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  • Diagnosis of Hearing Loss

    The doctor will ask about your symptoms and medical history, and perform a physical exam. As part of your diagnosis, your doctor may try to determine the following:
    • Location of the problem —This will be determined through testing.
    • Degree of loss —This will also be determined through testing.
    • Cause —It is not always possible to identify the exact cause of hearing loss. If a cause can be found, this information can help guide treatment.
    Depending on the type of hearing loss you have, the doctor may order tests such as:
    Otoscopy —This is a visual exam that looks at the structures inside the ear. It can detect ear wax, foreign bodies, and problems with the ear canal skin.
    Weber Test —A tuning fork is sounded and placed on your scalp, forehead, nasal bones, or teeth. This can help distinguish conductive from sensorineural hearing loss. It can also indicate the side of the hearing loss.
    Rinne Test —A tuning fork is sounded and placed in front of and then behind the ear. This can help distinguish conductive from sensorineural hearing loss.
    Audiometric Tests (also called hearing tests)—A doctor or an audiologist (hearing specialist) may carry out these tests. The tests involve listening to tones in a soundproof room and reporting whether you hear them or not. You wear earphones and listen to sounds sent to one ear and then the other. A range of tones is repeated at different levels to determine when you can hear them. You also listen to words at different levels to determine when you can understand them.
    Tympanometry —This test introduces air pressure in the ear canal, which makes the eardrum move. A special machine measures the pressure in the middle ear and the movement of the eardrum.
    Acoustic Reflex —This test measures the response of a very small ear muscle that moves when there is a loud sound. Lack of this movement or the loudness at which the movement occurs provides important information about hearing loss.
    Static Acoustic Measures —These measures estimate the amount of air in the ear canal. They help detect a perforated eardrum or if ear ventilation tubes are open.
    CT Scan of the Head —This is a type of x-ray that uses a computer to make pictures of the inside of the head. It may be done to check for a tumor or bone injury.
    MRI Scan of the Head —This scan uses magnetic waves to make pictures of the inside of the head. It may be done to check for a tumor or bone injury.
    Auditory Brainstem Response —Electrodes are attached to the scalp to measure electrical response in the brain to sounds. This test helps determine the exact location of certain hearing problems. It is frequently used with babies.
    Otoacoustic Emissions —These emissions are faint sounds produced by the cochlea when sound stimulates it. Although people cannot hear these sounds, they can be picked up and measured by a small probe placed in the ear canal. These emissions are produced by people with normal hearing but not by those with hearing loss greater than 25-30 decibels. This test can detect blockage or damage in different parts of the ear and is often used with babies.

    References

    Academy of Otolaryngology Head and Neck Surgery website. Available at: http://www.entlink.org/healthinfo/index.cfm

    Hearing loss. Mayo Clinic website. Available at: http://www.mayoclinic.com/invoke.cfm?id=DS00172 . Accessed August 10, 2005.

    Hearing screening. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/hearing/testing/default.htm?print=1 . Accessed August 10, 2005.

    Isaacson JE, Vora NM. Differential diagnosis and treatment of hearing loss. Am Fam Physician. 2003;68:1125-1132.

    Revision Information

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