Evaluation and Testing

There are several types of tests that we use in order to assess your hearing and balance. Our audiologists choose the appropriate type based on factors such as as age, level of comfort and reason for visit. The length of your appointment will vary based on which tests are being performed. Typically, a hearing test takes 30 minutes while a comprehensive balance test may take up to two hours.

Types of Auditory Tests

Comprehensive Audiometry (Puretone and Speech Audiometry)

This test is most often used for patients ages 5 years and up. The patient is asked to respond each time a tone is heard through the ear phone. The elicited response may be raising a hand, saying a catch word, or pressing a button. The patient may also be asked to repeat a list of words.

Tympanometry/Acoustic Immittance

This test helps to determine how the middle ear is functioning, by assessing the movement/mobility of the eardrum, pressure in the middle ear space and the middle ear's muscle reflex. To perform this test, a small probe is placed in the patient's ear canal and a slight pressure is applied. Tympanometry is obtained as part of the audiological evaluation on patients of all ages.

Otoacoustic Emissions (OAE) Testing

Otoacoustic Emissions (OAE) testing assesses the function of the cochlea or inner ear. To perform this test, a small probe is placed in the patient's ear which plays a series of sounds. The probe then records the otoacoustic emission, which is a sound produced by the ear in response to the stimulus. It is very important for the patient to be quiet and relatively still during this test. OAE testing is most often obtained as part of the audiological evaluation on patients of all ages. It is specifically used as a screening test on newborns/infants.

Auditory Brainstem Response (ABR)

The ABR is a special hearing test that can be used to track the nerve signals arising in the inner ear as they travel through the hearing nerve (called the auditory nerve) to the region of the brain responsible for hearing. The test is useful because it can tell us where along that path the hearing loss has occurred. For example, the ABR is often used for individuals with sensorineural (nerve) loss in just one ear. This loss can sometimes be caused by a benign (non-cancerous) tumor on the auditory nerve. If the ABR is normal along that region of the path, the chances of having this tumor are quite small.

Electrocochleography (ECochG)

The ECochG test measure an electric potential generated in the inner ear  in response to a sound. An electrode is placed in the ear canal or on the eardrum and sound is transmitted through an earphone. This testing is often used to detect increased inner ear pressure.

Vestibular Tests

Videonystagmography (VNG)

The VNG test assesses the vestibular function of the inner ear and helps determine if a disorder in the vestibular system is contributing to a patient's dizziness or imbalance. For this test the patient must wear a pair of goggles which records eye movements. The test has three main parts: Ocular mobility testing entails following a moving dot with your eyes to look for any slowness or inaccuracies in your ability to follow visual targets. Positional testing looks at eye movements during different positions of moving the head and body. Caloric testing involves stimulating both ears with warm and then cool air. This change in temperature stimulates the inner ear which in turn causes reflex movements of the eyes. From the three main parts of VNG, eye movements are recorded and measured. Analyzing these eye movements reveals how well the balance mechanism is functioning and may indicate if a central or neurological problem or problem in the inner ear exists.

Rotational Chair Testing

The rotational chair testing is typically done in conjunction with the VNG test and measures whether or not a disorder of the inner ear may be contributing to a patient's dizziness and imbalance. For this test, electrodes are placed near each eye and on the forehead. The patient is rotated slowly back and forth in the test chair, which is located in a darkened room. Unlike the VNG test, the rotational chair test is able to assess both the right and left ears at the same time to determine how they are working together.

Vestibular Evoked Myogenic Potential (VEMP) Testing

VEMP testing assesses a portion of the vestibular system separate from those of the VNG or rotational chair testing. During VEMP testing, electrodes are placed on the neck muscles and insert earphones are placed in the ears. The presentation of the stimulus through the headphones produces a response that is measured from the neck muscle.