Audiology

• Digital Hearing Aids
• Completely in the canal Hearing Aids
• Pediatric/infant testing
• Auditory brainstem response evaluations (ABR's)
• Electronystagmogram (ENG's) and dizziness testing

Please visit our sister company for many more information on our audiological services. - physicianshearingservices.com

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If you suffer from hearing loss or other hearing and balance related conditions, you may benefit from audiologic testing. These comprehensive diagnostic exams can determine the cause, severity and best treatment option for these conditions. Audiologic tests usually precede the visit for convenience.

Some of the common types of audiologic tests include:

Diagnostic Audiogram - An audiogram uses sounds of specific frequencies and intensity levels to determine what a person can hear in each ear. The sounds are heard through earphones and the patient is asked to identify each time they hear a sound and in which ear. The sounds will become lower and lower to determine the level in which a patient can barely hear. An audiogram also includes speech in the form of two-syllable words to determine how well a patient can comprehend what is being heard.

Tympanometry - Tympanometry examines and diagnoses the middle ear by varying air pressure in the ear canal to see how the ear responds. A probe is inserted into the ear to change the air pressure, produce a tone and then measure the responses. The patient may not speak, move or swallow during the test because these actions can affect the ear pressure. Tympanometry measures the functionality of the ear drum or tympanic membrane. Abnormal results may be the result of fluid in the middle ear, perforated ear drum or impacted ear wax.

Brainstem Auditory Evoked Response Test (BAER) - is also known as the Auditory Brainstem Response (ABR). The BAER examines brain waves that are stimulated by a clicking sound to evaluate the auditory pathways in the brain. Electrodes are placed on the scalp and earlobes and the patient listens to a clicking noise through headphones. The electrodes record the brain's reaction. The BAER is used to diagnose nervous system abnormalities and hearing loss in infants, which may also be the result of multiple sclerosis or a stroke.

Otoacoustic Emissions (OAE) Testing - OAEs are very soft acoustic responses to stimuli from the outer hair cells in the cochlea. The test is performed by inserting a microphone and two speakers into the ear to emit a sound and then record the response signal. The test is often performed on children when hearing loss is a possibility. Absent or very soft response signals could be the result of hearing loss, fluid behind the ears or damage to the cochlea.

Videonystagmography (VNG) - VNG is a test used to record the involuntary eye movement of the eye jerking back and forth, known as nystagmus. This movement is generated and the data recorded is known as the vestibular ocular reflex. The VNG is a basic balance test used to diagnose dizziness. The VNG is actually composed of 7 different tests which help to determine if the dizziness is caused by the ear or a different factor. These tests may take up to 2 hours and cause nausea.

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Hearing Aids

Hearing aids are a common non-invasive treatment option for hearing loss. A hearing aid is a small electronic device that is worn in or behind your ear and amplifies sounds so they can be heard better and listening and communicating with others is made simpler. The device consists of a microphone, amplifier and speaker. The sounds are received through the microphone and then increased in power by the amplifier, which then sends the signals to the ear through a speaker. 

Hearing aids magnify sounds based on the severity of a patient's hearing loss. Hair cells within the ear detect these magnified sounds and convert them into signals to pass to the brain. There is a limit on how much amplification can be given to sounds, so hearing aids are not for everyone.

There are 3 basics of hearing aids that vary in size, placement and degree of amplification. Determining which is best for you depends on the severity of your hearing loss. 

• Behind the ear (BTE) - These hearing aids are worn behind the ear and connected to a plastic mold that is placed inside the outer ear and are used by people with mild to profound hearing loss. New technology has introduced a smaller BTE aid that only places a small tube into the ear canal, keeping the canal open and keeping the device from being damaged by wax buildup. It also provides a clearer sound.

• In the ear (ITE) - These hearing aids are smaller devices that fit inside the outer ear. They can be used for mild to severe hearing loss but are not typically used for children because the device will be too small as ears grow.

• Canal - Canal aids are the smallest type of aid and fit either in the canal (ITC) or completely in the canal (CIC). Since they are so small, they may be hard to adjust and do not have extra space for batteries and other devices. Therefore, canal aids are recommended for people with mild to moderate hearing loss.

Aside from the different types, hearing aids also work in different ways depending on how they are programmed electronically. 

• Analog - These aids convert the sound waves into electrical signals which are then amplified and transmitted back to the ear. They can be custom made to fit each patient's hearing needs. They can also be customized for different listening environments and can be changed by the patient. Analog aids can be used in any type of hearing aid.

• Digital - Digital hearing aids have similar features to analog aids, except they convert the sound waves into numerical codes and then amplify them. Some frequencies can be amplified more than others. Digital aids can also be programmed to focus on sounds coming from a certain direction. These aids tend to be more expensive than analog.

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Lyric® Hearing

Lyric hearing aids are the first and only completely invisible aids that are positioned inside the ear canal with no need for surgery or anesthesia. Patients can benefit from improved hearing at all times, for several months at a time with no need to take the device in and out on a daily basis. These devices utilize the natural anatomy of the ear to produce exceptional sound quality directly into the ear canal.

A Lyric hearing aid is ideal for patients with mild to moderately-severe hearing loss, with each device customized for each patient’s individual hearing loss, ear size and shape, and lifestyle. There is no maintenance required for Lyric hearing aids, aside from a 10-minute replacement office visit every few months to receive a new device.

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Pediatric Audiological Diagnosis

While pediatric audiological conditions often occur, they may be difficult to diagnose because of a lack of communication in young children. We perform a series of highly accurate yet noninvasive tests to effectively diagnose audiological conditions in infants and children. Many of these tests are the same as those performed on adults, and may include:

• Auditory Brainstem Response (ABR) screening
• Behavioral hearing test
• Behavioral Observation Audiometry (BOA)
• Visual Reinforcement Audiometry (VRA)
• Conditioned Play Audiometry
• Tympanometry

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Electronystagmogram (ENG)

An electronystagmogram (ENG) measures normal eye movement and rapid eye movement, otherwise known as nystagmus. An ENG checks the effectiveness of your eyes, brain and middle ears in maintaining your balance when changing position, as well as any damage to those systems. Such damage causes symptoms of dizziness, vertigo, and/or loss of balance.  While nystagmus typically occurs when the head is moving, constant nystagmus or nystagmus when not in motion may indicate damage to the brain, eyes, and/or middle ears. ENGs usually last about 60 to 90 minutes.