If you suspect that you have a hearing loss or have ringing/buzzing in your ears, you will need a hearing evaluation. At the time of the hearing evaluation, we will take a full case history to determine how much your hearing problems impact your day-to-day life as well as the lives of your family. The results of your hearing test will provide the audiologist with an outline of what sounds you may be missing or hearing in order to create a plan to help address your needs.
How do we hear?
There are three main sections of the ear – the outer ear, middle ear and inner ear. Each section has a unique function that converts sound waves into electrical impulses that can be processed and interpreted by the brain. The outer ear receives the sound waves and guides them toward to the middle ear. The middle ear amplifies the sound vibrations and sends them to the inner ear. The inner ear transforms the vibrations into electrical impulses which are carried through the auditory nerve to the brain.
- Outer Ear – captures sound waves and guides them into the ear canal
- Ear Canal – carries the sound waves towards the eardrum
- Eardrum – (tympanic membrane) vibrates from the sound waves
- Middle Ear Bones – (malleus, incus and stapes) pick up vibration from the eardrum
- Cochlea – as vibrations pass through this organ, the fluid inside the cochlea moves, causing thousands of “hair cells” to set in motion so they can translate the sound waves into electrical impulses
- Auditory Nerve – sends the electrical impulses to the brain to be processed as sound
What is a Diagnostic Hearing Evaluation?
A diagnostic hearing evaluation is the first step in determining your hearing capability. If you have a hearing loss, it will detail the extent, type, and specifics of your particular hearing loss. The diagnostic hearing evaluation will be performed by a certified licensed audiologist, using equipment called an audiometer.
The diagnostic hearing evaluation consists of a variety of tests to determine the unique aspects of your hearing loss, as well as the level at which you can detect and understand speech.
It is recommended that you bring a family member with you to the evaluation appointment. Hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations.
A diagnostic hearing evaluation at Millburn Audiology & Balance includes the following tests:
- Air conduction testing
- Bone conduction testing
- Speech testing
- Tympanometry or acoustic immittance testing
The diagnostic hearing evaluation is covered by most health insurance policies, though you may need a referral from your primary care physician to qualify for coverage.
What Can I Expect During a Diagnostic Hearing Evaluation?
You will want to arrive 15 minutes before your scheduled appointment to fill out paperwork, including a complete case history. The case history is an important starting point of any audiologic evaluation. An effective case history is used to guide the audiologist in a number of ways. It provides important information about any complaints you have about your hearing. This includes:
- Difficulty hearing in one ear or both ears
- Experiencing ringing or buzzing (tinnitus)
- Exposure to excessive or loud noise
- Balance problems.
Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.
The audiologist will go over your case history with you prior to beginning the hearing evaluation
The evaluation will probably last about 30 minutes in length. You should also allow for time for discussion with the audiologist to review test results, and ask questions.
The results of your hearing test will determine if your hearing loss is conductive (relating to the outer and/or middle ear, sensorineural (relating to the inner ear hair cells and nerves) or a combination of the two. The results of the evaluation will also rate your hearing loss as mild, moderate, severe, or profound. The speech discrimination results will provide a practical look at the level of speech understanding with hearing instruments.
If the determination is made that you need hearing aids, allow for sufficient time to discuss your options. With the results of the complete hearing test, a hearing instrument solution can be developed that best meets your specific and unique hearing needs now and for the foreseeable future.
The diagnostic hearing evaluation is a good chance to establish a relationship with your audiologist. Above all, don’t be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.
How do I know if I have hearing loss?
Most hearing loss occurs when people age. However, it can result from over-exposure to noise, infections, trauma, congenital or hereditary factors, medications or other causes. About 90% of all cases of hearing loss can be corrected with hearing instruments.
There are over 30 million Americans with some type of hearing loss. Hearing is an integral part of the human experience and when it is diminished, it affects all aspects of that experience. If you are uncertain whether or not you may have a hearing loss, we invite you to take our 5-Minute Speech Understanding Test. It may help you decide whether or not you need to take additional steps necessary for amplification.
