A hearing evaluation provides the necessary results to find proper treatment of various types of hearing loss. Our offices use industry-standard tests to find solutions. During your evaluation, we will do our best to provide you with the answers and care you need.
Preparation is key to a successful and stress-free hearing evaluation, and we are here to make sure you have everything you need to make your evaluation go smoothly. If you have seen a physician prior to making your appointment with us, please bring any reports from those visits with you. If your insurance requires it, you must bring a referral for your test, as well as all of your active insurance cards and photo ID.
Hearing evaluations identify a range of hearing and health issues, ranging from hearing loss, to tinnitus, to balance issues. If you have seen a physician prior to making your appointment, bringing any documentation that they provided to you to the evaluation will help to guide treatment options.
We will start off with a short examination to rule out any obstructions or physical damage to your ears. Questions leading up to the evaluation will cover family health issues, current daily noise exposure and future hearing expectations. This evaluation will help decide which tests are effective. With the information provided, we will explore all options before moving on to the full evaluation.
Testing is done to measure potential hearing loss in your inner, outer and middle ear. The two main test types are pure-tone and speech tests. Pure-tone tests create an enclosed environment with the use of headphones. Various sounds are played through a headset or speaker at different volumes. These tones require you to acknowledge that you heard the sound.
Speech testing also uses headphones, but this time instead of hearing sounds, you’ll hear words that you should repeat. We use speech testing to monitor the recognition of words repeated at variable levels. The results of speech tests are a good measure of how well you hear in noisy environments.
Tympanometry is also part of the test, that measures the function and movement of the eardrum and middle ear. Bone conduction testing tells the audiologist how well you hear and if there is a problem in the outer or middle ear.
It is recommended that evaluations are performed annually.
Hearing Aid Services
In many cases, your insurance will require that you obtain a document called "Medical Clearance" prior to authorizing us to order your devices. We can provide you with printed documents that clearly lay out what Medical Clearance is, as well as our process -- most of which is done by our offices -- in the time between your evaluation and your fitting.
There are many steps that are part of a hearing aid evaluation. If you suspect that you might need a hearing aid, you will first need to have a hearing evaluation. 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. Questions will be asked about when and how the hearing loss started, if there is ringing in your ears (tinnitus), etc. You may also have to provide some basic questions about your general health history.
The results from your hearing test will provide our 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 if you are a candidate for hearing aids or if there are other medical conditions your hearing professional thinks should be addressed before hearing aids are recommended. This referral can often be the first step in the hearing aid examination.
After these questions and discussions, a hearing aid may be recommended for one or both ears. Your hearing professional may explain what sounds you are not hearing and what a hearing aid(s) can do to help. Our audiologist will help you choose the best hearing aid(s) style, features and level of sophistication based on your degree of hearing loss, lifestyle, and financial circumstances. The final decision on which hearing aid(s) is purchased is your choice.
Once you make a decision, the hearing professional may take impressions of your ears, if you select custom hearing aids or behind-the-ear hearing aids that require earmolds. Hearing aids must be ordered from a manufacturer and then programmed by your hearing professional to meet your specific hearing needs.
This process can take several weeks, so do not be disappointed when you do not receive your hearing aids the same day as your evaluation.
When your hearing aids are put on for the first time, you may have different emotions about the sounds you hear. This is normal and to be expected. The goal of the hearing aid is to make every-day sounds audible and comfortable, but the sound you hear should be clear and pleasant. Small changes can be made to the hearing aids at your first fitting if there are things that you feel should be adjusted right away. The hearing professional may do some testing to make sure the hearing aids are giving you enough sound where you need it.
Be honest about what you hear so that the hearing professional can work with you to create the best listening experience with your new hearing aids. Your hearing aid fitting is only a starting point; other changes to customize the hearing to your liking may need to take place over a few appointments, as you wear the hearing aids in more situations and adapt to all the new sounds you are hearing.
Attitude is one important key to success with hearing aids. Hearing aid studies have shown that people who have a positive attitude do better with hearing aids. If you, as well as your spouse or family, approach your hearing aid fitting with a positive outlook you will have a much better listening experience more quickly. Keep in mind that it may take some time to get used to the sounds you were missing, and by working closely with your audiologist, you will get the most out of your new hearing aids.
