Audiology Diagnostics
In order for ENTs and Audiologists to introduce the most appropriate management to meet the individual hearing needs it is important that the diagnostic tests are performed by qualified personnel in a properly setup environment.
At Super Quality all diagnostic hearing tests are performed by qualified Audiologists in an acoustically treated sound booth. The tests results obtained will also be clearly explained to the patients. The professional setup and experienced personnel assist to:
• Obtain accurate ear specified and frequency specified information on the type and degree of hearing loss.
• Ensure accurate pre and post surgery hearing assessments.
• To assist in selecting the most appropriate hearing devices such as hearing aids or implantable hearing devices.
PTA (PURE TONE AUDIOMETRY):
This test is to determine the severity, type and reason of Hearing Loss.
What is puretone audiometry?
Puretone audiometry is a hearing test to determine the presence or absence of hearing loss. If hearing loss is present, the type and degree of hearing loss will be determined.
How is it being performed?
The test will be performed by a qualified Audiologist with the patient seated in a soundproof booth. The Audiologist will be seated outside the sound booth and perform the test using a calibrated audiometer. The tester will have a clear view of the patient through a glass window.
This test comprises of two parts:
Air-conduction thresholds test and bone-conduction thresholds test.
For air-conduction test, the test signals are delivered through a pair of headphone or insert earphones. For bone conduction test, the test signals are delivered through a bone vibrator which conducts the sound directly to the inner ear. Test signals ranged from 250 Hz to 8 KHz and the patients are required to response by pressing a response button when he/she hears the test signals. The test will takes about 20 to 25 minutes and the results will provide ear-specific and frequency-specific information on the degree and type of hearing loss.
A comprehensive hearing test report indicating the type and degree of the hearing impairment will be given at the end of the assessment session.
FFA/BOA (Free Field Audiometry, Behavioral Observation Audiometry):
This test is also called play audiometry in which we estimate the threshold by giving the sound through speakers and observe the reflex of the patient it can be used in babies for diagnosing estimated threshold prefitting or post fitting aided threshold. It is also used as a tool for getting the hearing response after fitting the hearing aid. But the Automated tests i.e. ABR & ASSR are more accurate.
SPEECH AUDIOMETRY
What is Speech Audiometry?
Puretone Audiometry allows us to evaluate the softest sound one can detect but it does not provide any information about one’s ability to hear and understand speech. Hearing test using speech stimulus will help to find out the person ability to hear and understand speech and this test is called Speech Audiometry.
Speech test helps in different aspects:
- To cross check the puretone hearing thresholds
- Help in hearing aid selection
- To assess the suitability of various implant solutions such as
- Cochlear implant
- Bone Anchored Hearing Aid
- Middle Ear Implant
- Help in identifying functional hearing loss.
How is speech test being performed?
The test is performed by a qualified Audiologist with the patient seated in a calibrated, soundproof room. Live or recorded speech stimulus can be delivered through either headphone or speaker. Patient is required to repeat the speech stimulus they hear. There are two different speech tests:
SRT: Speech Reception Threshold
This test help to determine the lowest level a patient can hear and repeat two syllable words at 50% of the time.
SDT: Speech Discrimination Test
This is to determine the speech discrimination ability of an individual. The test is done at supra threshold level (about 25 to 30 dB above SRT) and is calculated in terms of percentage:
Number of positive response
———————————————————- x 100%
Total number of speech stimulus presented-
IMPEDANCE/TYMPANOMETRY:
This test is to determine the problems in the middle Ear due to middle ear Pathology. Tympanometry is a test of the middle ear function and the eardrum. It provides valuable information on the condition of the middle ear and assesses the mobility of the eardrum by varying the air pressure in the ear canal. Prior to tympanometry testing it is important to do an otoscopy to ensure that the ear canal is cleared from impacted earwax and fluid.
The test helps to:
- Assess the eardrum movement (compliance)
- Monitor chronic middle ear fluid
- Confirm tympanic membrane perforation
- Monitor Eustachian tube function
It is an objective test and it only takes a few minutes and can be easily performed on patients of all ages. The test is performed by inserting the tympanometer probe in the ear canal which generates a puretone signal and measures the sound reflected from the eardrum at different pressures. The wave form is called a Tympanogram.
It is important to note that Tympanometry is NOT a hearing test. It does not assess the sensitivity of hearing and the results of this test should be viewed together with Puretone Audiometry. The result of the test helps to distinguish between sensorinneural and conductive hearing loss especially middle ear conditions such as otitis media with effusion, otosclerosis, cholesteatoma, tympanic membrane scarring, tympanosclerosis, etc.
The Tympanogram can be broadly classified into 3 types.
SPECIAL TESTS(SISI, TD..): SISI(Short Increment Sensitivity Index) and TD(Tone Decay)
These test are to identify the Cochlear and retro-Cochlear Pathology. BERA (Air Conduction)(Screening, Chirp or Stacked):
Test to determine the integrity of Auditory nerve, Hearing loss and severity in difficult to test population. This test is also used to determine retro cochlear pathology, Auditory Neuropathy, Dys-synchrony & CAPD (central auditory processing Disorder)
BERA (Bone Conduction)(Brainstem Evoked Response Audiometry) :
This test is to determine the Hearing loss and severity in cases where the conduction of sound to inner ear is affected i.e. due to middle ear pathology, incomplete formation of canal, fully
closed canal (Atresia) & post burning cases where Air conduction test can’t be performed. It is also known as ABR or ERA.
Cortical Auditory Evoked Potential & aided Cortical Auditory Evoked Potential:
This test is to determine whether the amplification provided to the child is giving benefit to the client or not. It tests the particular sound produces electrical activity at the brain level or not. It can be done through insert earphones, Bone conduction Vibrator and through Speakers for Hearing Aid users. This test is performed in awake stage.
ASSR (Auditory Steady State Response Audiometry):
This test is to determine Frequency Specific thresholds for difficult to test patient
(Automated computerized Audiometry)
Aided ASSR:
This test is to determine Aided thresholds i.e. Hearing Threshold after post hearing aid fitting (Automated free field computerized Audiometry)
ECochG & VEMP (Electro Cochleography & vestibular Evoked Myogenic Potential):
These tests are to check the Balance/Vestibular function of Vestibular organ of Cochlea. This is useful in Diagnosing balancing disorder, Cochlear Hydrops, Meniere’s cases and tool to find our possible reason for vertigo and Dizziness.
DPOAE & TEOAE (Distortion & Transient product Oto Acoustic Emission):
This test is to check if the outer hair cells in the cochlear are healthy or not. This is also used as initial screening test for Hearing Loss.
Tinnitus Diagnostic & Management:
This test is to identify the cause, Type, Severity and possible management for Tinnitus problem. In this we follow standard set of procedures based on which the management is done. In this
we provide the solution through Sound Therapy & NEUROMONICS.
Corporate Associations:
We provide training for Hearing Diagnostic, Hearing Conservation and Noise control program to companies. We provide Noise Plugs and Noise Maskers to the corporates.
VESTIBULAR DIAGNOSTICS & REHABILITATION using VIRTUAL REALITY (DIZZILABS)