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 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 helps 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 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 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.²