HEARING PROCESS & HEARING EVALUATION

Hearing is a complicated process of catching sounds and adding meaning to them. In order to understand the world around us, one should be able to hear well.

A human ear starts to develop as early as the 6th week of pregnancy at a time when your tiny embryo is still smaller than a pea. The cells inside her head are already starting to arrange themselves into distinctive tissues that will eventually become her brain, face, eyes, ears and nose. Although ears cannot be distinguished on an ultrasound yet, the complicated maze of tubes that fill the inner ears are starting to stick out from the rest of the cells inside the head. The ears are fully developed parts of human body at baby’s birth and respond to both faint and loud sounds. Actually infants can respond to sound even before they are born.

So, how do we hear?

There are three parts of the ear: outer ear, middle ear and inner ear.

  • The ear canal and eardrum are components of the outer ear. Sound passes through the ear canal, strikes the eardrum and it vibrates.
  • The middle ear is an area behind the eardrum that consists of three tiny bones called ossicles. They are linked to the eardrum at one end and to an opening of the inner ear at the other end. The eardrum vibrations cause the ossicles to vibrate which, in turn, produces movement of the fluid in the inner ear.
  • The fluid movement in the inner ear causes changes in so-called hair cells. This movement of the hair cells transmits electrical signals from the inner ear up the auditory nerve to the brain. Then it’s brain responsibility to interpret these electrical signals into different sounds.

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DIAGNOSTIC AUDIOLOGIC EVALUATION

The audiologist or hearing instrument specialist is the person who performs diagnostic hearing evaluation in his/her office, using a special tool called an audiometer.

The diagnostic hearing evaluation consists of a variety of tests to accurately discover the unique aspects of the patient’s hearing loss, as well as his/her level of detection and understanding audible speech. This evaluation can be conducted on people of any age, from newborns to adults.

A diagnostic audiologic evaluation may include the following tests:

  1. Pure-tone air conduction testing
  2. Bone conduction testing
  3. Speech testing
  4. Distortion product otoacoustic emissions (DPOAE) testing
  5. Tympanometry

After a routine medical check-up you or your child could be referred for a diagnostic audiologic assessment, it means that hearing loss has to be ruled out or further checked. The diagnostic audiologic assessment may be suggested for individuals who did not pass an initial hearing screening. This assessment is performed to determine if a hearing loss or a balance disorder is present. The main symptoms of balance problems are dizziness and the feeling of a spinning around you.

Other symptoms include:

  • blurred vision
  • nausea and vomiting
  • disorientation
  • feelings of depression, fear, or anxiety
  • difficulty concentrating
  • tiredness
  • diarrhea
  • blood pressure and heart rate changes

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Pure-tone Air and Bone Conduction Testing

Pure-tone air conduction testing helps to determine the quietest tones that a patient can hear at different frequencies, both low and high. Bone conduction testing is similar to pure-tone air conduction testing, but a different type of headphone is used in this case, and the results show the audiologist if the hearing loss is stemming from the outer, middle or inner ear.

Speech Testing

A speech reception threshold (SRT) test is often used with older children and adults to confirm the results of a pure-tone air conduction testing. The speech reception threshold (SRT) test is done to confirm the validity of a pure-tone air conduction test results. If the levels match, the validity is good. If the levels do not match, further testing or retesting is required. This test determines the lowest level at which the patient can recognize words or speech stimuli.

To check the health of the ear canal and the middle ear the audiologist may also perform otoscopy (examining the ear canal) and tympanometry (testing of the middle ear).
Specialized tests are used for infants and younger children, as well as children and adults with developmental and cognitive impairments. They allow the audiologist to test the hearing when the patient cannot actively participate in the tests or evaluation.

Why is it important to check your hearing?

Diagnostic hearing evaluation can identify hearing loss at its early stages and provide important info on how to proceed with the treatment. Some hearing loss issues can be treated medically or surgically, so it is necessary to rule out certain hearing loss types before assigning hearing aids or considering other treatments. If you do need hearing aids, diagnostic hearing evaluation is a great asset in determining which hearing aids are the most appropriate for your situation.

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What is audiology?

Wikipedia defines audiology as a branch of science that studies hearing, balance, and related disorders. This word originates from Latin word audīre, which means "to hear"; and from Greek -λογία, -logia. Practitioners, who treat patients with hearing loss and actively prevent related problems, are called audiologists or hearing instrument specialist. As a healthcare profession, audiology also includes evaluation, supervision and therapeutic rehabilitation of people with hearing and balance disorders, and issues associated with them. Patients of all ages – infants and toddlers, teenagers and adults, as well as elderly people – fall into the sphere of audiology.

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