Nearly 10 percent of people in the US have some degree of hearing loss.
Hearing loss can be congenital or acquired, progressive or sudden,
temporary or permanent, affect one or both ears, and be mild or
profound. Aging, infections, head trauma and accumulation of ear wax can
all contribute to hearing loss. Even newborns can have hearing loss and
Hearing problems in early childhood can result in lifelong impairments
in learning and language skills. Children who have other sensory,
linguistic, or cognitive deficiencies are affected most severely.
Adolescents are at risk from excessive exposure to noise, head trauma,
or both. Older adults typically experience a progressive decrease in
hearing which is usually related to aging and noise exposure.
If you or someone you care for has hearing loss, an audiologist can
measure hearing function with appropriate tests. If the cranial nerves
are involved, you may need additional imaging tests such as an MRI
(magnetic resonance imaging) or a CT scan (computerized x-ray) for the
ENT to make an appropriate diagnosis and treatment plan.
Why Main Line Health for your Hearing Services?
Main Line Health System has doctorate-level audiologists who can
assess your hearing and evaluate any hearing loss. If you have
hearing loss, we can prescribe, custom fit and service your
hearing aids, with technology ranging from the basic to advanced
computer programmable digital devices.
We offer the latest testing to evaluate your condition and
create a customized treatment plan for your individual needs.
Comprehensive Audiologic Testing includes:
Physical examination – The external ear is inspected for
any blockages, infection, congenital malformations, and other
lesions. The eardrum is examined for perforation, drainage,
inflammation, fluid or masses. The cranial nerves are examined
during the neurologic portion of the exam.
Pure tone audiometry (PTA) – This test uses an audiometer
that plays a series of tones that the person can hear through
headphones. The frequency and loudness varies.
Speech reception threshold (SRT) – one of the most
important screenings you will have when you go in to see an
audiologist for a thorough and comprehensive screening. This
process tells the doctor if you have any lost ability to hear as
well as what type and what extent it is at. Generally, you will
be asked to repeat two-syllable words during this screening. You
will hear the word and then need to repeat it. However, the
sound and intensity of the sounds you hear will rise and fall
throughout the screening. The goal is to find the softest level
at which you are able to repeat at least half of the words
presented to you.
Word recognition (formerly called Speech discrimination)
– assesses how well you understand words used in normal
conversation by repeating a series of one syllable words that
are louder than your speech reception threshold test result
(loud enough you will not have any problem hearing the words).
Acoustic reflex testing – it's helpful in diagnosing
problems beyond the inner ear—in the pathways leading to the
brain. The purpose of the test is to see if the ear's natural
reflex to lower the volume of very loud sounds is working
properly. The test is conducted like tympanometry, but in
addition to using the pressurized probe, the audiologist (a
health professional who assesses hearing and balance, as well as
fits and dispenses hearing aids) delivers a sound of about 80 dB
to see if the muscles in the middle ear contract to decrease the
volume sent to the middle ear. The audiologist keeps increasing
or decreasing the volume to find the decibel level at which this
reflex occurs. It normally occurs at 65 to 95 dB. A reflex that
starts at a higher decibel level or doesn't occur at all
suggests that your hearing loss may be at least partially the
result of a neurological problem.
Weber Test – determines whether an issue is conductive or
sensorineural hearing loss. Conductive hearing loss occurs when
sound waves are not able to pass through the inner ear. This can
be caused by an infection, a buildup of earwax, a punctured
eardrum, and fluid in the middle ear. Sensorineural hearing loss
occurs when auditory nerves or hair cells are damaged in the
inner ear. This is also known as "nerve deafness," and it is
caused mostly by aging.
Rinne test – compares air- and bone-conduction hearing.
Air-conduction hearing occurs through air near the ear, and
bone-conduction hearing occurs through vibrations.
Tympanometry – aids in diagnosing and monitoring problems
with the middle ear and measures the ear’s response to both
sound and pressure. This test can help determine if the hearing
problem is a result of fluid in the middle ear, ear infection, a
tear in the eardrum, or a problem with the Eustachian tube that
connects the middle ear to the upper part of the throat.
Acoustic reflex measure – provides information about the
possible location of the hearing problem by testing response to
sound by the contraction of a tiny muscle in the middle ear. The
loudness or absence of sound tells the audiologist about the
type of hearing loss.
Static acoustic impedance – measures the physical volume
of air in the ear canal. Helps identify a perforated (torn)
After the initial testing, the audiologist will review your evaluation
of your hearing abilities and individual needs. Additional testing may
be needed such as:
MRI of the head in patients with an abnormal neurological
evaluation or those with poor word recognition in the audiology
Magnetic resonance angiography is done when there are vascular
CT scans are done if a bony tumor or erosion is suspected.
The auditory brain stem response using surface electrodes to
monitor brain waive response to sound stimulation is conducted
when a patient does not have another way to respond.
Electrocochleography measures the activity of the cochlea and
the auditory nerve with an electrode placed on or through the
eardrum. It can be used to assess and monitor patients with
dizziness, can be used in patients who are awake, and is useful
in intraoperative monitoring.
Otoacoustic emissions testing measures sounds produced by outer
hair cells of the cochlea in response to a sound stimulus
usually placed in the ear canal. It is used to screen neonates
and infants for hearing loss and to monitor the hearing of
patients who are using ototoxic drugs (eg, gentamicin ,
Central auditory evaluation is done when patients seem to hear,
but do not understand such as when they may have difficulty
understanding speech in noisy environments, following
directions, and discriminating (or telling the difference
between) similar-sounding speech sounds.
The results of the testing will be the basis of any treatment
For more information, call 1.866.CALL.MLH.