Hearing Tests

How Hearing Tests Work

How hearing tests work

You’ve realized that all those rock concerts in your younger days may have finally caught up with you after you’re once again scolded for having the TV volume up too high. It might be time for a hearing test with your Philadelphia audiologist.

Hearing loss can have real effects on many aspects of life including mental health and cognitive ability. Hearing tests are designed to not only detect the presence of a hearing problem but also determine its type and severity. From here, your audiologist can then guide you with a plan to manage your hearing loss (spoiler – this may involve avoiding future rock concerts).


The hearing test

Your appointment will likely kick off with a chat about your history and your symptoms. Understanding your general health, medical history, and even family medical history, such as smoking, past head trauma, or having genetic conditions in the family, can offer clues to the state of your hearing. The audiologist will also be interested to hear about any habits, activities, or events that can contribute to hearing loss, such as working in a construction zone or that one time you put your ear to the speaker at a rock concert. Going through your symptoms are also useful in forming a picture of your situation. Symptoms such as tinnitus (a ringing in the ears), difficulty following conversations in noisy environments, or being scolded for the TV volume every night should be mentioned to your audiologist.

There are several different types of hearing tests, designed to pinpoint the type and location of hearing loss. Some tests also provide a measurement of hearing ability in more real-world situations, such as the ability to pick out speech against a loud background. All these tests are painless, completely safe, and noninvasive. After going through your history and symptoms, your audiologist may suggest one or more of the following hearing tests for you:

  • Pure tone audiometry: This is the standard test and probably what first comes to mind when most people think of hearing tests. A series of short tones (beeps or whistles) is played through a set of headphones, one side at a time, with varying pitch and volume. Your audiologist will ask you to press a button or indicate in some other way that you were able to perceive the sound, with the goal of identifying the softest sound you can hear across a number of specific pitches.
  • Bone conduction testing: This test uses a device to transmit tiny vibrations directly to the inner ear via the mastoid bone behind the ear. By bypassing the outer and middle ear structures, your audiologist can localize hearing problems arising from the inner ear.
  • Speech/words in noise testing: These are various tests that help to quantify a person’s functional hearing though they do not identify the type or location of the hearing loss. Assessments such as the Speech Perception in Noise test or the Connected Speech test involve repeating back words that you hear against an increasingly noisy background.
  • Other hearing tests: Within the audiologist’s armament are further fancy hearing tests such as tympanometry (changes in pressure are applied to the ear via a soft plug; this assesses the movement of the eardrum), acoustic reflex testing (an assessment of the reflexive muscle responses of the middle ear), and auditory brainstem response (brainwave activity in response to sounds played through headphones is detected by electrodes attached around the head; this test is often used for hearing screening in newborns).

These tests are usually performed in a sound-treated booth to control external noises that may affect the results.


The results

The outcome of your hearing test is charted on a graph known as an audiogram, which plots the least audible sounds that you were able to perceive across a range of frequencies. The results of each ear are drawn up separately on the chart and it is not uncommon for these lines to differ from each other. By comparing the results from various tests and looking over your history, your audiologist can identify the source of your hearing loss and suggest appropriate solutions.

There are 3 types of hearing loss: conductive, sensorineural, or mixed. Sensorineural hearing loss arises from problems in the inner ear or auditory nerve and may be due to factors such as age, toxic medications, or damage from excessive noise. Conductive hearing loss occurs when sound is unable to reach the inner ear; there may be an obstruction such as fluid, impacted earwax, or damage from a ruptured eardrum. Mixed hearing loss is exactly as it sounds – a combination of sensorineural and conductive problems.

Hearing is quantified in decibels (dB) and is typically categorized into the following levels:

  • Normal hearing: 0 to 25dB
  • Mild hearing loss: 26 to 40dB
  • Moderate hearing loss: 41 to 55dB
  • Moderate to severe hearing loss: 56 to 70dB
  • Severe hearing loss: 71 to 90dB
  • Profound hearing loss: 91 to 100dB

Different models of hearing aids are more appropriate for different levels of hearing loss. For example, a larger behind the ear (BTE) aid has the capacity to carry more power to assist severe hearing loss compared to a smaller in-the-canal (ITC) device, which is better suited for mild to moderate forms of hearing loss. With all the modern hearing aids available, equipped with features such as Bluetooth connectivity and tinnitus therapy, Listen 2 Life Hearing Aid Centers can fit you with an appropriate device suitable for your specific hearing requirements and lifestyle. In addition to being fitted with an aid, talk to your audiologist about good habits that can help to preserve your remaining hearing. But beware – this will probably mean going easy on those rock concerts.