing loss, and OAEs will help your audiologist to determine how to best help you.