Hearing Evaluation - what does this include?
What to do beforehand
It is a good idea to make sure that your ear canals are clean before a hearing test. Earwax can affect the results and make them unreliable. It is preferable to have the earwax removed by a specialist or an audiologist that is specially trained to do so.
Confirm your appointment and bring any prior hearing tests with so that a prognosis can be formed from all the available information.
What will happen at the first appointment?
The audiologist will do a thorough hearing test consisting of:
Case History:This entails establishing a rapport with a patient, as well as trying to determine the patient's main complaint.
Otoscopic Examination:This entails the audiologist to rule out any obstruction of the outer ear canal with debris such as ear wax/cerumen, foreign particles such as insects, or abnormal growths within the canal, such as congenital malformations and bony growths of the ear canal. In the event that any obstruction is found, the audiologist would not be able to continue testing the patient prior to an ENT referral for further management of the obstruction. In some cases, an audiologist training in wax/cerumen management would be able to remove the wax.
Tympanometry:This involves the measurement of the ear canal volumes, the pressure within the middle ear cavities, and the presence or absence of acoustic reflexes, either ipsilaterally or contralaterally, or both. These measurements would provide information regarding the functioning of both the tympanic membrane/eardrum and the middle ear cavity.
Often times, this test would also determine whether an ENT referral is necessary, or if further testing can be continued.
Pure Tone Audiometry:This involves the establishment of one's true hearing thresholds via both air conduction and bone conduction testing. Air conduction testing is the establishment of one's thresholds via presenting pure tones through earphones to the ear.
The tones pass from the outer ear, through the middle ear to the cochlea in the inner ear and finally to the brain. Bone conduction testing involves presenting the tones via a bone conductor directly to the mastoid bone, which bypasses the outer and middle ear, and directly transmits the tones to the cochlea.
Speech Audiometry:This involves assessing one’s speech reception thresholds as well as determining one's ability to discriminate speech in noise.
There are various other further audiological tests such as otoacoustic emission testing, auditory brainstem response testing and other electrophysiological tests that can be conducted when deemed necessary by your audiologist.
You will be referred to an Ear, Nose and Throat specialist if there is something that can be done clinically in order to improve your hearing. A hearing loss that is found to be purely in the cochlea or one that cannot be treated medically will be considered for a hearing aid fitting.