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Diagnostic Audiologic Evaluation

If you have been referred for a diagnostic audiologic evaluation, it means that the presence or absence of a hearing loss needs to be examined further. A diagnostic audiologic evaluation may be indicated for individuals who are experiencing hearing loss, tinnitus, balance problems, or dizziness.

After the evaluation is completed, type and severity of hearing loss can be determined. These results may provide insight into the cause of the hearing loss or other presenting symptoms. This information will also provide guidance for the audiologist when evaluating appropriate treatment recommendations, or referrals to other professionals. 

What tests will be done?

There are several different diagnostic evaluations that are available to use when trying to determine etiology of symptoms. The tests completed in the evaluation will depend on several factors including the patient’s age, symptoms, and medical history. These exams will help to determine the type and degree of hearing loss, as well as conditions of the ear canal, middle ear, and inner ear. From the results, the audiologist will also establish whether the hearing loss is conductive (middle or outer ear problem) or sensorineural (inner ear problem or issue with the auditory nerve/pathways).

At a minimum, the diagnostic audiologic evaluation includes pure-tone testing, bone conduction testing and speech testing.

Pure-tone and bone conduction testing

This portion of testing determines a patient’s hearing sensitivity, by finding the quietest tones that a person can hear across different frequencies from low to high. This testing is completed with foam insert earphones or over the ear headphones that transmit the tones through the ear canal, middle ear, and inner ear. Bone conduction testing is completed in a similar manner to traditional pure-tone testing, however a headset that goes behind the ear presents the tones via bone conduction. This method of testing bypasses the middle ear and test the nerve of hearing directly, which will help the audiologist determine if the hearing loss is conductive or sensorineural. 

Speech testing

Speech reception threshold (SRT) will help to confirm the results of the pure-tone testing by making sure both tests are in agreement with one another. This determines the quietest level that the patient can identify words or speech.

Word recognition score (WRS) testing is used to determine the percentage of speech that a patient understands when words are presented at a comfortable volume. This testing gives an indication into a patient’s speech comprehension, and will help the audiologist determine appropriate treatment options.

Additional tests:

The audiologist may also perform tympanometry if a middle ear pathology, such as fluid in the middle ear, is suspected. Tympanometry asses the status of the middle ear by applying positive and negative pressure to the ear and measures the movement of the ear drum in response to the pressure changes.

What can I expect during a diagnostic hearing evaluation?

Prior to your appointment, the audiologist will complete a thorough medical history and will want to hear about any complaints you have concerning your hearing. Make sure any history of ear surgeries, noise exposure, tinnitus, and problems with balance/dizziness are noted at this time. Make sure to bring a complete list of any medication and supplements you are taking to your appointment, as some medications can impact hearing status.  

Your evaluation will last about 20-30 minutes. You should also plan time to discuss the results of your exam with the audiologist as well as to ask questions to clarify any information.

If the results of your exam indicate that you are a good candidate for hearing aids, plan for additional time or a follow-up visit for a formal hearing aid evaluation (HAE) to discuss your amplification options with the audiologist.

It is highly recommended that a family member be present at your HAE appointment. Hearing loss not only affects the patient coping with the deficit, but the whole family as well. It helps to have a family member or another supportive person at the appointment to help you understand all of the information and recommendations. This appointment is also a good chance for the family to better understand how hearing loss can affect the patient’s everyday life.

The diagnostic audiologic evaluation is a good chance to establish a relationship with your audiologist. Above all, don't be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding the hearing healthcare solutions that work best for you and your lifestyle.