Dr. Wright's Blog

What is a Diagnostic Audiological Evaluation?

A diagnostic audiological evaluation is a series of audiological tests performed by an audiologist to determine the health of your auditory system.

What is audiology? This is an excellent description by the Canadian Academy of Audiology https://canadianaudiology.ca/for-the-public/about-audiology/

In order for us to hear, there are several processes that take place before your brain registers that you have heard a sound. A sound wave will enter the ear canal and reach the eardrum which will vibrate. This vibration will send the ossicles (3 tiny bones in your middle ear) into mechanical motion. The last bone in this chain, called the stapes, will pump on the membrane of the cochlea. The cochlea is filled with fluid and this pumping action will send a transverse wave through the cochlea at a specific frequency. This will stimulate the outer hair cells in the cochlea and translate into a nerve impulse that travels up the auditory nerve to the brainstem and then on to the auditory cortex. It is in the auditory cortex where we “process” and “understand” sound. A complete diagnostic hearing evaluation measures the function of the outer, middle, and inner ear. It also assesses the brain’s ability to process complex sounds, such as speech. In order for audiologists to make recommendations on improving your hearing, we must first know where the problem is and whether there is any requirement for further medical investigation.

A complete diagnostic audiological evaluation involves the following tests. Otoscopy is an examination of the ear canal with an otoscope. It allows us to check for wax or debris in your ear canal and to determine the health of your eardrum. Tympanometry usually comes next and is a measure of the middle ear function. We send air pressure into your ear canal to measure the movement of your eardrum to rule out fluid in the middle ear or a perforation in the eardrum. Air conduction testing involves listening to pure tones at specific frequencies. These are the “beeps” that you are likely familiar with if you have had a hearing screening in the past. These beeps translate into specific speech sounds and helps us determine how clearly you are hearing speech. We will also do some speech testing to determine your brain’s ability to process complex sounds. We also do bone-conduction testing which involves listening to the same pure tone beeps but you will be wearing a headband that directly sends the sound to your cochlea. This will help us determine if your hearing loss is coming from the outer/middle ear or the inner ear. We will sometimes measure acoustic reflexes, which are measurable reflexes to loud sounds to determine the integrity of your auditory nerve function.

An initial diagnostic hearing evaluation should include these tests. However, a particular test may be excluded if it is not necessary or contra-indicated.

When you see one of us for a diagnostic hearing evaluation, we will explain each of these tests as we conduct them. We will also provide a thorough explanation of your results after the test is complete. If there is an audiological red flag in your audiogram we will refer you for further medical investigation and send a complete report to your family physician.

It is recommended that anyone over the age of 60 years old have a baseline audiological evaluation.

If you have any questions about having a diagnostic audiological evaluation, please don’t hesitate to contact us.



The Use of Communication Strategies to Enhance Hearing

Hearing aids will help you hear better than without hearing aids, however certain situations are more challenging than others and there are things that we can do to optimize listening situations. 

For example,

  1. Face the person you are speaking with
  2. Have good lighting
  3. Reduce the amount of background noise; for example, turn off the radio or TV in the background.
  4. Speak clearly, not louder.
  5. Get the person’s attention before you start speaking to them; say their name or tap their shoulder.
  6. Reduce the distance between you and the listener.
  7. Pause between sentences.

Communication breakdowns leave both listener and speaker frustrated. If the speaker is talking to you from another room, turning away while they are speaking, or speaking before asking for your attention the listener might reply with “what? speak up.”  This breakdown in communication interrupts the natural flow of the conversation and often ends in frustration, or the worst response to say to someone with hearing loss: never mind. 

Remember that hearing loss is an invisible disability that already makes social situations stressful and can leave the listener feeling embarrassed or left out of the conversation. 

Be empathic, be kind, have compassion for the one with hearing loss.

The New Oticon Opn Hearing Aid

Lia Best with Tomas Behrens and Kris Hewitt from Oticon

(photo above is Thomas Behrens an Oticon engineer, Lia Best, Audiologist and Kris Hewitt from Oticon)

Broadmead Hearing Clinic's Audiologist Lia Best recently joined more than 400 Audiologists at a professional conference in Toronto that introduced Oticon Opn.  Opn expertly manages multiple speech and noise sources so people don’t have to work as hard to understand speech, even in challenging listening situations like restaurants or social gatherings. 

What Lia learned is that preliminary testing shows that Opn increases speech understanding, the parameter most important to hearing aid wearers, by 30%. People who wear Opn also experience 20% less listening effort when trying to understand speech.

The small, discreet hearing aid is a powerhouse of innovative technology.  Opn is powered by the high speed Velox platform – 50 times faster than previous technology – that scans, analyzes and reacts to sounds in the environments more than 100 times per second.  Opn allows wearers to enjoy an open sound experience where surrounding sounds are available but not intrusive. They can easily follow the sounds they want to hear and quickly shift their attention when desired. 

Opn offers easy wireless connectivity to a variety of smartphones and other iOS and Android devices.  Audio is streamed directly to the hearing aids using Bluetooth technology developed especially for hearing aids that uses significantly less battery power when streaming. 

With the free, downloadable Oticon OPN App, wearers can control volume, program or device selection and other functions with just a tap of their smartphone.

This new hearing aid is available for shipping starting today, June 6, 2016. 

We are very excited about this shift away from traditional directionality and are curious to see if our patients will prefer this approach.  If you are interested in being one of our first to try this new hearing aid please give our office a call and we can arrange a free 3 week trial.

New Phonak Microphone

Great news for people who have trouble hearing in groups.  Phonak has just released a brand new microphone that is meant to be used in dynamic or noisy environments .  

This microphone is called a Roger Table Mic and is set on a table picking up the speech of the people who are nearby.  This piece of assistive technology works alongside hearing aids

The way it works is that the microphone picks up the sound from the microphone (which looks like a box on the table) and transmits it wirelessly into a receiver that is attached to your hearing aid.  This will work with any brand of hearing aid. 

Currently  we have one of our clients using the table top microphone with her Phonak hearing aids for playing bridge. She absolutely loves it as she can hear the bid with so much more ease. 

If you are having trouble hearing in groups, let us know and we can set up a microphone for you to try to see if it works for you.

Phonak Microphone Video


Tinnitus Awareness Week

May 16-20 is National Tinnitus Awareness week. 

A few years ago, our clinic was part of a pilot project testing new equipment to try to sound match tinnitus.  In this study people used iPads to create different sounds together to try to recreate their tinnitus sound.  It was through participating in this exercise that my empathy for those with tinnitus increased a hundred fold.  Some of the sounds that people were creating were like fingernails on a chalkboard combined with a cat's meow.  It was present constantly and the volume they had recreated was surprisingly loud to me.  I had often thought of tinnitus being a high frequency constant pure tone that was for the most part innocuous.  Or that has been the type of tinnitus I had experienced after leaving a loud concert.  The sound that some people manage all day is exhausting.  Tinnitus is exhausting.  Truly.  The cortisol being produced by the body in reaction to the autonomic nervous system's flight or fight response has to be metabolized by the adrenal glands which can lead to fatigue. 

The frustrating thing is how people for years have been told by their doctors just to live with it.  In fact, THERE IS HELP!!!  We have successfully managed tinnitus in about 85% of cases that come into the clinic.  There are products and counseling strategies that we can give patients as tools to learn to habituate the tinnitus. 

If you, or someone you know has tinnitus, the number one most important thing is to know that there is help, and to see an Audiologist to have a proper diagnostic evaluation to determine the cause of the tinnitus.  The cause is critical to the solution.