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Diagnostic Hearing Tests - What to Expect

Getting your hearing checked accurately and professionally is the first step towards better hearing.

Your Hearing Test Visit

Longmont Hearing and Tinnitus Center provides hearing care services — whatever they may be — and that can include diagnostic hearing tests. Your first visit with one of our audiologists will start with answering questions about your medical and hearing history. The testing will evaluate your entire auditory system, from outer ear to inner ear. The first step involves looking into your ears to check for anything in the ear canal that might be obstructing sound. Then middle ear and eardrum function will be evaluated. You’ll then be set up in our sound booth where several types of tests will be conducted to map your hearing test results. These tests may include speech discrimination in quiet and in noise, otoacoustic emissions (which can detect damage to the hearing system before it appears on the audiogram), and your standard “push the button when you hear the beep” test. These tests will assess:

Beyond the Traditional Hearing Test

While traditional hearing tests evaluate how well your ears are doing their job — collecting, amplifying, organizing, and transmitting the amplified and organized signal to the auditory nerve — there is SO much more to hearing than what happens in the ears! Once that signal hits the nerve, that is when the magic happens. The signal travels from the ear to the brainstem, on to the midbrain, and then to the auditory cortices. These signals criss-cross your brain multiple times while sending information up and down that chain.

Additional Investigation as Needed

What if all of the “criss-crossing” isn’t working as it should? Perhaps there is an unexpected pause, or a part of the brain has somehow become damaged. What if processing speed is slower, and we can’t keep up with what we’re hearing due to a rapid conversation, or lots of background noise? Maybe our memory is impacted, and we can’t associate a sound with anything we have heard before. These variables inspired us to add additional measures to better analyze and understand test results.

How do we hear?

Vibrations — caused by dropping a fork or speaking a word, for example — are transformed into mechanical energy by the tympanic membrane in the ear. That mechanical energy is then transmitted through small bones called ossicles to the inner ear, where it is changed again into hydraulic energy for transmission through the fluid-filled cochlea. 

The cochlea’s hair cells are stimulated by the fluid waves, and a neurochemical event takes place that excites the hearing nerve. The physical characteristics of the original sound are preserved at every energy change along the way, until this code becomes one the brain can recognize and process. 

Hearing loss creates a malfunction in this chain of events by distorting or interrupting the original sound message. This, in turn, prevents the brain from processing the original signals properly. Changes in the brain’s ability to effectively process stimuli — from head trauma, disease, or from aging — can result in symptoms that mimic hearing loss. 

The ears and the brain combine in a remarkable way to process neural events into the sense of hearing. Perhaps it’s fair to say that we “hear” with our brain, not with our ears!

Types of Diagnostic Hearing Tests

An audiological evaluation is much more than “just a hearing test.” After the tests are completed, the audiologist will review each component of the audiologic evaluation with you to obtain a profile of hearing abilities and needs. Additional specialized testing may be indicated and recommended based on these initial test results. The hearing evaluation may result in recommendations related to:
  • Further follow-up, such as medical referral
  • Educational referral
  • Hearing aid/Implant/Sensory aid assessment
  • Assessment for assistive listening devices
  • Hearing rehabilitation assessment
  • Speech and language assessment and/or counseling

PURE-TONE TESTING

A pure-tone air conduction hearing test determines the faintest tones a person can hear at selected pitches (frequencies), from low to high. During this test, earphones are worn so that information can be obtained from each ear. The person taking the test may be asked to respond to the sounds in a variety of ways, such as:
  • Raising a finger or hand
  • Pressing a button, or pointing to the ear where the sound was received
  • Saying “yes” to indicate the sound was heard

SPEECH TESTING

The audiologist will conduct tests that evaluate your ability to process and understand speech in both quiet and noisy environments. The first speech test is called speech reception threshold (SRT) which records the faintest speech that can be heard and accurately repeated. The second is a speech discrimination test which evaluates the patient’s ability to comprehend words at a comfortable loudness level. Your speech comprehension may also be evaluated in the presence of background noise, as this is a common complaint of people with hearing loss.

Difficulty understanding speech in background noise is a common complaint of people with hearing loss and this report is informative to the diagnosis.

TESTS OF THE MIDDLE EAR

The audiologist may also take measurements that will provide information about how the middle ear is functioning. These measurements include tympanometry, acoustic reflex measures, and acoustic decay measures.

Tympanometry assists in the detection of fluid in the middle ear, perforation of the eardrum, or wax blocking the ear canal. Tympanometry pushes air pressure into the ear canal, making the eardrum move back and forth. The test measures the mobility of the eardrum. Graphs are created, called tympanograms. These can reveal a stiff eardrum, a hole in the eardrum, or an eardrum that moves too much.

Acoustic reflex measures add information about the possible location of the hearing problem. A tiny muscle in the middle ear contracts when a loud sound occurs. The loudness level at which the acoustic reflex occurs — or the absence of the acoustic reflex — gives information to the audiologist about the type of hearing loss.

OTOACOUSTIC EMISSIONS

Otoacoustic emissions (OAEs) are sounds given off by the inner ear when the cochlea is stimulated by a sound. When sound stimulates the cochlea, the outer hair cells vibrate. The vibration produces a nearly inaudible sound that echoes back into the middle ear. The sound can be measured with a small probe inserted into the ear canal. People with normal hearing produce emissions. Those with hearing loss greater than 25–30 decibels (dB) do not produce these very soft sounds. This test can detect blockage in the outer ear canal, as well as the presence of middle ear fluid and damage to the outer hair cells in the cochlea. An audiological evaluation is much more than “just a hearing test.” After the tests are completed, the audiologist will review each component of the audiologic evaluation with you to obtain a profile of hearing abilities and needs. Additional specialized testing may be indicated and recommended based on these initial test results. The hearing evaluation may result in recommendations related to:
  • Further follow-up, such as medical referral
  • Educational referral
  • Hearing aid/Implant/Sensory aid assessment
  • Assessment for assistive listening devices
  • Hearing rehabilitation assessment
  • Speech and language assessment and/or counseling

Cognivue Thrive Hearing Exam in Longmont, Colorado

Thrive is a quick, 6-minute computer-based cognitive screening that involves watching a screen and moving a joystick. It’s a simple test to take that provides insight into what happens beyond the ear AND beyond the auditory system.

Longmont Hearing & Tinnitus Center

Getting your hearing checked accurately and professionally is the first step towards better hearing. Longmont Hearing & Tinnitus Center offers a wide range of hearing tests using the most updated equipment and technology to ensure that you get only the best hearing solutions in town.

Our office will be closed 7/3-7/5 for Independence Day!