Full Hearing Evaluation

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

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

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

• Self-assessment of the hearing loss
• Detailed history of the current problem
• Medical history, including ototoxic drugs and chemotherapy
• Family history for possible genetic influence

VIDEO Otoscopic exam helps to observe the condition of the ear canal and eardrum:

• Visual Inspection of the external ear canal
• The direction of the ear canal
• Presence or absence of any unusual landmarks
• Presence or absence of earwax

To continue the test, we need to see at least 30% of your eardrum. If there is excessive earwax obstructing our view, we may recommend that you see your family doctor to have it removed.

• • Visual Inspection of eardrum
    • The diameter
    • The length
    • The appearance

An otoscopic exam may indicate the need for a medical referral to your physician.

Immittance testing

It measures the function of the entire middle ear system, located between the eardrum and cochlea. Without the middle ear, we would not hear sounds between 1000 – 4000 Hz and would experience hearing loss of 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

The pure-tone audiometric test assesses a person’s ability to hear sounds at the lowest intensity levels.

Sound signals reach the cochlea through two pathways: air conduction and bone conduction.

Air conduction involves the transmission of sound from the atmosphere to the cochlea via the ear canal and middle ear. In contrast, bone conduction occurs when the skull vibrates directly, bypassing the outer and middle ears, and stimulating the cochlea.

Using an audiometer, we measure hearing sensitivity across a broad range of pitches using both air conduction (achieved by placing earphones in the ear canals) and bone conduction (utilizing a headband placed on the head). Comparing air and bone conduction results helps 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 uses 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 processes speech.

• It helps identify hidden abnormalities that require medical attention.
• It identifies any unusual asymmetry in the results between the right and left ear.
• The results assist in choosing the appropriate hearing aid. For instance, if a client has symmetrical hearing loss but asymmetrical results on the speech test and wants only one hearing aid, we will know which one to fit.
• The scores obtained from this test can aid in diagnosis if speech recognition has changed over time.

Loudness test (LDL)

• • The loudness of hearing aids cannot be set to a “one size fits all” approach; it must be based on the client’s preference, which may vary.

    For example, 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 ranging from 72 to 130 dB SPL. Without this test, the programmed hearing aids could be significantly too loud or too soft for many individuals.

    The LDL test, or Loudness Discomfort Level test, helps us measure your individual tolerance to loudness and set the correct limit of loudness you need in the hearing aids. This is crucial as it prevents loud sounds from becoming uncomfortably or painfully loud.

    Without this test, loud sounds might be too intense, leading you to lower the volume. However, if the volume is too low:

    • Speech quality and understanding may decrease.
    • Background noise may become more prominent than speech.
    • Music might sound dull.

    In summary, the LDL test ensures that the loudness settings on your hearing aids are tailored to your comfort and hearing needs, enhancing your overall listening experience.²