Open Hours:  Tues, Fri - 9 am to 5 pm       Wed, Thurs - 12 pm to 8 pm        Sat - 9 am to 4 pm         5544 Calgary Trail, Edmonton T6H 4K1

Our Service

“If you want to improve something, you first have to measure it”, Robert Boyle

FULL HEARING EVALUATION

Hearing tests can reveal not only hearing loss but underlying medical issues.

A case history is a documented record of your reported personal history

Self-assessment of the hearing loss 

Detailed history of current problem

Medical history, including ototoxic drugs and chemotherapy

Family history for possible genetic influence

VIDEO Otoscopic exam meant to observe the condition of the ear canal and eardrum.

Visual Inspection of the external ear canal

  • The direction of the ear canal
  • Present or absent any unusual landmark
  • Present or absence of earwax

To continue the test, we need to see at least 30% of your eardrum. If you have too much earwax, we will suggest you see your family doctor to flash it out.

Visual Inspection of eardrum

  • The diameter
  • The length
  • The appearance

An Otoscopic exam may indicate needs for a medical referral to your physician.

Immittance testing

  • measures the function of the entire middle ear system (between eardrum and cochlea). Without the middle ear, we would not hear sounds between 1000 – 4000 Hz and have hearing loss around 30 to 40 dB
  • eardrum movement
  • ear canal volume
  • contraction of the middle ear muscles that provides some slight protection to the ear from loud sounds around 85 dB HL or louder
  • the function of the Eustachian tube, how well it ventilates the middle ear space

This exam will determine if a medical referral to your physician is needed.

Pure-tone audiometric test – person’s ability to hear sounds at the lowest intensity level

Sound signals travel to the cochlea in two ways: air conduction and bone conduction.

The air conduction path is the transmission of sound from the atmosphere to the cochlea through the ear canal and middle ear to the inner ear. The bone conduction way is a direct vibration of the cochlea by vibrating the skull and not using the outer and middle ears.

With an audiometer, we will measure the hearing sensitivity across a broad range of pitches by both air conduction (using earphones placed in the ear canals) and bone conduction (using a headband placed on your head). The relationship between air and bone conduction will identify the type and degree of hearing loss.

Statistic shows, that

  • 5% hearing loss from Bone Conduction
  • 95% sensori-neural hearing loss

Conductive loss usually is treatable by drugs or by surgery in ENT clinics.

Sensorio-neural hearing loss is resulting from damage to the hair cells in the cochlea. This type of hearing loss use hearing aids as the only treatment.

Speech tests in quiet (WRT)

This test evaluates the ability to understand two-syllable words from a phonetically balanced word list and shows how well your brain process the speech:

identify hidden abnormalities that need medical attention. 

identify unusual asymmetry in the result for right and left ear

Choose the appropriate hearing aid (if a client has symmetrical hearing loss and asymmetrical WRT speech test but wants only one hearing aid, we will know which one to fit). 

Use the scores for diagnosis if speech recognition has changed over time.

Loudness test (LDL)

The loudness of the hearing aids cannot be set to “one size fits all”, it cannot be too high or too low but must be based on the client preference which may vary.

For a hearing loss of 50 dB HL, the automatic pre-setting of average loudness is 102 dB SPL, but in reality, people prefer loudness from 72 to 130 dB SPL.  Without this test, the programmed hearing aids  could be significantly too loud or too soft for many people.

Every hearing aid has a maximum level of loudness it can produce. The LDL test helps us measure your individual tolerance to the loudness and set the correct limit of loudness you need in the hearing aids. It is important because it keeps loud sounds from becoming uncomfortably or painfully loud.

Without this test, the loud sound might be too loud, causing you to turn the volume down, but with no volume, no speech.

In case, if the limit is too low,

  • Speech quality and speech understanding are getting poor.
  • Noise becomes louder than speech.
  • The music sounds dull.

HEARING AID PROGRAMMING

All hearing aids need to be programmed before you can use it.

Most of the providers choose the manufacturer’s proprietary fitting method for programming because the goal of hearing aid manufacturers is to make the introduction to hearing aids as pleasant as possible and easy to sell.

