NIDCD

Audiogram

An audiogram or hearing test is done to determine if a patient has a hearing loss, what type of hearing loss (conductive, sensorineural, or mixed), and what level of loss (mild, moderate, severe) the patient has. The patient sits in a soundroom wearing either headphones or insert earphones. Then different pitches or frequencies are presented to the patient through these headphones or earphones. The patient responds to the softest level or threshold that they hear these frequencies. Speech testing is also done to see how well a patient understands speech. Hearing aids may be recommended depending on the audiogram test results.

Tympanogram  

A tympanogram or “tymps” determines how the patient’s eardrum moves. Negative and positive air pressure is presented into the ear canal using a probe. The eardrum will move back and forth with this air pressure if the middle ear is working normally. If a patient has fluid behind their eardrum or has Eustachian tube dysfunction, the eardrum may not move properly with this air pressure.

Otoacoustic Emissions Test  

The “OAEs” determine how well the outer hair cells are functioning in the inner ear. A probe is placed in the patient’s ear canal and very soft sounds are emitted by the probe and are heard by the patient. The response of the outer hair cells in the cochlea to these sounds are recorded. This is an objective measurement of a patient’s hearing.

Videonystagmography (VNG)/Electronystagmography (ENG)  

Videonystagmography (VNG) is a test designed to give the physician information about the source of a patient’s dizziness or unsteadiness. A VNG uses a video goggle worn over the patient’s eyes in order to measure subtle eye movements. An ENG uses electrodes placed next to each eye and on the forehead in order to measure subtle eye movements. There are 3 parts to the test: Tracking (following a light with your eyes), Sitting and laying in different positions, and “Irrigating” each ear with warm and cool air.

Auditory Brainstem Response (ABR)  

Auditory Brainstem Response test measures the speed in which a sound travels up the auditory nerve through a portion of the brainstem to the brain. This is an objective test (meaning the patient does not have to actively respond during this test). This is a test that is done if the physician suspects that the patient has an acoustic neuroma (benign tumor on the VIII nerve) or it is done to determine a patient’s hearing threshold if the patient is unable to respond appropriately during their hearing test in the soundroom. Electrodes are placed behind the patient’s ears and on the forehead. Earplugs are placed in each ear and the patient lies quietly with eyes closed listening to loud clicks in one ear and static like noise in the other ear.

Electrocochleography (ECoG)  

Electrocochleography is a non-invasive test of the inner ear. This test may be done if the physician suspects that a patient has Meniere’s Disease. An electrode is placed on the patient’s forehead as well as in each ear (in the form of an earplug.) The patient lies quietly with eyes closed listening to “clicking” sounds. The electrodes record responses elicited from these sounds.

Electroneuronography (ENOG)  

This test records facial nerve activity. The test may be done if a patient has Bell’s Palsy (paralysis or drooping on one side of their face.) The facial nerve on each side of the face is electrically stimulated and the response of the affected side is compared to the unaffected side. The physician may determine that the patient needs surgery on their facial nerve depending on the outcome of the test.

Fistula Test  

This is a diagnostic test designed to detect a labyrinthine fistulae. Air pressure is put in the external auditory meatus to determine if objective nystagmus or subjective dizziness can be elicited.

Dix Hallpike Maneuver  

The Dix Hallpike Maneuver is a maneuver performed by turning the patient’s head 45 degrees right or left and then laying the patient on their back with their head hanging down. The patient then sits up and their head is turned to the opposite direction and they lay back down again. This is a diagnostic test to determine if patient has BPPV (Benign Paroxysmal Positional Vertigo) which is a type of dizziness and to determine which side is affected.

Epley Maneuver aka Canolith Repositioning Maneuver or BPPV Maneuver  

The Epley Maneuver or Canalith Repositioning Maneuver is a procedure performed for the treatment of Benign Paroxysmal Positional Vertigo (BPPV). BPPV is the most common peripheral vestibular disorder. BPPV occurs when small crystals known as otoconia become detached from their usual position in the inner ear. The ocotonia migrate through the fluids in the inner ear causing the patient to perceive a spinning perception or vertigo upon certain movements. The Epley Maneuver has been proven as an effective treatment for BPPV.  

The maneuver consists of moving the patient’s head and body in several positions to move the misplaced otoconia to the region of the inner ear so they will not provoke vertigo with movement. The patient lies on their back with the head tilted back at a 45 degree angle towards the affected ear. The head is then rotated toward the unaffected ear followed by rolling the patient onto the unaffected side. The patient is then brought up to a sitting position with their head towards their chest. Each position is held for one minute after the nystagmus has stopped. The procedure takes approximately 10 to 15 minutes to complete depending upon the patient’s abilities and cooperation during the maneuver.

All of these tests are available for both children and adults, and they are conducted with only the most modern equipment. In most cases, you will need only one office visit for testing, however, some extensive tests may require more than one visit. After the tests are completed, the audiologist will interpret the results.

If the problem is medical and needs a physician's treatment, the audiologist will refer you to a physician. Referrals are also available to speech pathologists when needed.

The Central Florida Hearing and Balance Center communicates all information to your referring physician.