Words aren’t as clear as they used to be and you are now missing out on the conversation and missing out on engaging with others like you used to. Congratulations, it’s time for a hearing test. Dr. Ivory will attempt to explain what you can expect to experience, what will be tested and next steps for you to take in order to regain control of the conversations you may have missed up until now. A hearing test is a tool used to help determine how much you are hearing. Specifically, a hearing test finds how much loss there is (in units of Decibels) at specific frequencies (measured in units of Hertz). When there is hearing loss at specific frequencies this translates to missing specific speech sounds which might impair communication and hearing words correctly. Before we begin, Dr. Ivory will need to collect some information from you.

THE INTAKE

We need to have a conversation about your hearing history. The idea is that as we are talking, you will help to create a hearing profile. This seemingly easy-going conversation is a grand tool that will aid us in being better equipped to get you back on the path to hearing and tracking what you will need in the future as part of a medical profile. Dr. Ivory will ask questions like, what kinds of noise exposure have you had in the past? Maybe you were a hunter and shot guns, or maybe you liked to sit next to the loud speakers at the concert. Did you wear hearing protection? Have you experienced vertigo recently or in the past? What is your family history as it relates to hearing loss? What type of medications do you take? Is there hearing loss with anyone in your family, and so on.Case history is an important part of your hearing test. You will have the opportunity to ask questions because Dr. Ivory operates from a patient centered approach. Many studies show that when a patient is actively involved in their health care they tend to do quite well. Dr. Ivory will however need to inspect your ears to make sure we will have success in doing a hearing test as part of an otoscopic evaluation.

THE INSPECTION

It is important to look at and, in your ears, to make sure there is nothing that would prohibit us from going forward with a hearing test. Otoscopy might reveal an accumulation of ear wax, or cerumen. A certain amount of ear wax is actually healthy as it helps protect our ears from dirt, fungus and even insects.  Cerumen might appear to be yellow or brown in color and when impacted will prevent us from seeing the eardrum. If this is the case, Dr. Ivory will try and remove the impacted (and access cerumen) or refer out to an otolaryngologist or your primary physician in some cases.

EARDRUM

We will look for redness, as well as, other key landmarks of the eardrum signaling a possible ear infection or some other issue at hand. There are several abnormalities that could occur on or around the ear drum. Some will prevent the hearing test from taking place and others not so much. There could be a rupture to the ear drum presenting in the ear which could potentially heal on its own but may benefit again from medical treatment. You could be suffering from tympanosclerosis which can appear as flaky, greyish or cloudy discoloring on the eardrum. Tympanosclerosis is the result of scared tissue. One possible cause is that you have experienced several ear infections.With very clear visual inspection, which is hard to see sometimes, we can see the ossicular chain.  If we see scaring and hence calcification it starts to restrict the movement of the ossicular chain. The ossicular chain is the three tiny bones in the middle ear (malleus, incus, and stapes) that work in tandem to pass sound to the inner ear. Once we have passed inspection, we are ready to bring out the audiometer so you can tell us what tones you hear!

THE AUDIOMETER

It is at this juncture in the process that Dr. Ivory will inform you of the impending hearing test and what Dr. Ivory needs of you. Dr. Ivory is going to use an audiometer to test your hearing. The audiometer can determine which kind and level of hearing loss you have. This device measures your hearing in decibels. The audiometer is calibrated so that the (SPL) sound pressure level corresponds with the (HL) hearing level. The audiometer can put forth pure tones called pure tones.  These pure tones are tones that represent various frequencies but are not found in nature.The audiometer can play different tones at different levels of loudness. On the audiometer there are options for the tester to attenuate certain sounds. The sound pressure level that is delivered at a certain frequency by an audiometer represents the hearing level. If Dr. Ivory deliver an 80 Decibel sound and attenuate (soften) it so that you receive it at 45 dB then, 45db is the hearing level produced by the audiometer. The audiometer can be used to test pure tone conduction, bone conduction and even speech recognition.

LET US RECAP

The audiometer is used to test the acuity of your hearing. Sound pressure level is the vibratory force cause by sound waves in the air and can be attenuated with the audiometer to produce a desired intensity, thus the hearing level. In a nut shell this is the audiometer and the tool used for hearing test purposes.

THE INSTRUCTION

Dr. Ivory will play different sounds at different tones at different frequencies one ear at a time. You will push the button indicating when you hear a sound. Dr. Ivory will administer the sounds one ear at a time. If you are guessing to much Dr. Ivory will re-direct, you and we will begin anew. At first it is typical to guide you into a sound proof room and place ear inserts into your ears. Then we begin to administer the series of sound or pure tones measured in Hz.  First, we test you via air conduction and then test you through bone conduction. The sensors are placed on your mastoid which is that bone at the side of your scull and right behind your ear.Later, Dr. Ivory will play a recorded calibrated and standardized voice (speech sample) and they will say words that you will repeat so that we can get an understand of your speech discrimination. Speech discrimination is also referred to as speech comprehension and this is an important component of potential hearing aid success. When we are done, we will go over the results that are printed on an audiogram. The audiogram will visually show us where you struggle and where you are hearing well.

IN SUMMARY

A hearing test is an important and fairly easy and quick method to determine type, degree and level of potential hearing loss (or you might have normal hearing). You can expect to be treated with care, as an individual, and your input and feedback is considered and appreciated every step of the way. The path to hearing is treaded carefully and with intention. Your next step is to schedule an appointment today so Dr. Ivory can test and explain your particular hearing situation.