So you're finally going to do something about getting your hearing checked...(2 of 2)
In last month’s edition, we looked at how/where to schedule an audiological evaluation. For this piece, you will get to know what to expect next.
As with all medical practices, there will be some 'paperwork' for the office to obtain your personal/demographic and insurance information. Some practices may have forms online, while others may have you fill them out in the office once you arrive.
As with all good medical practitioners, audiologists are trained to begin by getting a full/complete audiological history. This will include questions addressing the primary complaint (“I have a hard time understanding my wife”, “I can hear, but I can't understand in noisy situations”, “The TV needs to be louder”, etc.), its duration and progression (i.e. sudden* or slow). You will be asked about subjective associated symptoms (tinnitus or 'ringing of the ear', dizziness, fullness/pressure). Some medications have negative (“ototoxic”) effects on the ear, so it would be helpful to have a list of your medications. We ask about sinus and allergy issues, since the ears are essentially contiguous with the throat (via the eustachian tube) and play a part in overall ear health and hearing. In my practice we also get a “communication history” to understand the practical aspects of your hearing loss and how it affects communication.
Before testing, the audiologist will look into your ears with an otoscope to assess the health of the ear canal and ear drum. Unsurprisingly, ear wax can be a significant issue for some. If you suspect you have excessive ear wax, it's a good idea to get your ears cleaned prior to testing.
The next step is the actual hearing test. Testing should always be done in a very quiet environment, preferably a testing booth. A complete hearing test includes both listening for tones/beeps and repeating back words. Tones are used to determine your audiometric thresholds, the softest sounds you can hear at different frequencies/pitches. You are asked to listen via headphones and indicate when you hear them by pressing a button or verbally indicating. Word testing is used to verify the threshold results and assess basic word recognition at a comfortable volume, and may be recorded speech or live voice. A full audiometric evaluation will also include “impedance audiometry” (tympanometry & acoustic reflex testing) to assess the health of your eardrum/'middle ear' and the nerve pathways from the ear to the brainstem. These tests just require you to sit still and quiet. These tests can (infrequently) be mildly annoying, but they give us valuable information.
Your audiologist now has the information needed to counsel you and make recommendations. Whatever the results are, audiologists are ideally suited to guide you regarding what's next. If indicated, they can refer you to an otolaryngologist to address any medical issues. If you are referred by or to a physician, the results/recommendations should be sent to them. However, much more often than not, hearing loss can only be addressed via amplification (i.e. hearing aids). Either way, you have made the wise and appropriate choice to begin the process of addressing your hearing issues and improving your quality of life!
* A sudden hearing loss (sudden drop or awakening with a hearing loss, hearing loss over a few days. selective low/high frequency loss, distortions in speech perception) is classified as a true medical emergency requiring immediate medical care for treatment to be most effective.