Here's what we cover in our extensive hearing test.

Step 1: Otoscopy

We start by inspecting the ear canal and eardrum for any obstructions, such as wax, or any other abnormalities, such as infection or eardrum perforation. If an obstruction is found, it's important to remove this before proceeding any further as this could skew the result of a hearing test. See Wax Removal.

Step 2: Pure Tone Audiometry

This is the foundation test of a hearing assessment. This first part of this test involves playing soft beeps or tones via special headphones and measuring your responses, usually via a push button (or using a toy with younger children), to ascertain the softest sounds you can hear at a range of different pitches. This is how we determine your hearing sensitivity and work out whether it is within the normal range, or if you may require any assistance.

One of the problems with this test in some centres is the lack of a sound-treated environment, as well as poor quality or poorly-maintained equipment. It is important that this equipment is regularly serviced and calibrated in order for the results to be accurate and reliable, something you can be assured of at Hello Hearing.

<label for="refineSearch">
   <span class="refineSearch__toggle">
     <a class="refine__toggle btn--dropdown" type="button">
The Nitty Gritty:          <i class="icon  icon-down-arrow icon--small" aria-label="down arrow"></i>
     </a>
   </span>
 </label>
<input id="refineSearch" type="checkbox" class="hidden">
<div class="refineSearch__menu">
The second part of this test (not usually carried out in a screening test) again involves responses to beeps and tones, however, the sounds are delivered via a bone conductor which is placed on the skull behind your ear. The sounds delivered via bone conduction bypass the middle ear and stimulate the inner ear directly. This allows us to determine the efficiency of your middle ear system in conducting sounds into the inner ear, and therefore means we can diagnose whether a hearing problem is due to an issue in the outer/middle ear, or in the inner ear or beyond. This guides our decision-making as far as whether further medical referral is required, and also what rehab options would be most suitable.</div>

‍

Step 3: Word Recognition

We continue our testing with word recognition. This test involves repeating back single words which are presented via headphones at various volume levels. The reason that this test is so important is that it helps to provide confirmation of the Pure Tone Audiometry results, and provides more of a real-world, functional measure of hearing ability. This is extremely important when considering hearing rehabilitation as it provides us with clues as to whether hearing aids are likely to be a good option, or whether an implant would be more suitable.

Step 4: Tympanometry

This is an important measure of ear drum and middle ear function, best used in combination with acoustic reflexometry. It involves a small probe being placed in the ear canal which delivers positive and negative air pressure, assessing both the movement of the ear drum and the air pressure level in the middle ear.

The Nitty Gritty: This can detect various issues such as a tear or hole in the ear drum, fluid in the middle ear cavity, a dysfunctional Eustachian tube (responsible for equalising middle ear pressure), a fixation or a discontinuity of the middle ear bones, among a number of other less common issues.

Step 5: Acoustic Reflexometry

This test assesses a muscle reflex in the middle ear. Similar to when the doctor hits your knee to check your patellar reflex, an acoustic reflex is elicited using a loud noise and, when active, is a reassuring sign that the middle ear is likely functioning normally. While an absent acoustic reflex is often not cause for alarm, depending on the configuration of other findings, these results can help strengthen our suspicion of a range of potential issues such as middle ear abnormalities, cochlear or retrocochlear disorders, facial nerve involvement, among others.

Step 6: Transient Evoked Otoacoustic Emissions testing (TEOAE)

TEOAE testing is an objective test of inner ear (cochlear) function. This test is not always necessary, but is often used when some other results are incomplete or unavailable. The test involves a small probe being placed in the ear canal which delivers ultra fast click noises. These sounds travel along into the cochlea and the cochlea then produces a low-level sound emission which we can measure on the machine. Emissions of a suitable level and across a specified range indicate healthy functioning of a group of sensory cells in the cochlear known as the outer hair cells. This test is often especially useful when assessing young children as it is fully automatic and generally very quick, giving us high quality information without requiring any active listening.

‍