The health of your auditory system is our primary concern.
You may have been referred to us by your primary care doctor, or Ear, Nose and Throat Specialist for a comprehensive audiological (hearing) evaluation; or, you may be in our office seeking hearing aids. Whatever the reason, the first thing we do is determine the cause of your hearing loss and rule out any serious health conditions. During your visit, we will thoroughly examine the health of your auditory system utilizing advanced diagnostic test equipment, review the results with you, and send a written report to your physician(s).
Education is the first step to preserve and improve your hearing health.
An otoscope is what the doctor uses to look inside of your ear. Via otoscopy, we will be able to determine the health of your external ear and eardrum to better understand if your hearing difficulties may stem from abnormalities of the ear such as: build-up of earwax, a hole in the eardrum, inflammation, or infection.
Immittance testing refers to the diagnostic testing of the middle ear system. Immittance measures can be used to assist in determining type and degree of hearing loss.
- Tympanometry: Measures the movement of the eardrum. Tympanometry is useful to identify middle ear pathology such as a hole in the eardrum or ear infection. It can also be used to determine if earwax is completely blocking the ear canal.
- Acoustic Reflex Testing: The acoustic reflex is a muscle response to loud sounds. During testing, we are determining whether the muscle is reacting at normal sound levels, at louder than normal sound levels, or is not reacting. When administered and interpreted accurately, acoustic reflex testing gives diagnostic information regarding the integrity of the facial nerve, auditory nerve, and a portion of the auditory areas of the brainstem.
Otoacoustic emissions (OAEs) measure the sounds that the outer hair cells of the inner ear make in response to an auditory stimuli or input. OAE testing is often utilized for Newborn Hearing Screenings provided in the hospital just after birth. OAE testing can also be utilized for testing adults and children to identify the source of hearing loss or tinnitus.
Audiometry is most often referred to as the “hearing test”. Earphones or headphones are placed on the patient’s ears and (s)he is asked to press a button every time they hear a beeping sound. A bone oscillator headband is also used which allows direct stimulation to the inner ear. Test results are used to determine type and degree of hearing loss, and are used to estimate the degree of communicative impairment and to develop prescriptive hearing aid programs.
- Pediatric Audiometry: Visual Reinforced Audiometry (VRA) is used to test very young children (6 months to 2 years), while Conditioned Play Audiometry (CPA) is used to test children age 2 to 5 years (approximate ages). Using VRA, we are able to identify when children are hearing sounds by observing him/her instinctively look for the sound. When they find the sound source, a toy is activated to reinforce the child to continue to turn his/her head every time they hear the sound. VRA may be completed using earphones, headphones, or sound speakers in the sound booth. During CPA, the child is trained to drop a block into a bucket every time they hear a sound. These pediatric specific techniques allow us to determine which sounds the child is able to hear, and how loud the sounds must be before the child identifies the sound.
- Unsedated (Natural Sleep) Auditory Brainstem Response: Auditory Brainstem Response (ABR) testing is an electrophysiological measurement that allows the audiologist to obtain information about the hearing status of a person that cannot respond by traditional measures. ABR testing is most often used to identify the hearing status of infants and very young children, and is the most critical procedure in the initial test battery because it is the only accurate and reliable predictor of hearing loss in infants who are too young to respond to behavioral hearing testing. The ABR measurement provides information on the degree, type, and configuration of a hearing loss and allows the audiologist to fit an infant with a hearing aid(s) when needed.
During unsedated ABR testing, the infant/child is tested during natural sleep in a sound proof booth at the audiologist’s office. This procedure can take up to two hours to complete, so it is very important that your child arrive at his/her appointment sleep deprived. It is often best to schedule the appointment during your baby’s typical nap time, and plan on feeding your baby at the office to encourage a good sleep pattern.
Speech audiometry identifies the patient’s ability to identify various levels of speech in different listening environments. We test how quietly and accurately you can understand speech in quiet, as well as incorporate listening in noise tests to identify how difficult it may be to listen in complex listening environments. Speech audiometry test results are used in helping to identify appropriate levels of technology and programming information for hearing aid selection.
- Pediatric Speech Audiometry: Children that are not yet able to repeat words are asked to identify and point to body parts (i.e. nose, mouth, hair, etc.), or may be asked to point to pictures of the word being said. In very young children that are not yet aware of the names of body parts or pictures, we utilize familiar sounds and songs to simulate interest and attention to determine how quietly he or she can identify speech is being presented.
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Auditory Processing Evaluations
In order to “hear”, you not only need your ears, and an intact auditory system; but also a properly functioning brain that is able to store, organize and retrieve auditory information. Auditory Processing Disorder occurs when the auditory centers of the brain do not function properly, although peripheral hearing (what the diagnostic hearing test evaluates) is normal.
The auditory processing evaluation is a thorough evaluation aimed at tasking the auditory centers of the brain in more difficult listening environments. Multiple subtests are administered during the auditory processing evaluation focusing on listening in noise, listening to filtered words with pieces “missing”, listening to two different stimuli (often words or sentences) in both ears, and listening to sped-up (i.e. Mickey Mouse) sentences.
The auditory processing evaluation is time intensive and can only be performed after normal peripheral hearing sensitivity has been determined by the diagnostic audiological evaluation. Treatments for auditory processing disorders vary per individual and identified area of auditory processing weakness.
Although cerumen (ear wax) is healthy and serves an important role in your ear health, it sometimes can block up the ear canal causing a hearing loss and must be removed. Should it be determined during otoscopy there is a buildup of cerumen (ear wax) in the ear canal, we utilizing various techniques to remove the wax from the ear canal. Sometimes it may be necessary to use a softening agent for a few days prior to removal.