Hearing Evaluation
The appointment for a comprehensive hearing evaluation begins with a complete hearing health history. The audiologist will then inspect your ear canals to ensure they are clear of debris. Using either traditional headphones or insert earphones, the audiologist will perform testing to determine your level or threshold of hearing over a wide frequency range. A bone vibrator will then be placed behind your ear to help determine if any loss of hearing is due to a problem with the outer or middle ear space or the inner ear. Speech testing is performed by having you repeat several soft words, followed by a list of words presented at a comfortable listening level. Further testing may be performed depending on the outcome of these results. Following the evaluation, the audiologist will sit down and discuss your test results with you in detail and will provide any appropriate recommendations. A detailed report is generated for your record and sent to your referring physician. Hearing evaluations can be performed on patients of any age using a variety of test methods. For further information on specific test methods used for children, please see Pediatrics.

Tympanometry
Tympanometry is a test used to evaluate the eardrum and the middle ear cavity. Air pressure is applied to the eardrum and the test measures how well it moves back and forth from its resting position. This test can provide a lot of useful information regarding the status of the middle ear. If there is fluid behind the ear drum, then it will not move when pressure is applied. This test can tell us if the eardrum is too stiff or too mobile. Tympanometry also measures the amount of space in the ear canal.  If there is an open pressure equalization tube or perforation (hole) in the eardrum, then the space will be larger than normal. The results of the graph obtained from this test, or tympanogram, are evaluated in conjunction with the results of your hearing evaluation to get a complete picture of your hearing status.

Acoustic Reflex Testing
The acoustic reflex test measures the contraction of a tiny muscle in the middle ear in response to loud sounds. The level of loudness needed to elicit the response, or the absence of any response gives information that aids in identifying the location of the problem along the auditory pathway. The results of the acoustic reflex test are evaluated in conjunction with the results of your hearing evaluation and tympanogram to help gain a complete diagnostic picture of your hearing status.

Otoacoustic Emissions (OAE)
Otoacoustic emissions are inaudible sounds that are emitted by the cochlea (inner ear) when it is stimulated by a sound.  In OAE testing, a small probe is inserted into the ear canal. A soft tone is presented and if an emission is present then it is likely that the hearing is normal at that frequency. Otoacoustic emissions are usually absent in patients with hearing loss. OAEs are often used as a screening method to determine whether or not a hearing loss is present. Since the person does not have to respond, it is an ideal test method for infants or those who cannot be evaluated using conventional techniques. 
 
OAE’s are also valuable in evaluating the integrity of the outer hair cells in the cochlea. The absence or reduction of otoacoustic emissions can help explain why some people have tinnitus (or ringing in their ears) or have difficulty hearing in noisy environments despite normal or near normal hearing. OAEs are valuable in testing for ototoxicity as well. Ototoxicity is damage to the cochlea because of medication that is toxic to the ear, which includes some chemotherapeutic agents.

Central Auditory Processing Evaluations (CAP)
The inability to understand spoken language in a meaningful way in the absence of what is commonly considered a hearing loss is called a Central Auditory Processing (CAP) disorder. In simple terms one may describe CAP as how well the ear communicates to the brain and then how well the brain understands what the ear is saying. Through a battery of tests, an audiologist can evaluate hearing and identify possible processing problems. These tests involve listening to different types of speech under a variety of difficult listening situations. CAP problems can affect learning, particularly in the areas of spelling and reading. For more information, please see Pediatrics.