This section is provided to give you an appreciation of what hearing tests will be conducted during an initial consultation at HEARINGLife.

The Audiogram

The most common hearing test is known as an Audiogram. This involves finding the threshold of hearing for pure tone sounds at a number of different frequencies across the range that is important for speech understanding. The patient will click a button when they hear a tone, as shown here.

Reading an Audiogram.

Graphed results display the patient’s hearing threshold (the softest sounds they can hear) for a range of frequencies for both ears. By comparing the figures, the Consultant can assess the respective degree of hearing loss and find clues as to its origin. The results of the Audiogram are usually classified in the following ways:

• Type of hearing loss — sensorineural, conductive, mixed
• Degree of loss — normal, mild, moderate, moderately severe, severe, profound
• Slope of loss — flat, sloping, reverse slope, cookie bite, corner audiogram
• How the ears compare — bilateral/binaural, unilateral, symmetrical/asymmetrical

When there is a detectable hearing loss, the next step is to try and determine whether the loss is caused by a sensory problem (sensorineural hearing loss) or a mechanical problem (conductive hearing loss). This distinction is made by using a bone vibrator that bypasses the mechanical parts of the middle ear. If hearing is better using bone than air, this suggests a conductive hearing loss.

The results of the Bone Conduction tests are shown on the audiogram using the symbols ‘[’ and ‘]’. Where there is a significant gap (>10dB) there is said to be an Air-Bone gap. For example, in the graph to the right, the results may indicate a Middle-Ear Infection.

Speech Tests

Speech tests are commonly used to measure how well a patient can understand speech. They usually consist of lists of single words presented one by one at appropriate levels for the hearing loss. For example, common age-related hearing loss (presbyacusis) typically begins with the loss of higher frequencies, so that certain speech sounds (such as ‘p’, ‘f’ and ‘t’) end up sounding very similar.

A further variation on speech tests is “Speech-In-Noise” testing. HearingLife conducts these tests as standard procedure, recognizing that the greatest difficulty that most people with a hearing loss report is the ability to follow conversations in noisy environments. The results of these tests indicate the level of benefit a patient requires with a hearing solution.

Tympanometry

Tympanometry measures the mobility of the eardrum and is used to identify possible middle-ear dysfunction. It is helpful in detecting fluid in the middle ear, negative middle ear pressure, and disruption of the ossicles, tympanic membrane perforation, and otosclerosis.

To perform this test, a soft probe is placed into the ear canal and a small amount of pressure is applied. The instrument then measures movement of the tympanic membrane (eardrum) in response to the pressure changes.

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