In order to determine what hearing aids or treatments are best suited to your specific needs, a certified provider will usually put your hearing through an exam comprised of five different tests. The overall hearing test is mostly the same across different clinics despite some variations in procedures and different parts of the exam being performed by separate specialists. The five main tests consist of:
- Health History
- Otoscopy
- Tympanography
- Speech Test
- Air and Bone Conduction Test
Insight regarding your health and lifestyle is derived from information gathered in the first four parts of the exam. The final component, the air and bone conduction test, provides an in-depth account of the entire spectrum of aural frequencies you can perceive. The results of each test are compiled to generate a comprehensive report of your ultimate hearing ability.
Health History
Much like the questionnaires you are asked to fill out when visiting healthcare providers for any other issues in the past, the questions regarding case history for a hearing exam are not much different. They will likely cover topics such as current/past medications, family history of hearing loss, extent/frequency of noise exposure, hobbies, work history, and details surrounding any hearing problems that you are currently experiencing. In addition to providing a picture of your current hearing health, the answers to these questions allow your provider to anticipate your performance on the subsequent tests and how you are likely to respond to certain treatments.
Otoscopy
In this part of the test, your provider will be visually examining your ears for physical impediments. They will be checking for the presence of blockages in the canal resulting from infections, built-up earwax, or obstruction by foreign objects. They will also be able to view your eardrums and check for any signs of abnormalities or scarring.
Tympanography
This segment of the exam gauges the flexibility of your eardrum by manipulating the pressure within the ear canal. This is accomplished by establishing an airtight seal around the opening of the ear and gently drawing air out or pushing air in with the use of a probe by the provider. The probe’s sensors will be able to determine the extent of flex in the eardrum and results are drawn up in the form of a line graph with a single peak. The magnitude of the peak signifies whether or not there is a problem with the eardrum’s flexibility, with flat lines showing little or no flex and extreme peaks indicating too much flexibility.
Speech Testing
Speech testing is completed in two phases, both of which you will be seated in a sound booth with a pair of headphones on. You will hear a series of words that you must recite to the best of your ability. The first segment measures your SRT (Speech Reception Threshold). The loudness of words played through the headphones is gradually reduced until you only repeat half of them correctly. This denotes the level at which you can begin to perceive speech. The second part of the test measures your ability to repeat words played at a normal volume. This is the WRT (Word Recognition Test) and it measures the extent your hearing ability deviates from the norm. Results from these two tests help determine how successfully different hearing aids or devices might eventually serve you.
Air and Bone Conduction Test
Like the Speech Test segment of the exam, the Air and Bone Conduction test is also made up of two different parts. In the air conduction test, you will again be wearing a pair of headphones. However, as opposed to listening for spoken words, you will be asked to raise your hand or press a button whenever you hear a series of beeps played at varying tones and frequencies. The second part of the test is the Bone Conduction Test, which applies the same principles but instead of headphones, you will be wearing a headband that creates vibrations through a tiny piece of plastic placed directly behind your ear. These vibrations bypass the mechanisms of the outer ear and directly stimulate the nerves of the inner cochlea. The combined results of the two tests allow providers to discern whether the source of hearing impairment stems from physical inhibitions or an internal deterioration of the auditory nerves themselves.
What is Best for You
A hearing exam is an important tool to help you and your provider understand what may be causing any difficulties you’re experiencing with hearing. This evaluation can give providers a complete picture of many aspects of your hearing and lifestyle to better make recommendations on treatment options, if necessary. After your provider completes your evaluation, it’s crucial that you ask any questions you or family members may have about your hearing.