Diagnostic Audiologic Evaluations

The evaluation is done to determine if a hearing loss is present, and if so, to detail the type and severity of the hearing loss.  It also may provide insight as to the cause of the hearing loss as well as provide guidance for the audiologist in making appropriate treatment recommendations.

At the time of the hearing evaluation, a case history will be taken to determine how much your hearing problem impacts your day-to-day life as well as the lives of your family. A complete history will be taken, and questions will be asked about when and how the hearing loss started, if there is ringing in your ears (tinnitus) and if you experience dizziness. You may also have to provide some basic questions about your general health history. 

The results from your hearing test will provide the audiologist an outline of what sounds you may be missing or hearing, but the personal answers about your daily life and perception about your hearing provide the basis for a more comprehensive hearing evaluation.  You may be referred to a medical doctor specializing in disorders of the ear, an Ear, Nose, and Throat (ENT) physician, if you are a candidate for hearing aids and there are other medical conditions your audiologist thinks should be addressed before hearing aids are fitted.

The audiologist will typically perform otoscopy (examining the ear canal) and tympanometry (test of the middle ear) to determine the health of the ear canal and the middle ear.

The specific tests performed during the evaluation will depend on the patient’s age, and what is already known about the patient’s hearing status. These various tests will determine the degree of hearing loss, the type of hearing loss, and the conditions of the ear canal and middle ear. The audiologist will also determine if the hearing loss is conductive (middle or outer ear problem) or sensorineural (inner ear problem or central processing difficulty of the brain).

A diagnostic audiologic evaluation includes pure-tone testing, bone-conduction testing, and speech testing. Pure-tone air conduction testing is obtained by headphones or insert ear phones (like foam earplugs) and determines the quietest tones that a person can hear at different frequencies. Bone conduction testing is similar to pure-tone air conduction testing but a different type of device is used behind the ear with a headband to hold it in place. The results help the audiologist determine if the hearing loss is originating from the outer/middle ear or from the inner ear.

A speech reception threshold (SRT) test determines the lowest level at which the patient can recognize words or speech stimuli.

Specialized tests exist for children and adults with developmental and cognitive impairments. These more specialized tests allow the audiologist to test the auditory system when the patient is not able to actively participate in the tests or to check the reliability and validity of test results. Referrals will be made when deemed appropriate to gather more test data in order to determine an accurate diagnosis and treatment plan. Other tests may include: Auditory brainstem response (ABR) and Otoacoustic emissions (OAE) testing.

Along with the evaluation, the audiologist will take time to review the results with you.  He or she can interpret the tests for you, answer your questions, provide you with information and referrals as needed, as well as begin planning for treatment, if indicated.

Audiologists are specialists in hearing and hearing rehabilitation.  Never hesitate to ask your audiologist for clarification or further information on anything you do not understand.