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Hearing Evaluation

What to expect at your appointment for a hearing evaluation.


1) Paperwork: As with all medical appointments there will be intake paperwork, but we have tried to make it as painless as possible.  We will obtain your demographic information so we can identify you. At Lancaster Hearing Center we are HIPAA compliant so your signature will be needed stating you understand the privacy statement, that we have the permission to evaluate your hearing loss, permission to let your physician know your results if you wish and to whom, if anyone we can discuss your hearing loss or hearing aids.  So that you are not bothered needlessly and your privacy is protected we request your preferred method of communication and if messages can be left, emails sent etc.


For the evaluation we also will obtain, either in writing or conversation your health and your hearing health history.  This will help with both the diagnosis of your hearing loss and the appropriate treatment. Many seemingly unrelated health problems contribute to hearing loss and affect the type of treatment. Often medications are a factor in tinnitus, hearing loss or dizziness and if you provide us with a list of your medications, we will be happy to discuss that possibility with you. It is also important that we know what types of communication problems you are having.  The more information we have, the better we can specifically fit your needs.


2) Otoscopic examination: At the beginning of every appointment your external ear canals will first be examined with an otoscope. An otoscope allows the audiologist to look at the external ear canals and eardrums to determine if significant wax or debris is present that might affect the accuracy of auditory testing. Examination with an otoscope also allows the audiologist to examine the size and shape of the ear canals and any abnormalities. 


3) A complete diagnostic audiologic evaluation is necessary to determine the type and cause of a hearing loss, allows a physician to determine medical diagnosis and treatment if necessary, and to determine appropriate referral, treatment or methods of improving your ability to hear.  The puretone testing through insert earphones consists of you listening carefully for tones or beeps of various volumes and pitches and pushing the button when you are able to hear the tones, no matter how soft they are.  Threshold is the softest volume that you can hear each tone 1/2 the time, and that is what we are looking for to determine the sensitivity of your hearing. The tones through the insert earphones go through the outer ear canal, the eardrum, the middle ear, the cochlear, the auditory nerve and the brainstem to the brain. Several hearing evaluations stop there, but it is critical to also determine how softly you can hear the same tones or beeps though a bone oscillator.  The sound from the bone oscillator bypasses the ear canal, the eardrum and the middle ear and goes straight to the cochlear.  Only through this test can we be certain how much of the loss is due to an outer or middle ear problem that may respond to medical treatment. Purchasing hearing aids without both air and bone conduction testing can be unnecessary and dangerous if a medical condition is left un-diagnosed or treated.


Speech testing is also necessary to fully understand and accurately determine the cause of and treatment for a hearing loss.  Speech reception thresholds consist of repeating two-syllable recorded words to determine the softest level at which you can understand speech, even if guessing. Speech recognition testing or speech discrimination testing consists of repeating 25 words at a volume where it is expected for you to do the best.  This gives the audiologist information on the cause of the hearing loss, especially if the speech scores are inconsistent with pure-tone test results, and aids in expectations for treatment.


4) Tympanometry and ipsilateral acoustic reflex testing determines the functioning of the eardrum and the middle ear space and gives information on the auditory nerve and is useful in diagnosis of hearing loss and in medical diagnosis.