TEST |
ABOUT THE TEST |
|
PURPOSE |
|
OUTCOME |
Otomicroscopy |
 |
External ears and eardrums
are examined using a highly illuminated microscope and, if necessary,
cleaned. |
|
Rules out abnormalities of
the external ear including the pinna, ear canal, and/or eardrum. |
|
If significant cerumen is revealed, cerumenectomy using otoloop or
lavage is completed. If necessary, patient is referred to ENT. |
Tuning Forks |
 |
Tuning fork is vibrated and
placed at the skull's vertex and around ears and patient asked to
respond to questions regarding localization and loudness.
|
|
Yields information about the nature of the hearing loss,
differentiating conductive versus sensorineural hearing impairment. |
|
May affect further testing if hearing loss is conductive in nature. |
Tympanometry - objective test of middle
ear function |
 |
Soft probe is inserted into
the ear to measure the mobility and flexibility of the eardrum.
Does not require a patient's active participation.
|
|
Rules out abnormalities
involving the middle ear structures, including the eardrum.
|
|
If middle ear abnormality is determined, medical referral is indicated. |
Acoustic Reflexes - objective test of middle ear &
VIIIth nerve function |
 |
Same probe for
tympanometry is inserted along with an earphone to the opposite
ear. Test measures does not require a patient's active participation.
|
|
Rules out
abnormalities involving the stapedius muscle and/or eighth nerve.
|
|
If
reflexes are absent or elevated in either ear, further testing
is indicated to rule out other potential medical factors. |
Sound booth testing |
 |
Adult or child is seated in an 8'x8' soundproof booth, per normal audiometric
protocol - using foam-insert or standard earphones. |
|
Testing in a controlled environment guarantees the most accurate and
reproducible audiometric evaluation. |
|
Extremely reliable hearing test results, repeatable if measured in
another laboratory. |
Speech recognition threshold |
 |
Patient repeats simple words like "baseball," "hot dog" cupcake,
"ice cream," etc. |
|
Establish patient's general level of audibility
|
|
Intensity of speech necessary to understand 50%. Used to
corroborate air conduction thresholds. |
Air
conduction thresholds (adult) |
 |
Using earphones, patient pushes a button when they hear, barely hear, or
think they hear, a sound. |
|
Establishes a patient's hearing threshold at various frequencies through
outer, middle, and inner ears; expressed as decibels (dB) hearing
loss. |
|
Basic audiogram. Determines type and degree of hearing
loss. 0-25dB (normal); 25-40dB (mild loss); 40-70dB (moderate
loss); 70-90dB (severe loss); 90dB or worse (profound loss). |
Air
conduction (pediatric) |
 |
For children age two to five, "play audiometry" is used to
elicit responses. In play audiometry, children learn to pair
hearing tones while playing a game.
|
|
"Play audiometry" yields reliable threshold responses, and is mostly used to "screen" hearing ability in cases where a child's
speech/language development is delayed. |
|
PASS SCREENING - no
hearing loss
FAILED SCREENING - further testing warranted |
Word recognition (speech discrimination) |
 |
Patient repeats a
list of one-syllable words (without the aid of context) like "carve"
"bathe" "ace," etc. |
|
Yields a
general measure word clarity and expressed as a percentage. |
|
90-100%->excellent; 80-90%-> fair; 70-80%->poor; <60%0>
profoundly impaired. |
Hearing-in-Noise Testing |
 |
Patient repeats short
sentences with competing background noise interference. |
|
Determines patient's
level of difficulty while in the presence of background noise. |
|
Affects decisions
regarding effective hearing aid management. |
Bone conduction* |
 |
Using a bone
oscillator positioned on the mastoid process, patient pushes a button
when they hear a sound. |
|
Bypasses the outer
and middle ears, and establishes thresholds exclusively in the inner
ear. |
|
The main purpose is to rule out "conductive" hearing loss. |
Acoustic reflexes* |
 |
A probe is inserted into the ear to measure the presence of
absence of the stapedius muscle. |
|
The stapedius muscle
normally contracts in response to a loud sound. The test rules out
various abnormalities of the ear. |
|
PRESENT - normal
ELEVATED - suspicious of
retro-cochlear involvement
ABSENT - abnormal |
Comfortable loudness |
 |
Patient listens to
sounds to establish point of most comfortable loudness (MCL) and
loudness discomfort level (LDL). |
|
If hearing aids are
necessary, this testing assists with setting gain and maximum
output limits in the hearing aid circuitry. |
|
Affects decisions
regarding effective hearing aid management. |