A hearing evaluation is performed to assess the level of a person’s hearing. You may have been referred by your GP for suspected hearing loss or by an ENT Specialist to help determine the degree and potential cause for a hearing loss, or as part of investigations for other complaints such as tinnitus or dizziness. The result of these tests will provide guidance to the audiologist in making appropriate recommendations for the management of a hearing loss. This may include advice for better hearing communications skills, hearing aids or referral to an ENT Specialist.
A variety of tests may be performed and will include:
- Pure-tone Audiometry (PTA)
Pure-tone audiometry is the primary hearing test which is performed to determine the lowest sound level that a person can hear. This involves presenting sounds (tones) at various sound levels and frequencies through both headphones (air conduction) or against the bone behind the ear (bone conduction). The test is done in a sound proof environment.
- Tympanometry
This test involves measuring the pressure in the middle ear and assessing the movement of the ear drum. A small probe is inserted into the ear and a small pressure change may be felt along with hearing some beeps.
- Speech Audiometry
This involves an assessment of a person’s ability to hear a variety of spoken words at different levels of sound intensity.
The audiologist will also perform otoscopy (examining the ear canal). If the ears are full of wax or there are signs of infection the hearing evaluation may have to be postponed until the ears are clean and free of infection. You may be asked to see your GP or an ENT Specialist depending on the issue.
Specialized tests exist for infants and young children, as well as children and adults with developmental and cognitive impairments. These specialized tests allow the audiologist to test the auditory system when the patient is not able to actively participate in the tests or evaluation.
For children, it is important to have a diagnostic audiological evaluation whenever a hearing loss is suspected. The tests used for young children will depend on age and the ability to understand simple instructions. Some children are able to perform a standard PTA as for an adult. For others Play Audiometry is used when the child is presented sounds of varying frequencies and loudness and responds by playing simple games. The Audiologist will explain the test and for some children the test will need to be repeated at different times to obtain consistant responses and therefore a reliable assessment. Very young children will have sounds presented to them and when they respond by turning to the side that the sound was presented are rewarded with a visual ‘prize’. This test is known as VRA (visual response audiometry). Otoacoustic Emissions is another test often used and this involves measuring sounds emitted from a child or baby’s ear in response to sounds presented through small ear inserts. This test does not involve the child or baby having to participate in the test. All children will have Tympanometry performed to rule out middle ear fluid as a cause for a hearing loss.
For children or indeed adults who are unable to perform any kind of test and in whom a hearing loss is strongly suspected there are more advanced specialized tests such as ABR (acoustic brain response audiometry) which may be required but these tests are not available in Bermuda. Your ENT Specialist will therefore refer the child overseas.
What Can I Expect During a Diagnostic Audiologic Evaluation?
A routine evaluation will probably last about 30 minutes. You should also allow time for discussion with the audiologist to review test results, and ask questions.
If the determination is made that you need hearing aids, allow for sufficient time to discuss your options. You may need to schedule an appointment for a detailed hearing aid discussion.
It is recommended that you bring a family member with you to the evaluation appointment. Most audiologists agree that hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations.
At your appointment a complete medical history will be taken. The audiologist will also want to know about any complaints you have about your hearing. He or she will pay special attention to any concerns you have about exposure to noise, tinnitus, and balance problems. Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.
The diagnostic audiologic evaluation is a good chance to establish a relationship with your audiologist. Above all, don’t be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.