Hearing Test

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A thorough hearing test is easy and painless, and it will get you started on your path to better hearing. Find out what to expect when you are tested for hearing loss.

Do you suspect you have a hearing loss? How can you be sure? Hearing loss can affect anyone and often progresses so gradually, it can be difficult to notice until you experience symptoms. Hearing loss has far-reaching effects on your health, so getting a baseline hearing test and annual follow-up tests can help you catch it early.

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Hearing tests are easy and painless.

The purpose of a test for hearing loss is to determine not only if you have a hearing loss, but how mild or severe it is. A thorough hearing test can also help define the type of hearing loss you have: conductive, sensorineural or mixed and whether it will respond best to medical treatment or hearing aids.

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A hearing health history

When you visit a hearing healthcare professional, their first step will be to get to know your personal hearing health and medical history and find out what concerns you have. There are many potential causes of hearing loss, so the history helps determine if you could have anything inherited or genetic in your family. Medical conditions like allergies, head colds, ear infections and even impacted earwax (cerumen) can also contribute to hearing loss. Also, the hearing health practitioner might ask if you’ve experienced any trauma to the head or ear structures recently. Any kind of injury to the cranial area can result in temporary or permanent hearing damage.

Your hearing healthcare professional may also ask about your exposure to loud noises or if you work in a loud environment. Noise-induced hearing loss is very common in our sound-filled world.

Finally, your hearing health professional might want to discuss the symptoms you are experiencing and how they are affecting your daily life. They will want to understand your lifestyle and the types of work, hobbies and social situations that are important to you.

After your hearing health history is complete, the hearing test can begin.

Getting a hearing test

Hearing tests are painless and non-invasive. You will be asked to wear headphones or soft earplugs with wires connected to an instrument called an audiometer that is used to conduct the test.

You will be asked to listen to tones at different pitches and volumes and push a button or raise your hand when you hear them. The test measures the very softest sounds you can hear at each frequency tested. This part of the test is called pure tone audiometry.

Speech audiometry is another component of most hearing tests, and it uses recorded or live speech instead of pure tones. The speech portion of the exam evaluates the softest speech sounds (threshold) you can hear and understand. You will then be asked to repeat back words that are presented at a level well above threshold to see how well you can understand them accurately. Some practitioners use speech sounds to determine your most comfortable listening level and the upper limits of comfort for listening.

If necessary, the practitioner may perform tympanometry and a test of your acoustic reflexes. For these tests, a soft plug that creates pressure changes and generates sounds will be placed in the ear. This will determine how well your eardrum is moving and will measure the reflexive responses of the middle ear muscles.

Understanding your hearing test results

Test results are presented on a graph called an audiogram that displays the softest sounds you can hear at different pitches or frequencies. The vertical axis of an audiogram represents the intensity or volume of the sounds. The horizontal axis depicts the frequency or pitch of the sound.

Your results will be plotted in decibels of hearing threshold level (dB HL). These units are unique to hearing testing but are based on the perception of sound pressure levels across all frequencies. For each tone you heard during the test, there will be a mark on the audiogram at the appropriate decibel level. Each ear is plotted separately and represented by two different lines. The lines may be quite similar and follow the same pattern or they may be very different.

Hearing loss is measured in decibels (dB) and in the following categories:

Normal hearing (0 to 20 dB HL)
Mild hearing loss (21 to 40 dB HL)
Moderate hearing loss (41 to 70 dB HL)
Severe hearing loss (71 to 90 dB HL)
Profound hearing loss (greater than 91 dB HL)

Although some people talk about hearing loss in terms of percentage, it is not an appropriate or meaningful measure of hearing loss. It is very common to have more hearing loss at some frequencies than for others, so the percentage of hearing loss would be different at each test frequency, making it virtually meaningless when describing the overall hearing loss or determining a course of treatment. In a clinical setting, hearing loss is not described in percentages.

Online hearing tests

Online hearing tests are available, and thanks to technology, they are getting more advanced all the time. There are generally two types of online hearing tests:

Some use audio samples to determine a range of hearing loss.
Some ask questions to determine if you’re having enough trouble to see a hearing healthcare professional.

Online hearing tests are by no means a replacement for a thorough diagnostic hearing evaluation.

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