The problem is no one can measure exactly how much sound the manufacturer’s formula gives to the client’s hearing aids. The manufacturer’s fitting formulas don’t have targets. Hence, we would never know if hearing aid users receive either too little or too much volume at different pitches. On top of it, the differences like the length, diameter, thickness of the skin lining the ear canal, and the sensitivity of the eardrum, depth of hearing aid insertion affects how much sound passes the eardrum.

For these clients, less gain sounds more like no hearing aids at all, which is what they are used for. However, the main purpose of hearing aids is understanding speech in background noise.

We program all hearing aids only with SCIENCE EVIDENCE-BASE prescriptive algorithms (NAL-NL2 or DSL) and never with a manufacturer’s proprietary fitting algorithm icon. After that, we do verification on accurate fitting to determine that soft sound is audible, speech sound is comfortable and loud sounds are not too loud. We do that because several researchers found a 10 dB variation in the amount of gain prescribed by NL-NAL2 or DSL for the various hearing aids among all brands. That means that if we program 6 hearing aids (each from different manufacturers) with the same formula and the same amount of gain, they produce different amounts of gain into the ear canal of the same client.

REM – REAL EAR MEASUREMENT TEST

 

New hearing aids, re-fitted, returned from repair, adjusted, new earmold/dome installed need to be determined that soft sound is audible, speech sound is accessible and loud sounds are not over amplified.

REM (real ear measurement) is an evidence-based method for assessing the performance of hearing aids in the client’s ears. This is the only way to confirm the appropriate amount of gain provided by hearing aids to a client and improve speech understanding performance in background noise. Without this test, hearing aid users receive either too little or too much volume at different frequencies (pitches).

The reduced audibility leads to reduced speech understanding in background noise.

Here is an example of how your REM should look after the test and adjustments.    

The little dots are the targets.

Green line – soft sounds,

red line – comfortable,

and the blue line – is loud sounds

ULTRA-HIGH FREQUENCY AUDIOMETRY (UHFA)

Humans are capable of hearing up to 20 000 Hz. Traditional pure-tone tests include testing between 250 Hz – 6 000 Hz because this an area of human speech sounds.

If you are at risk for ototoxicity from medication commonly used in cancer treatments, using UHFA tests (up to 16K Hz) could detect small changes and help health care providers in drug therapy to prevent further damage to your hearing.

Testing frequencies above 8000 Hz can show changes in hearing related to aging and medication’s use.  It can also explain a musician’s complaint about the perception of reduced fidelity of music over time.

VIDEO INSPECTION OF EAR CANAL & EARDRUM, PHOTOS FOR MEDICAL REFERRAL

With Video otoscopy we visualize minor abnormalities in the ear on a large video screen and detect early signs of health problems.

It also helps us to better see any pressure sores from hearing aids if it occurs.

We record all photos and use them to monitor any changes for follow-up appointments.

We sent the photos along with referrals to family doctors when our clients need medical care.

HEARING SCREENING TEST FOR WORK

Audiometric screening tests indicate your ability to hear tones at six different frequencies (pitches) and various decibels (loudness). The result will show the degree of hearing loss related to exposure to noise or non-occupational causes. It also helps to determine the effectiveness of ear protection.

The audiogram tests include documenting a comprehensive noise exposure history and determining the current hearing status by checking for recent loud noise exposure and physically examining the ear.

Depending on the result, we will provide recommendations for intervention if needed.

SPEECH IN NOISE TESTS

Are you wondering why so many people are not happy with their hearing aids?

The main reason is that their hearing aids don’t help them communicate in noisy environments?

Research of Richard Wilson (2011) clients who received both speech in quiet and speech-in-noise testing shows that approximately 70% of the clients had good speech results in the quiet, and only 6.9% of these same clients had normal speech-in-noise results. The standard word recognition test in the quiet doesn’t reflect a success with hearing aids.

QUICK SIN

With the Quick SIN test, we measure a client’s ability to understand speech in noise and give the true to life realistic expectations from hearing aids, and help to make the right choice on a technologic level.      

