Procedures: Hearing Exams

If you are concerned about having your hearing tested, the following page provides information about the hearing examination process, in layperson's terms.

• Your hearing health care professional
• Your medical history
• Looking into your ear
• Pure tone tests
• Speech tests
• Impedance test (of the middle ear)
• Audiogram

Your hearing health care professional

An audiologist, or licensed hearing instrument specialist, will most likely test your hearing in a number of different ways to determine where the hearing problem is located. At the end of your hearing test, your professional will explain the tests he/she performed and interpret the results for you.

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Your medical history

Before proceeding with your hearing tests, your hearing health care professional will ask you some questions about your medical history including:

• Noise and noise levels you have been exposed to;
• Possible physical damage to your ears;
• Past illnesses or other conditions that may have affected your hearing;
• Medications that may have affected your hearing.

Understanding your medical history helps your professional decide the best way to assist you with your hearing loss.

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Looking into your ear

After recording your medical history, your hearing health care professional will will look into your ear using an instrument called an otoscope. An otoscope is a cone-shaped instrument with a light on one end, and it helps your audiologist view the inside of your ear.

With an otoscope, your professional can determine if there are any abnormalities in your ear canal or with your eardrum.

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Pure tone tests

After your hearing health care professional looks inside of your ear, the next step is to place you in a sound booth. The sound booth, or sound room, ensures that outside noises will not interfere with your hearing test.

Pure tone testing helps your professional determine the threshold at which you hear different frequencies. For the pure tone test, you will be asked to either (a) insert a small set of earplugs into your ears, or (b) place headphones over your ears. The ear plugs or headphones will deliver a series of tones into your ears. An audiometer electronically generates the "pure tones" which will vary in tone and volume. Whenever you hear a "pure tone," you will either raise your hand or push a button to indicate that you hear it. For this test, your professional will test each ear individually.

For the next set of pure tone tests, your hearing health care professional will place a small bone conductor behind your ear. The bone conductor transmits sound through bone vibration to the cochlea of the inner ear, bypassing the middle and outer ear. This set of pure tone tests helps your professional determine your type of possible hearing loss.

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Speech tests

After the pure tone tests, your hearing health care professional will give you speech tests. You will be taking this test in the sound booth, just like the pure tone tests.

For the speech tests, your professional is trying to determine the level at which you can detect and understand speech. You will hear a series of words that you will be instructed to repeat. Some of the words will be 2-syllable words, and the words will become softer as the test proceeds. Next, you will be asked to repeat a set of 1-syllable words; however, the volume of these words will stay the same.

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Impedance test (of the middle ear)

Your hearing health care professional will most likely check your middle ear using an impedance test. For this test, your professional will place a probe inside of your ear. Then your audiologist will increase and decrease the air pressure on the probe while presenting a tone. The results will be generated into a graph.

Depending on the results of the pure tone, speech, and impedance tests, your professionalo might want perform other hearing tests. The results of these tests will be presented to you in a paper, graph, or report format. And your professional will be able to interpret them for you.

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Audiograms

A chart called an audiogram shows the results of these hearing tests. An audiogram is a graph with red Os and blue Xs connected with little lines. The Os represent the right ear and the Xs represent the left ear. Marks near the top of the graph indicate better hearing and marks near the bottom of the graph indicate poorer hearing. Across the top or bottom of the audiogram are frequency numbers ranging from 125 Hz (a very low tone) to 8,000 Hz (a very high tone), while the numbers goingdown the side of the graph represent hearing level.

To the right is sample audiogram.

Along the side of the graph, a series of decibel (dB) numbers indicate loudness. Very soft sounds are at the top (-10 dB or 0 dB) and loud sounds (110 dB) are at the bottom. Zero decibels (0 dB) is the softest sound a person with normal hearing ability can perceive 50% of the time. Normal conversation usually occurs at approximately 55 dB.

Your audiogram indicates:

• Which is the better ear;
• Your level of hearing loss; and
• The frequencies (in Hz) at which you hear best.

The speech tests indicate test reliability and/or where in the hearing system you could have problems.

Your professional will take the time to explain your test results. If you do not understand something, please do not hesitate to ask your professional to explain in layperson's terms.

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