08 Clinical Services
Audiologic Assessment (hearing test, audio)
This test is used to assess how well you hear the various pitches that are important to understanding speech. Testing is done in a sound-treated booth. How the test is performed depends upon the age of the patient. This type of test can be performed on infants to geriatrics. Adults are also tested on softly they can hear speech and how clearly they can understand short words at moderately loud levels.
This test is important to quantify the type and amount of hearing loss and can assist the doctor in developing the right treatment plan for you whether it be medical, surgical or rehabilitative. (30 minutes)
Degree of Hearing Loss: A chart called an 'Baudiogram' is used to plot the results of your hearing test. Hearing loss is documented in the amount of hearing loss measured in 'decibels' or 'dB' for various pitches or frequencies. The low-frequencies or BASS sounds are responsible mainly for 'vowel' information (i.e., /a/ or /e/ or /o/) while the TREBLE sounds or high-frequencies contain mostly 'consonant' information (i.e., /sh/ or /th/ or /z/).
Normal hearing 0 to 25dB HL
Mild 25 to 40dB HL
Moderate 40 to 60dB HL
Moderate-severe 60 to 70dB HL
Severe 60 to 90dB HL
Profound greater than 90dB HL
The communication impairment is dependent both upon the amount of loss, and which frequencies are affected. Type of Hearing Loss:
The vast majority of hearing loss (probably around 90%) is caused by problems in the inner ear or 'cochlea'. In the past this has been referred to as 'nerve' loss. However some people have hearing loss resulting from problems in the mechanical portion of the ear; either the ear canal or eardrum or small bones behind the drum. Wax impaction, holes in the eardrum, fluid behind the drum all can cause this type of hearing loss.
Tympanometry (tympanogram, tymp.)
This test measures the mobility of the eardrum and very small bones in the 'middle ear' (space behind the eardrum). It is painless and takes only a few minutes and can be done on all ages. We use it to measure:
- Pressure behind the eardrum (middle ear)
- Fluid behind the eardrum
- Holes in the eardrum.
- It if often used to determine if the ventilation tubes the doctor placed in the eardrum are functioning properly.
Oto-Acoustic Emissions (OAE)
OAE testing assesses the health of the hair cells of the inner ear (small structures that are usually damaged and the under lying cause of hearing loss). This is painless, takes only a few minutes and can be performed on almost anybody. In infants we use this test to assess hearing. In adults and children it is often used to check the inner ear health during chemotherapy. We prefer infants be sleeping or very quiet when this test is performed.
Auditory Brainstem Response (ABR)
This is a 'brain wave' test to assess hearing sensitivity (in infants and small children) and location of the hearing abnormality in adults. The 'waves' were very small (about 0.5 millionth of volt) and are part of the normal brain activity when a sound is processed through the inner ear and lower part of the brain (brainstem). It is important the patient be very s till and relaxed. We encourage patients to sleep through this test and often need to sedate infants/children.
ENG testing is used to assess the performance of the inner ear's contribution to the balance system. Your doctor may order this test when you complain of vertigo, imbalance, lightheadedness or the many other vague balance complaints. Since many medications can have an affect on the results of this test, please click here to obtain a summary of pre-test instructions. A complete list of the disorders that cause dizziness can be obtain here (icsmedical2.com/DiagnosticGuide/default.htm)
Epley or Canalith Repositioning Maneuver (CRP Maneuver)
This 'Maneuver' is used in the treatment of a specific type of positional dizziness call BENIGN PAROXYSMAL POSITIONAL VERTIGO or more simply referred to as BPPV. This is the most common cause of vertigo and usually the most easily treated. Patients with this problem suffer intense spinning when moving into certain positions. It is thought to occur because small crystals (otoconia) are freely floating in the inner ear where they shouldn't be. It is diagnosed with a Dix Hallpike Maneuver. BPPV is the most common cause of dizziness in the United States (64 cases per 100,000 people; possibly as great as 8% of the elderly population) and about twice as frequent in women (64%) as men.