The hearing evaluation involves several different types of hearing tests. The results will help us determine the type and degree of hearing loss. Depending upon patient age, participation and purpose of testing, some of the following tasks may not be performed.

Otoscopy is a visual inspection of the ear, ear canal, and eardrum. If earwax is blocking the ear canal, then hearing testing will most likely be done after earwax removal.

Non-Behavioral Tasks:

Tympanometry is a measurement of how sound flows through the eardrum while the air pressure against the eardrum is varied from positive to negative pressure. A small ear tip is placed in the ear; you will feel a sensation of slight pressure, like a delicate puff of air. This test requires that you sit quietly, no response on your part is necessary.

Acoustic Reflexes are a measurement of the middle ear muscles contracting in response to a loud sound. A small ear tip is placed in both ears; you will feel a sensation of slight pressure, then a series of loud tones. This test provides information about the nerves from the ear to the brainstem and back. This test requires that you sit quietly, no response on your part is necessary.

Otoacoustic Emissions are a measurement of the inner ear hair cells’ response (an echo) to a series of tones at different pitches. A small ear tip is placed into the ear. The test requires that you sit quietly, no response on your part is necessary.

Behavioral Tasks:

Speech Threshold is the quietest level at which speech is heard (speech awareness) or heard and correctly identifying the word by pointing to a picture, body part or repeating the word (speech reception). This test is performed in a sound room with a pair of earphones placed over your ears. This test may be performed with speakers in the sound room instead of earphones.

Word Recognition is a percentage score of words that are correctly repeated while listening at a comfortable level. This test is performed in a sound room with a pair of earphones. It provides information about the brain’s ability to understand and process consonant and vowel sounds.

Pure Tone Threshold is the quietest level at which a pure tone is heard. This test is performed in a sound room with a pair of earphones. There will be a series of tones at different pitches, just raise your hand or push a button when you hear the tone. Another way of responding to the tone is a conditioned play response, like dropping a bear in a bucket when the sound is heard. Also, a visual reinforcement response would be looking for the sound and using a toy with lights as a reward. These games will encourage the response to be repeated each time a sound is heard. This test may also be performed with a bone oscillator placed behind the ear. The sounds are passed through the head directly to the inner ear, bypassing the ear canal, eardrum and middle ear.

Some of the above information was found in Introduction to Audiology, Fourth Edition, written by Frederick N. Martin, Englewood Cliffs, NJ: Prentice Hall, 1991. “Appendix I: Instructions for taking the hearing examination”.

Please contact Texas Center for Hearing for more information and to schedule an appointment.

Auditory Brainstem Response Evaluation

An auditory brainstem response (ABR) test may be recommended for infants, children or adults to confirm normal hearing, hearing loss, or to rule out the presence of an auditory nerve problem.

During an ABR test, electrodes are placed on the patient’s forehead and ears. Click sounds are then presented through earphones. The electrodes detect neuroelectrical responses from the inner ear, auditory nerve, and brainstem. The responses the electrodes pick up are processed by a computer and then evaluated by an audiologist. An ABR evaluation will give us information about whether or not a hearing loss is present and how severe it is. It can also tell us if a problem exists with the auditory nerve. The test is generally administered while the patient is sedated with chloral hydrate. If chloral hydrate is being used, instructions will be given for the patient to have no food six hours prior to the test and no clear liquids two hours before the test.

Currently, we perform ABRs on infants between the ages of 0 – 3 months of age, as a follow up to the newborn hearing screening process. For children older than 3 months of age and for adults, our doctors will make the referral and all of the necessary arrangements including the sedation orders to have the test done at another facility. Most of our ABR referrals are made with Texas Children’s Hospital or Methodist Hospital.

lease contact Texas Center for Hearing for more information.

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