Because of the potential consequences hearing loss can have on your overall health and quality of life, regular hearing assessments should be a top priority, especially if you are over the age of 50.
Though there are a number of reasons that people put off having their hearing tested, one of them is not understanding what takes place during a comprehensive hearing assessment. Our objective in this blog post is to help demystify the process.
Understanding the 3 Different Types of Hearing Loss
An understanding of the three different types of hearing loss and the characteristics of each one helps explain why so many different types of testing are necessary during a comprehensive hearing assessment.
Sensorineural Hearing Loss
Sensorineural hearing loss, the most common type of permanent hearing loss, involves damage to the tiny, hairlike cells of the inner ear, known as stereocilia, or the auditory nerve that transfers sound signals to the brain.
Though sensorineural hearing loss can be related to a genetic syndrome or an infection passed from mother to fetus inside the womb, most cases of sensorineural hearing loss develop after birth, much later in life. Presbycusis, or age-related hearing loss, is the most common form, but damage from ongoing exposure to loud noise or noise-induced hearing loss (NIHL) runs a close second.
Hearing difficulties related to both loudness and clarity are common for individuals with sensorineural hearing loss, but many also begin to develop ringing in the ears (tinnitus), dizziness, balance disorders, and/or cognitive decline if the condition is left untreated.
Conductive Hearing Loss
Conductive hearing loss involves an obstruction or damage at some point along the hearing pathway, blocking sound signals from reaching the inner ear. It can be temporary or permanent, depending on what causes the obstruction.
Common outer ear obstructions include:
- Stenosis or a narrowing of the ear canal
- Impacted earwax
- Exostoses (bone-like protrusions inside the
- ear canal)
- Otitis externa (swimmer's ear)
- Obstructions caused by foreign bodies
- inserted into the ear
- Microtia or atresia (congenital deformity)
- Rupture of the tympanic membrane (eardrum)
- Tympanosclerosis (thickening of the tympanic membrane)
- Otitis media (ear infection) that produces fluid in the middle ear
- Blockages in the Eustachian tube
- Otosclerosis (a middle ear disorder)
- Growths or tumours (cholesteatoma or glomus tumours)
- Ossicular chain discontinuity (a break in the connection of the middle ear bone, due to injury)
Mixed Hearing Loss
Mixed hearing loss is any combination of sensorineural and conductive hearing loss. There are three instances that can lead to this combination hearing loss:
- Someone with sensorineural hearing loss experiences some sort of injury or illness leading to the addition
- conductive hearing loss
- An individual with conductive hearing loss develops sensorineural hearing loss as they age or due to
- inner ear damage
- Blast injuries or other traumas cause simultaneous sensorineural and conductive hearing loss
Why Do We Ask So Many Questions?
Your audiologist will ask a lot of questions during your first visit. There are several reasons behind asking so many questions.
To begin with, we’re interested in getting to know you better as we start our journey toward better hearing health, but we’re also gathering information related to your hearing health as you respond to our questions.
The answers you provide for questions about your family history, medications you’re taking, your vocation or career, activities and hobbies you enjoy, and your level of social activity provide us with possible causes for hearing loss, but they also help guide the customized hearing care plan we develop to meet your specific needs, circumstances, and personal preferences.
The Reason for a Physical Examination of Your Ears
Imagine going to see your audiologist because of intense pressure in your ears, muffled sound, and feelings of dizziness. On the way to your appointment, you’re worried that you’re going to have to start wearing hearing aids, everybody’s going to think you’re old, and you’ll have to go buy a rocking chair to sit out on the porch.
However, your audiologist takes a look inside your ears and finds that they’re full of earwax, a bug, or some other foreign object. Instead of the hearing aid you’ve worried about, your hearing is back to normal after removing the obstruction.
Many cases of obstructive hearing loss are quickly treated through the removal of an object, treatment for inflammation, or the removal of a growth or tumour. The physical examination of your ears also allows us to assess damage to the ear canal, eardrum, or middle ear, which can contribute to obstructive hearing loss.
Common Tests Used to Diagnose Hearing Loss
To get at the cause of your hearing loss, determine its type, and measure its severity, audiologists make use of a full series of tests. Not all audiologists use every test for each case, but any of the following tests may be used in the process of diagnosing hearing loss.
The test that everyone is familiar with is called pure-tone audiometry, which involves the transmission of pure tones presented in descending levels from 250 Hz to 8000 Hz through the ear canal using headphones. It establishes your hearing threshold, or the lowest level you can hear each frequency. It helps identify the type and severity of your hearing loss and is used to program your hearing aids.
There are two tests included in speech audiometry testing in order to determine how well you process speech.
Speech reception threshold (SRT) testing helps establish the low-end threshold of speech reception, similar to the pure-tone audiometry test, while the score from your speech discrimination test is conducted at a comfortable listening level in order to determine whether you have issues with speech clarity.
Bone Conduction Test
Bone conduction testing uses a specialized headset designed to bypass the outer and middle ear and transmit sound signals directly to the inner ear through the surrounding bones. Your audiologist will compare your bone conduction and pure-tone test results to help determine whether the type of hearing loss you’re experiencing is sensorineural or conductive.
Otoacoustic Emissions Test
Otoacoustic emissions, or OAEs, are a response (echo) emitted by healthy hairlike cells in the inner ear (cochlea). OAE testing involves transmitting clicking or buzzing sounds using a soft-tipped instrument inserted into the ear canal and then measuring the strength of their response, which helps evaluate the extent of damage to the cochlea.
Auditory Brainstem Response (ABR) Testing
Usually used with children or others not able to respond during a typical hearing screening, ABR testing identifies how the brain responds to sound. This test is used in the diagnosis of central auditory processing disorder as well as for early hearing loss screening in infants.
What Do Your Results Mean?
Unlike most medical tests, you can see the results of your hearing test as soon as testing is complete. Your audiologist will show you your audiogram and explain what it means in terms of your hearing.
If treatment is required to help correct your hearing, you’ll be an important part of the process of deciding which steps to take. When hearing aids are the best solution to provide better hearing, you’ll be involved in the selection process.
In addition to providing treatment for hearing loss, audiologists also provide their patients with preventive solutions like hearing protection, especially for those who are at risk of developing noise-induced hearing loss due to their occupation or the activities they enjoy.
A Comprehensive Hearing Assessment Is Your First Step Toward Better Hearing
Leaving your hearing loss untreated can lead to severe negative mental and physical health consequences, as well as prevent you from enjoying all of the rewarding sounds life has to offer. Regular hearing assessments, especially if you’re over the age of 50, help detect hearing loss early or establish a baseline against which changes can be measured.
A comprehensive hearing assessment that requires about 30 minutes of your time is a small price to pay for better hearing, a more active and independent lifestyle, and a better quality of life. Don’t put off having your hearing tested any longer – contact us today!