Call (865) 688-8700 for an appointment.
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 (audiogram) 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 appropriate, recommendations will be made. This
is a time when hearing aids will be discussed to determine what may offer the best help for your particular problem.
is an essential factor in a child's speech and language development. If they are not hearing well, speech, and
more importantly, language is very often delayed. It is important that any hearing impairment is detected at
the earliest possible age so that intervention can start. The earlier the intervention, the better chance of normal
speech and language to occur.
It is hard for most parents to accept that their child
has a hearing impairment, realizing that your child will have a significant challenge to deal with. So it is not
unusual for the parents to be in denial and do nothing thinking that their child "will grow out of it."
loss is not cause for despair. There is no reason why a child with hearing loss should not have a good childhood
and develop quite normally. Just remember to take one step at a time. Your doctor, your audiologist and other skilled
professionals will be able to advise you on how to best help your child. The process begins with a thorough hearing
evaluation. There are several ways to assess hearing in children, even in newborns. The following section details
hearing evaluations in children six months and above.
Visual Reinforcement Audiometry: For our younger patients (six to twenty-four months) we typically
use visual reinforcement audiometry when testing their hearing. Young children are not able to tell us or signal that they
hear so we use toy reinforcers. With this technique the test signal is paired with a visual reward (a light up or dancing
toy). Every time the child responds (turns his head toward the sound) he is rewarded for turning in the direction of the sound.
With this technique we can get a good measure of hearing across the frequency spectrum.
Preschool children and some younger school age children respond better when play techniques are used when assessing their
hearing. This approach is less intimidating for younger children and alleviates fears associated with the test situation.
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