Monthly Archives: December 2015


Hearing Test

I had a patient recently who reported having had a couple of hearing tests completed in the past year and a half and wondered why he would require another hearing evaluation before being fit with hearing amplification.  The answer is for pure tone testing, a test within the past 6-12 months can be sufficient, however, pure tone testing is only a small portion of a hearing evaluation.

Pure tone testing (beep testing) is a test where you are presented with a series of beeps at different test frequencies to determine the softest level at which you can hear a sound.  This is an integral portion of the test battery but alone provides little information.

When you add speech testing to the pure tone test results you can gain more knowledge on the function of the auditory system.  Speech testing is vital to provide a cross check for verifying if the results given during pure tone testing are accurate and can provide insight into the function of the inner ear, hearing nerve, brainstem, and speech centers in the brain.  Speech testing is not an MRI or CT scan, so it does not give an image of any structures, but poor speech test scores can sometimes be a flag that something may be off in one or more of these areas.

Speech testing can also be performed in the presence of background noise.  This is often referred to as speech in noise testing (clever name I know).  Speech in noise testing can be a fantastic tool for how a patient processes speech in a more realistic or real world scenario.  Let’s face it, pure tone beep testing is great to identify how soft you can hear but it provides little information into how you process and interact with the world around you.

The patient mentioned in the first paragraph scored a mild to moderate hearing loss on pure tone testing and scored in the 80% range on speech identification but when presented with speech in noise he scored more like someone with a severe or profound hearing loss.  His chief complaint is poor understanding in noise.  But without adding speech in noise testing it would not look like as big of an issue.

Using a full test battery is the best way to diagnose and understand what is happening in the auditory system.  So before you trial a pair of hearing aids make sure to ask if you have had at least pure tone testing, speech testing, and speech in noise testing because if you have not there may be a piece of your hearing puzzle missing and you may not be as successful.

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Hearing loss: Visible or invisible?

It is easy to think that hearing loss is invisible.  It does not have a unique shape, you cannot touch or pick up hearing loss, it has no tangible mass, smell (thank goodness), or color.  However, it is sensed and recognized often by loved ones and family members before the actual patient.

I saw a coffee mug while in graduate school that read, “Your hearing loss is much more visible than your hearing aids will be.”  It is a great joke but it rings so true especially today with the advent of microprocessor technology and the miniaturization of microphones and amplifiers.

Many of my first time patients report they made the appointment for hearing testing only to placate the wishes of their spouse or family member.  To the patient everyone else mumbles or speaks too softly, to their family the patient is deaf as a post, rude, irritating, or hearing selectively.

It is interesting how the question of visibility is based purely on perspective.  To the patient suffering from a gradual onset hearing loss the problem may be invisible while at the same time their family and friends are acutely aware of a hearing issue.

If you are 55 or older, an annual hearing evaluation is highly recommended to monitor your hearing health. The best solution is to call Accessible Hearing Aids for at least a hearing screening or better yet a comprehensive hearing evaluation.  Hearing testing will verify if there is a visible hearing loss you are unaware of or if you should get a new set of family and friends…(only kidding)  After a comprehensive hearing evaluation, you will be well aware of any notable hearing loss and what is the best solution moving forward.

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