How do we test your hearing?

A hearing test is risk free and gives you the information needed to diagnose the cause of your specific type of hearing loss. 

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How does it work?

Our ears have three distinct parts: the outer, middle, and inner ear (Fig. 1). Audiometry tests can detect whether you have sensorineural hearing loss (damage to the nerve or cochlea) or conductive hearing loss (damage to the eardrum or the tiny ossicle bones). During an audiometry evaluation, a variety of tests may be performed.

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A pure tone audiometry test measures the softest, or least audible, sound that a person can hear. During the test, you will wear earphones and hear a range of sounds directed to one ear at a time. The loudness of sound is measured in decibels (dB). A whisper is about 20 dB, loud music ranges 80-120 dB, and a jet engine is about 180 dB. The tone of sound is measured in frequencies (Hz). Low bass tones range 50-60 Hz, high-pitched tones range 10,000 Hz or higher. Normal hearing range is 250-8,000 Hz at 25 dB or lower.

A word recognition test (also called speech discrimination test) assesses a person's ability to understand speech from background noise. If your speech discrimination is poor, speech may sound garbled. Word recognition scores can be helpful in predicting the usefulness of a hearing aid.

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A tympanometry test detects problems such as fluid/wax buildup, perforated eardrum, ossicle bone damage, or tumors in the middle ear. Acoustic reflex testing evaluates the cranial nerves and brainstem.

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What will the test show?

Pure tone audiometry charts the hearing level of different tone frequencies in both ears. 

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Hearing loss is often described as follows:

• Normal = less than 25 db HL

• Mild = 25-40 db HL

• Moderate = 41-65 dB HL

• Severe = 66-90 db HL

• Profound = more than 90 db HL

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What happens during the test?

The audiometry tests are conducted in a quiet soundproof room (Fig. 3). Earphones will be placed on your head. You will be asked to sit still and not talk. The earphones are connected to a machine that will deliver the tones and different sounds of speech to your ears, one ear at a time. The audiologist will ask you to raise your hand when you hear a sound. For example, if you hear a sound with your left ear, raise your left hand; if you hear a sound with your right ear, raise your right hand. At some facilities, you may be asked to push a button or make some other sign that you have recognized a sound. The audiologist will record each tone at the lowest possible volume that you were able to hear it. Before or after the general audiometry test, tuning forks are also used to conduct the Rinne and Weber tests. Each test evaluates the potential for different kinds of hearing loss.

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To assess speech discrimination, you will be instructed to repeat words you hear. You will hear a series of two-syllable words at a volume that gradually decreases as the test progresses. In the second stage of the test, you will hear and repeat a series of one-syllable words at a volume that does not change.

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During a tympanometry and acoustic reflex test, a soft plug is placed in your ear. The plug will change pressure, make a loud noise, and track your responses to the sound and various pressures. Movement of the eardrum is measured as well as the reflexes of the tiny muscles attached to the ossicles.

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