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A Hearing Test Explained

The process

So, you have found yourself between unintelligible speech and wanting to be involved in the conversation. Congratulations, it’s time for a hearing test. I will attempt to explain what you can expect to experience, what will be tested and next steps for you to take in order to regain control of the conversations you may have missed up until now. A hearing test is a tool used to help determine how much intensity or dose of loudness you need in order to be able to hear a given sound. It helps to determine in which specific area you struggle, moreover, which frequencies you struggle with. Before we begin, I will need to collect some information from you.

The Intake

We need to have a conversation about your hearing history. The idea is that as we are talking, you will help to create a hearing profile or part thereof. This seemingly easy-going conversation is a grand tool that will aid us in being better equipped to get you back on the path to hearing and tracking what you will need in the future as part of a medical profile. I will ask questions like, what kinds of noise exposure have you had in the past? Maybe you were a hunter and shot guns, or maybe you liked to sit next to the loud speakers at the concert. Did you wear hearing protection? Have you experienced vertigo recently or in the past? What is your family history as it relates to hearing loss?

Question like these and more are quite important and serves both you and I in the developing of a plan that will allow you to enjoy better hearing. You will have the opportunity to ask questions because I operate from a patient centered approach. Many studies show that when a patient is actively involved in their health care they tend to do quite well. I will however need to inspect your ears to make sure we will have success in doing a hearing test. We cannot go forward if you have certain lesions of the ear or for instance cerumen or some obstacle blocking the path of sound.

The inspection

It is important to look at and, in your ears, to make sure there is nothing that would prohibit us from going forward with a hearing test. One thing, as mentioned earlier, that could prevent us from doing a hearing test is excess cerumen also known as ear wax. Although, a certain amount of ear wax is healthy as it helps protect our ears from dirt, fungus and even insects.  Cerumen maybe yellow or brown in color and when impacted will prevent us from seeing the eardrum. If this is the case, I will advise you to perform a series of water washes in order to remove wax and we will try again for a hearing test at a later point in time.

Eardrum

We will look for redness of the eardrum signaling a possible ear infection. I will more than likely refer you to your primary doctor so that you can be treated accordingly.  administered proper antibiotics if need be. I want to perform a hearing test with clear line of sight and healthy ear drums. There are several abnormalities that could occur on or around the ear drum. Some will prevent the hearing test from taking place and others not so much. There could be a rupture to the ear drum presenting in the ear which could potentially heal on its own but may benefit again from medical treatment,   You could be suffering with tympanosclerosis which can appear as flaky, greyish or cloudy discoloring on the eardrum. Tympanosclerosis is the result of scared tissue. One possible cause is that you have experienced several ear infections.

With very clear visual inspection, which is hard to see sometimes, we can see the ossicular chain.  If we see scaring and hence calcification it starts to restrict the movement of the ossicular chain. When I speak of the ossicular chain I am merely talking about the three tiny bones in the middle ear (malleus, incus, and stapes) that work in tandem to pass sound to the inner ear. Once we have passed inspection, we are ready to bring out the audiometer and get to the meat of the matter.

The Audiometer

It is at this juncture in the process that I will inform you of the impending hearing test and what I need of you. I am going to use an audiometer to test your hearing. The audiometer can determine which kind of hearing loss you have. This device measures your hearing in decibels. The audiometer is calibrated so that the (SPL) sound pressure level corresponds with the (HL) hearing level. The audiometer can put forth pure tones called pure tones.  These pure tones are tones that represent various frequencies but are not found in nature.

The audiometer can play different tones at different levels of loudness. On the audiometer there are options for the tester to attenuate certain sounds. The sound pressure level that is delivered at a certain frequency by an audiometer represents the hearing level. If I deliver an 80 Decibel sound and attenuate (soften) it so that you receive it at 45 dB then, 45db is the hearing level produced by the audiometer. The audiometer can be used to test pure tone conduction, bone conduction and even speech recognition.

Let us recap

The audiometer is used to test the acuity of your hearing. Sound pressure level is the vibratory force cause by sound waves in the air and can be attenuated with the audiometer to produce a desired intensity, thus the hearing level. In a nut shell this is the audiometer and the tool used for hearing test purposes.

The Instruction

I will play different sounds at different tones at different frequencies one ear at a time. You will push the button indicating when you hear a sound. I will administer the sounds one ear at a time. If you are guessing to much I will re-direct, you and we will begin anew. At first it is typical to  guide you into a sound proof room and place ear inserts into your ears. Then we begin to administer the series of sound or pure tones measured in Hz.  First we test you via air conduction and then test you through bone conduction. The sensors are placed on your mastoid which is that bone at the side of your scull and right behind your ear.

Later I will play a Recorded voice and they will say words that you will repeat so that we can get an understand of your speech discrimination. When we are done, we will go over the results that are printed on an audiogram. The audiogram will visually show us where you struggle and where you are hearing well.

 In Summary

There is a lot that goes into understanding the ear, sound, and how the field of audiology works and has evolved over time. In order to traverse the plains of unintelligible speech to the realm of hearing you need to under go a process. The process starts with a simple conversation. The conversation will reveal many aspects in your overall condition and prompt us to bring out thee old audiometer as we remain mindful of different abnormalities of the ear, coined concepts and our brains very own interpretation of sound. You can expect to be treated with care, as an individual, and your input considered every step of the way. The path to hearing is treaded carefully and with intention. And your next steps are to schedule an appointment today and let us focus together on what’s important and review your audiogram as we craft a plan best suited to put you in a position to gain control of that lost conversation.

Call Chears today, we are here to help you hear!

By Jeffery Bostic

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