Comprehensive testing is performed using either foam insert earphones or headphones, and takes place inside a soundproof room. The patient is asked to listen for a variety of soft tones that will vary in pitch/frequency. This range of frequencies (250Hz – 8000Hz) is most important for hearing everyday sounds and speech. This test is performed to determine the presence, type and severity of a patient’s hearing loss. The comprehensive test also includes speech testing. The patient will be asked to repeat two syllable words and the volume of these words will decrease until the softest level is determined. The patient will then be asked to repeat a list of words at a comfortable volume level to help determine their ability to understand speech. Tympanometry is also performed to help determine how the patient’s eardrum, or tympanic membrane, is functioning. This test helps determine if there is fluid behind the eardrum or even if there is a hole in the eardrum. The comprehensive hearing test typically takes thirty minutes and results are provided at that time. If hearing aids are recommended, it is encouraged for patients to schedule a full hearing aid evaluation that allows an hour to discuss options.
Hearing aid evaluation
During a hearing aid evaluation, results of the hearing test are reviewed. At that time, the audiologist helps decide what type of hearing aids may be most appropriate for you. This decision is based on several factors: severity of hearing loss, appearance of the aids, financial considerations, consideration for any dexterity or vision impairments, and especially daily lifestyle. During the one hour evaluation we will discuss the specifics of hearing aid options and address any questions or concerns from the patient. There is no charge for a hearing aid evaluation and certainly no pressure to purchase any hearing aids on the spot. We aim to provide a relaxed atmosphere to “guide” our patients to better hearing, not “sell” them hearing aids. Please visit our hearing aid information section for more information about products available through our office.
Electronystagmography (ENG) testing is composed of several subtests. The patient will have electrodes placed around their eyes in order for the computer to help detect any movement in the eyes as a result of multiple dizziness possibilities. The first part of the test is performed with the patient sitting upright. The patient is required to use only their eyes to follow the lighted dot on the bar and perform certain tasks. The second portion of the test is performed with the patient lying back in a reclined position. At that point, the patient will move their head in certain positions, again looking for any type of eye movement associated with certain types of dizziness. For the final portion of the test, the patient remains in the same reclined position. Air is then introduced into the patient’s ear canals one at a time. By irrigating warm and then cool air in each ear canal, the balance function of each ear can be measured separately. All subtests in the ENG are typically completed within one hour. Most patients are OK to drive after this test, but please bring a driver if you are excessively dizzy before any testing has begun. This test is typically performed to evaluate the balance function of the inner ear and also examines some portions of the central nervous system. There are specific instructions to follow prior to the ENG test and you will be asked to fill out a balance/dizziness questionnaire as well.
Auditory Brainstem Response (ABR)
The Auditory Brainstem Response (ABR) test is a procedure performed by placing electrodes behind each of the patient’s ears and two more on the patient’s forehead. Foam earplugs are then placed into the patient’s ears and a louder continuous clicking sound is heard. The electrodes measure the response of the auditory nerve. The test usually lasts about 30 minutes. The patient lies still with eyes closed and is not required to respond during testing. This test is typically performed to help aid in the diagnosis of a retrocochlear pathology and can also be utilized in the determination of hearing thresholds.
The Electrocochleography (ECOG) test is a procedure performed by placing a foam earplug coated with a special material into the patient’s ears. We also place two gel electrodes on the patient’s forehead. The patient will hear a louder continuous clicking sound that goes back and forth between each ear during the test. The audiologist will be measuring responses from your ears on a computer next to you. The test usually lasts about 30 minutes. The patient lies still with eyes closed and is not required to respond during testing. This test is typically performed to help aid in the diagnosis of Ménière’s Disease.
Canalith Repositioning Procedure (CRP)
This procedure is only used for patients with a specific type of dizziness called Benign Paroxysmal Positional Vertigo (BPPV). First, a subtest is performed that allows an audiologist to check to see if the patient has this specific type of dizziness. The patient sits upright with legs extended. The patient’s head is then turned by 45 degrees. The patient lies down quickly with their head hanging back in a certain position. The patient’s eyes are then observed for about 45 seconds to see if a rotational eye movement occurs called rotary nystagmus. If you have a positive result to this test, you are diagnosed with BPPV.
If you have a positive response, typically the audiologist will perform a Canalith Repositioning Procedure (CRP) if there are no physical limitations. The goal is to move dislodged crystals (otoliths) out of the very sensitive semicircular canals and back into the less sensitive utricle structure where the crystals do not cause trouble and are more easily reabsorbed. Your body and head are moved around on the table. Each position of the procedure is typically held for one minute after any symptoms or abnormal eye movement stops. This treatment is typically performed only to resolve BPPV and usually takes about an hour. Every patient reacts differently and it may be beneficial for someone to accompany the patient for the treatment.