The result of the test helps to make evidence based (unbiased) recommendations regarding hearing aid features.

For example, if your goal is to be able to communicate with friends in a busy Tim Hortons where SNR  is +4 dB (speech has to be 4 dB higher than noise) and the clients’ Quick SIN result is SNR +6, the directional microphone (adding up to 4 dB) is an important feature of your hearing aids.  If your result is SIN 15 dB, a remote microphone is the only option for proper communication.

The Brand and style of hearing aids (“behind the ear” or “in the ear”) we recommend are heavily dependent on this test.

The Threshold Equalizing Noise

With this test, we can determine whether or not you can benefit from hearing aid amplification if you have significant hearing loss

  • Severe to profound hearing loss
  • Steeply sloping hearing loss
  • Complaints of distortion
  • Extremely poor speech recognition

A test will identify cochlear dead regions where the receptors (inner hair cells) and/or neurons don’t function anymore.

In this case, the signal is heard by neighbouring receptors, because the loud sound vibrates a big portion of the basilar-membrane of the cochlea. This Off-frequency listening cannot be seen on a traditional pure-tone audiogram and the threshold on it might not be real.  

If you have a dead region, the traditional hearing aid may provide little to no benefit within that region, and may actually decrease speech intelligibility. You will need to use new advanced technology and fitting methods designed for your loss.

APD TEST FOR INDIVIDUALS WITH MILD TRAUMATIC BRAIN INJURY

Listening disorder is an inability of a person to attend to, focus on, or process the spoken message, to interpret sounds heard by ears even with normal hearing sensitivity.

Did you experience brain injury? Did you notice hearing or listening issues following a mild traumatic brain injury?
  • We offer you the tests which can help physicians to coordinate your care to minimize the impact of the auditory processing disorder at work, home and in the community.
  • We will provide the results of the tests together with a referral to your family doctor.

Tests for Auditory Processing in Adults and Adolescents – SCAN-3A

Dichotic CVs and 1-, 2-, and 3- pair dichotic digit recognition performance. This test provides useful information about the patient’s listening abilities.

Gaps-in-Noise test

The test and result take about 20 minutes.

GIN test is a series of computer-generated, 6-second-long noise segments. Each segment contains silent gaps. The GIN test performs in each ear separately and the clients will need to push a response button as soon as they perceive a gap.

Electro-acoustic test of hearing aids

The same as your mechanic uses a piece of special equipment for reading the diagnostic trouble codes to find out what part of the car needs to be fixed, we have equipment for reading the electronic performance of your hearing aids and find out what part of your aids need to be fixed.

Do you suspect that some features in your hearing aids stop working?

We will test your hearing aids and discuss the best solutions. In some cases, the problem can be solved in the clinic and your hearing aid doesn’t need to be sent away for 2 weeks to the manufacturer.

You won’t drive a “fresh out the oven” car from the manufacturer because you want to be sure all breaks work.

We also perform an electro-acoustic test on new hearing aids before fitting our clients. We guarantee that all features of hearing aids function 100%

Our advanced technology equipment allows us to verify that hearing aids work properly. We can check:

  • Directional mic
  • Noise reduction
  • Output limitation
  • Telecoil

Did you buy your hearing aids from another vendor? Are your hearing aids out of warranty but you want to sure they work properly?

We will do this test for you too.

Second opinion and counselling

Are you not happy with the hearing aid performance from your vendor?

Are you not sure your hearing aids provide a solution that is best for your needs?

Do you want to verify the hearing aids from another provider have been fit appropriately? 

You inherited hearing aids, but you need a professional to fit you correctly?

You purchased an over-the-counter hearing device, but you need a professional to assess if the device is appropriate for your hearing loss needs.

Do you need help, tips, advice to get the most out of your current hearing aids?

Study after study shows that most hearing aids out there that people are using are not fitted very well.  We are here, when you need some advice to verity that your hearing aids meet your individual’s needs. If it does not, we will optimize that specific device to meet the needs as best as possible. We will educate on the appropriate use and care of the device and how to integrate the device functionality into the overall hearing rehabilitation plan.

