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Colorado Springs

Audiology, Inc.

 

Phone  719.520.1155

LOCATION & DIRECTIONS

Dr. Gene McHugh

Licensed Audiologist

in Colorado

 

 

OFFICE HOURS

Mountain Time USA

Mon-Thurs

9:00 AM-5:00 PM

Closed Fridays

 

 © Copyright 2018 

 

 

 

 

 

 

 

  TEST PROTOCOL IN ROUTINE AUDIOLOGY

 

 
 
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.

* Conducted when necessary