Adult Hearing Evaluations

It is common for people to not always hear everything that is said to them. If this occurs frequently, causes embarrassment, or interferes with job performance, you may want to have your hearing checked to see if there is a problem. A hearing evaluation will determine how well you can hear sounds of different frequencies, as well as, how well you can understand speech. Hearing exams are conducted in a sound treated booth to minimize the interference of outside sounds.

The appointment typically takes between 45 minutes and one hour. A complete history of your hearing problem and hearing health is conducted. The audiologist then examines your ears with an otoscope to check for things like excessive ear wax, problems with the ear drum or middle ear fluid. Once the otoscopic exam is completed, you will be placed in the sound booth and ear phones are placed on your head. Pure tones are presented at various frequencies or pitches to determine the softest level that you can hear (threshold). These threshold values are plotted on a graph which is called an audiogram. Thresholds measured with earphones are called air conduction scores and represent how well the whole ear (outer ear through inner ear) works. These values are compared to bone conduction thresholds. Bone conduction thresholds are measured the same way as air conduction thresholds, but instead of using eaphones, a bone oscillator is placed on the mastoid bone behind your ear. When the pure tone signals are presented through the bone oscillator, the vibrations of the mastoid bone lead to perception of the tones just as when earphones are worn. Bone conduction measures essentially test the inner ear directly. By comparing how softly you can hear air conducted signals to how softly you hear bone conducted signals, we can determine where in the ear your hearing problem lies. Conductive hearing loss occurs when the outer ear, ear canal, ear drum or middle ear do not transfer the air conducted sound to the inner ear. In most cases this type of problem can be treated with medicine or surgery by your physician. Unfortunately, approximately 90% of hearing losses are the other type which involves damage to the inner ear structures or the hearing nerve itself. These types of problems cannot be treated with medicine or surgery, but, in most cases, hearing aids can offer considerable help.

Other measures are often used during the evaluation to study the function of your ears such a tympanograms and stapedial reflex studies. Tympanometry is used to determine if pressure or fluid exists behind the ear drum. Stapedial reflex testing examines the function of the muscles of the middle ear. Stapedial reflex measures give information regarding the middle ear muscle function which can be helpful when assessing a person with facial nerve paralysis (Bell's Palsy). These measures can also be used to estimate hearing ability in patients who are not capable of taking a traditional hearing test. A third use of stapedial reflex testing is to screen for pathology of the hearing nerve.

Once all of the data are collected, the audiologist will thoroughly discuss the results with you. Treatment options will be discussed and and if approproate, recommendations will be made. This is a time when ahearing aids will be discussed to determine what may offer the best help for your particular problem.