We are happy to

  • verify the fitting to your prescription,
  • offer additional tests like TEN, QuickSin (if required), an electro-acoustic test of hearing aids
  • give REM tests to improve hearing aids performance

Counselling on

  • What to get out of your hearing aids
  • What technology your hearing aids have.
  • What sort of adjustments you need
  • How to get the absolute performance from your hearing aids

Just remember:

  • Hearing aids should NOT cause any sore spots in the ear
  • Hearing aids should be comfortable physically and acoustically
  • Your own voice might sound different but it should NOT echo, vibrate or sound hollow.
  • Noise should be loud but NOT uncomfortable.

The appointment is typically 1 hour.

Virtual appointment

Real-time contact via text, message, voice call or video call.

■ Remote adjustment and fine-tuning.

Hearing aid users can send a secure message to us describing an experience or issue with the hearing aids and we will resolve the issue without you returning to the clinic for a follow-up visit 

Remote programming allows us to adjust your hearing instruments without visiting the clinic.

Remote programs are available for

  • Oticon Opn and Opn S 
  • Starkey Livio and Livio AI 
  • Phonak Marvel 
  • Signia

You will need to download APPs

  • “RemoteCare” for Oticon Opn users 
  • “Thrive” for Starkey Livio users 
  • “MyPhonak” for Phonak Marvel users
  • Signia

It’s just like a regular in-office appointment, only using remote video technology.

FOR CAREGIVERS, HOSPITAL STAFF, NURSING HOUSES, ETC…

Instruction about normal hearing, hearing loss, listening device technology, speech perception.

We offer FREE consultation on how to use and take care of hearing aids in our clinic or in your facility. Please call to make an appointment.

HEARING AID REPAIR

We will help to put broken, or not working correctly hearing aids back into good condition and make them work again

Most of the repairs can be done in our office on the same day.

In case it needs a factory repair, and your device is out of warranty, we will give you a price quote before the repair is done.

 

HEARING PROTECTION EARPLUGS AND CUSTOM EAR MOLDS

Are you a hunter, a professional musician, a concert goer, a bike rider? Do you work in noisy environments like airports, manufacturers, construction sites? Do you have noisy recreational hobbies or chores like snow blowing/grass mowing, and garage work?

CUSTOM EAR PLUGS are not only hearing loss prevention, but tinnitus and pitch perception problems as well.

Don’t underestimate the risk of permanent damage by working in noisy environments or participating in noisy recreational hobbies. Everyone should wear a hearing protector if the noise or sound level at the workplace exceeds 85 decibels.

Hearing protectors reduce the noise exposure level up to 30 dB and hence the risk of hearing loss if they are fit properly and worn regularly.

Hearing protection for musicians

Earbuds, headsets, and hearing aids are not substituting for hearing protectors and should not be worn where hearing protectors are required to protect against exposure to noise.

We will help you to make the right choice for your ear protection.

Defenders for the workplace (class A and B)

  • for swimming and bathing
  • for hunting
  • for music listeners and musicians with ER 15 or 25 filters
  • for flights
  • for sleep comfort
  • communication earmolds:
    • police headset
    • two-way radio
    • pilot earmold
    • police communicator

You will have two appointments:

Taking an earmold impression

Fitting & Verification.

  • Instruction on inserting & removal
  • Instruction on cleaning and maintenance

Verification

Just because the earplugs fit comfortably in the ear, that does not mean they actually perform according to the specification. Verification of the plugs is an important piece of what we do.

REAT measurement is a pure tone test with earplugs in your ears.

 

EMERGENCY SERVICE

If your hearing aids require emergency care, please call or text 7 days a week and get a phone consultation. We can also serve you at the clinic during off hours and provide necessary service or give loaner hearing aids.

Appointments Available Daily

Come see us!

Contact us

Call Us

(255) 352-6258

Email Us

Hello@divihealth.com

Our Location

5678 Extra Rd. #123
San Francisco, CA 96120

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