Tinnitus is a “phantom” auditory perception. Some people describe these sensations as “ringing”, “buzzing”, “roaring”, “hissing”, or “rushing”. Tinnitus can affect or interfere with an individual’s ability to hear, concentrate, and/or sleep at night. Untreated tinnitus may lead to sleep disorders, depression, PTSD, anxiety, anger, and other psychological effects.
The main concept to treatment is to help manage and minimize the negative effects of the tinnitus and to break the negative emotional reaction that tinnitus so often causes. Our tinnitus treatment focus is to support the way the brain makes sense of sound and our treatment options and devices are built on this mindset.
Tinnitus is often associated with hearing loss as 90% of individuals with tinnitus also have hearing loss. For many patients, amplification is an effective first step in managing their tinnitus.
Approximately 80% of patients report relief and lessening of their tinnitus symptoms simply using prescription-based digital hearing instruments. We now can also use a sound therapy approach by providing low level sound generators (or "maskers") built into the hearing aids. We can adjust these sounds according to patient preference, reducing the starkness of the tinnitus in the auditory brain. Research indicates that sound input needs to produce activity in the brain that is both reliable and synchronous in order to help break this negative cycle. Each patient can be given the sound input most compatible with their perception of what works best, so the patient's input in this treatment is vital.
Dizziness and Balance
Dizziness or loss of balance, sometimes referred to as vertigo, is the second most common complaint that doctors hear. According to the National Institutes of Health, dizziness will occur in 70 percent of Americans at some point in their lives.
Whether the dizziness is temporary or chronic may indicate how serious the potential health risks are to you as an individual. Equilibrium disorders typically fall into two categories:
- Acute attacks of dizziness, vertigo, or a general loss of balance that may last a few seconds or a few hours
- A persistent sense of imbalance, unsteadiness, or what some people refer to as a loss of sure-footedness
Although you may feel helpless when you’re hit with a dizzy spell, there’s plenty of hope for these balance problems. Proper diagnosis and treatment options have been enhanced over the last decade, making dizziness a much easier problem to resolve.
If you have been referred to us for a VNG, please carefully read and follow these instructions prior to your appointment:
1. Certain medications will alter test results. Please obtain your doctor's permission to discontinue any tranquilizers, antidepressants, sleeping pills and medication for dizziness 48 hours before your appointment. You should continue to take all essential medications, including heart, blood pressure, seizure and diabetes medications.
2. Stimulants will alter test results. Do not drink or eat any caffeinated beverages or foods (chocolate, coffee, tea, cold medicine with antihistamines) for 24 hours before your appointment.
3. You may eat a light meal three hours before your test.
4. Wear comfortable clothing.
5. DO NOT wear any make-up to the appointment.
A Videonystagmography, or "VNG" is used to find out if you have a disorder of the vestibular system (the balance structures in your inner ear) or in the part of the brain that controls balance.
Why do I need a VNG?
You may need a VNG if you have symptoms of a vestibular disorder. The main symptom is dizziness, a general term for different symptoms of imbalance. These include vertigo, a feeling that you or your surroundings are spinning, staggering while walking, and lightheadedness, a feeling like you are going to faint.
Other symptoms of a vestibular disorder include:
- Nystagmus (involuntary eye movements that go side to side or up and down)
- Ringing in the ears (tinnitus)
- Feeling of fullness or pressure in the ear
What happens during a VNG?
During a VNG test, you will sit in a dark room and wear special goggles. The goggles have a camera that records eye movements. There are three main parts to a VNG:
- Ocular testing. During this part of the VNG, you will watch and follow moving and nonmoving dots on a light bar.
- Positional testing. During this part, your provider will move your head and body in different positions. Your provider will check if this movement causes nystagmus.
- Caloric testing. During this part, warm and cool water or air will be put in each ear. When cold water or air enters the inner ear, it should cause nystagmus. The eyes should then move away from the cold water in that ear and slowly back. When warm water or air is put in the ear, the eyes should move slowly toward that ear and slowly back. If the eyes don't respond in these ways, it may mean there is damage to the nerves of the inner ear. Your provider will also check to see if one ear responds differently from the other. If one ear is damaged, the response will be weaker than the other, or there may be no response at all.