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Ask the Audiologist

How is hearing loss diagnosed?

By Ali Wright, Au.D.
Audiology Consultants, P.C.

Hearing loss can affect people across the lifespan, with many different causes ranging from age-related hearing loss, genetic factors, noise exposure, illness, or injury. Early detection is important for improving quality of life. Diagnosing hearing loss is a very reliable process that consists of a few steps that are all a part of a regular hearing test. Most hearing tests consist of the same important parts: case history, otoscopic exam, pure tone testing, speech testing, and counseling.

During the case history portion of an evaluation, it is important to relay all important medical conditions or important health factors that could be relevant to diagnosing and treating a hearing loss. This may include things like any recent or gradual changes in hearing, exposure to loud noises, history of ear infections or injuries to the ear, medications lists, and family history of hearing loss. The audiologist may also ask about recent associated symptoms like tinnitus (ringing/buzzing in the ears), dizziness, or ear pain, or ear pressure/fullness.

Following a thorough case history the Audiologist will typically complete a physical examination or otoscopic evaluation of the outer ear, ear canal, and ear drum. This is to rule out a physical cause for the change in hearing. They will look for any visible abnormalities or signs of infection, earwax buildup, fluid behind the eardrum, or structural issues. This is done with an otoscope, a handheld device with a light and magnifying lens. If any treatable condition, like impacted earwax or ear infection, is found, it may be addressed before further testing by the Audiologist or with a recommendation to have it evaluated further by a physician, usually an Ear Nose and Throat (ENT) physician.

The part that most people associate with diagnosing hearing loss is a series of audiological tests or a hearing test. The hearing test is broken down into a few different sections. Two parts are to evaluate the softest place that a person can identify sounds by listening for soft beeps or tones and repeating back words at a soft speech volume. The next part will be repeating back words at a comfortable volume to identify how well the person is able to understand different speech sounds. All sections are important to help build a full picture of what is going on with the hearing system and to assist the Audiologist in making a good recommendation for how to treat the person’s concerns. During this part of the evaluation the Audiologist will also be able to determine the type of hearing loss the patient is presenting with and the degree of the hearing loss. Different types of hearing loss may have different treatment options so it is important to know possible causes for the hearing loss before discussing which treatment will work best. Hearing loss is not measured in percentage of hearing loss but rather categorized in degrees of severity including: normal, mild, moderate, moderately-severe, severe, or profound.

Once the hearing test is complete the Audiologist will sit down with the patient to explain the results and review recommendations. Treatment options may include a medical treatment for infections or wax removal by recommending the primary care physician refer the patient to an ENT, treating the hearing loss with hearing aids or cochlear implants, and reviewing good communication strategies for success with hearing loss. The goal of the counseling portion of the exam is to review the test and help the patient start the process of determining what type of treatment plan is going to be most appropriate for their hearing loss and communication needs.

Diagnosing hearing loss is typically a starting point for most people to get the information they need to take the next steps. If no hearing loss is found the Audiologist may recommend retesting if concerns arise, however, if a hearing loss is determined further appointments to discuss treatment may be required. It’s very important to seek help at the first sign of hearing or communication difficulties, early diagnosis and intervention can significantly assist with good communication, prevent social isolation, and improve overall quality of life.

If you or a loved one suspects hearing loss, don’t wait. Schedule a hearing assessment and take the first step toward better hearing and a more connected life.

Ali Wright is an audiologist at Audiology Consultants, P.C.  For more information consult our ad in this publication for store locations and phone numbers.