Warning Signs of Hearing Loss
- Difficulty understanding conversation, especially in background noise
- Finding that people are mumbling or slurring their words
- Trouble comprehending certain sounds or pitches
- Continually asking people to repeat themselves
- Mistaking sounds of words such as: “dime”, “time”, “make”, “take”
- Preferring the TV or radio louder than others
- Straining to hear on the telephone
- Reading people’s lips
- Avoiding conversations or interactions with others because it is too difficult to hear and understand
- Nodding or agreeing with others during conversations while uncertain of the topic
What are the most common types of hearing loss?
Although there are many types of hearing loss, the most common type is sensorineural loss, and the second most common type of loss is conductive loss.
There are three types of hearing loss we encounter most frequently:
Conductive Loss – is caused by damage to the outer or middle ear. Sound waves are blocked as they move through the outer or middle ear. Since the sound cannot travel effectively, the sound energy reaching the inner ear is weakened or muffled. Conductive loss may result from infection, earwax buildup, fluid in the middle ear, damage to the middle ear bones, a perforation in the eardrum or an obstruction in the ear canal. This type of loss is usually treated with earwax removal, medicine or surgery.
Signs & Symptoms of Conductive Loss:
- Perceiving speech and other sounds as stifled or distant
- Ear discomfort or discharge from ear – Swelling or redness of the outer ear
- Pressure or fullness in the ear
Sensorineural Loss – (also known as “nerve deafness”) is caused by damage to the hair cells in the inner ear. The inner ear is unable to transfer the sound vibrations to the brain and it usually occurs in both ears. It is the most common type of loss and it can result from aging, noise exposure, disease, birth defects and nerve damage. This type of loss is usually treated with amplification (hearing devices).
Signs & Symptoms of Sensorineural Loss:
- Difficulty understanding speech in background noise
- Speech and other sounds seem unclear
- Trouble hearing high pitched sounds
- Persistent or episodic ringing or buzzing sound in ears
Mixed Loss- is caused by damage to the outer or middle ear and the inner ear. It is the combination of conductive and sensorineural hearing losses.
Signs & Symptoms of Mixed Loss:
- See “Signs & Symptoms of Conductive and Sensorineural Losses”
Things to Know about Hearing Loss:
- Hearing loss is a major public health issue that is the third most common physical condition after arthritis and heart disease.
- Gradual hearing loss can affect people of all ages — varying from mild to profound. Hearing loss is a sudden or gradual decrease in how well you can hear. Depending on the cause, it can be mild or severe, temporary or permanent.
- Degrees of hearing loss: mild, moderate, severe, profound.
- Congenital hearing loss means you are born without hearing, while gradual hearing loss happens over time.
- Hearing loss is an invisible condition; we cannot see hearing loss, only its effects. Because the presence of a hearing loss is not visible, these effects may be attributed to aloofness, confusion, or personality changes.
- In adults, the most common causes of hearing loss are noise and aging. There is a strong relationship between age and reported hearing loss.
- In age-related hearing loss, known as presbycusis, changes in the inner ear that happen as you get older cause a slow but steady hearing loss. The loss may be mild or severe, and it is always permanent.
- In older people, a hearing loss is often confused with, or complicates, such conditions as dementia.
- Noise-induced hearing loss may happen slowly over time or suddenly. Being exposed to everyday noises, such as listening to very loud music, being in a noisy work environment, or using a lawn mower, can lead to hearing loss over many years.
- Sudden, noise-induced hearing loss from gunfire and explosions is the number one disability caused by combat in current wars.
- More often than not severe tinnitus (or ringing in the ears) will accompany the hearing loss and may be just as debilitating as the hearing loss itself.
- Other causes of hearing loss include earwax buildup, an object in the ear, injury to the ear or head, ear infection, a ruptured eardrum, and other conditions that affect the middle or inner ear.
- For more questions and answers read An Overview of Hearing Loss – Its Signs, Implications and Solutions.
We offer a full range of choices, from basic level hearing aids to premium, top of the line devices.