At Atlantic Ear, Nose & Throat, an audiometric evaluation is administered and interpreted by an audiologist instead of a hearing aid dispenser. An important distinction to understand when treating hearing loss is the difference between Audiologists and hearing aid dispensers. Doctors of Audiology are trained to treat, diagnose, and monitor disorders of the hearing and balance system. They are trained in anatomy and physiology, amplification devices, cochlear Implants, electrophysiology, acoustics, psychophysics and auditory rehabilitation. An audiologist receives a doctoral degree, must pass a national examination, and have more than 1000 hours of clinical training. Hearing aid dispensers are trained in hearing testing and hearing aid fittings only, mainly for the sale of hearing aids. They must also pass an examination. Prior to taking the exam, certain requirements must be met, which vary from state-to-state. In many states, hearing aid dispensers are only required to have a high school diploma and 6 months of training.
Audiologists administer sophisticated tests that assess the nature and characteristics of a patient’s unique hearing loss. Unlike dispensers, Audiologists can interpret these tests properly, prescribe specific devices, and continue to be a resource for patients as their hearing evolves. When testing is performed elsewhere, we have often experienced that critical information is missing such as tympanometry, otoacoustic emission tests and acoustic reflex threshold testing. This testing comprehensively reveals the function of the ear to ensure the “whole picture” is understood prior to fitting the patient with a hearing aid.
- Along with a physical exam, tympanometry provides a way for doctors to monitor problems in the middle ear. Tympanometry measures the movement of the tympanic membrane (or ear drum) in response to changes in pressure. Abnormal results may reveal fluid or infection in the middle ear, a perforation or scarring in the tympanic membrane, middle ear pressure beyond the normal range, a tumor in the middle ear, earwax blocking the ear drum and a lack of contact between the conduction bones of the middle ear.
- The cochlea is the part of the inner ear involved in hearing. The cochlea does not just receive sound; it also produces low-intensity sounds called Otoacoustic emission tests can be used to partially estimate hearing sensitivity within a limited range, differentiate between the sensory and neural components of a sensorineural hearing loss, diagnose auditory neuropathy as well as test for a feigned hearing loss.
- An acoustic reflex threshold test for hearing loss is helpful in diagnosing problems beyond the inner ear, in the pathways leading to the brain. The purpose of the test is to see if the ear’s natural reflex to lower the volume of very loud sound is working properly. The test is conducted like tympanometry, but in addition to using the pressurized probe, the audiologist delivers a sound of about 80 dB to see if the muscles in the middle ear contract to decrease the volume sent to the middle ear. The audiologist keeps increasing or decreasing the volume to find the decibel level at which this reflex occurs. It normally occurs at 65 to 95 dB. A reflex that starts at a higher decibel level or doesn’t occur at all suggests that hearing loss may be at least partially the result of a neurological problem.
The best possible situation available for patients is to use an audiologist associated with an ENT. When the patient has a hearing evaluation, if there is an underlying medical condition (such as a perforated eardrum, otitis media, an asymmetrical hearing loss, etc.), our Johns Hopkins trained board-certified Otolaryngologists promptly work with one of our doctors of audiology to treat the patient’s condition. The ENT and audiologist work as a team for optimal results. Once the medical conditions are treated, if hearing aids would benefit the patient, the recommendation is then provided by the patient’s ENT doctor, not by a hearing aid dispenser with high pressure sales tactics.
If issues arise when a patient is wearing hearing aids (such as impacted ear wax), our doctors are close at hand to treat the situation. The patient does not have to travel to multiple locations for treatment. The hearing loss and medical conditions can be treated at one location and typically during one office visit by a team of dedicated professionals who have one goal in mind: meeting the individual needs of the patient. The patient would have to wait for medical clearance from an Otolaryngologist before returning to the hearing aid dispenser to purchase hearing aids.
At Atlantic Ear, Nose & Throat, the function of the ear is assessed using state-of-the-art equipment to evaluate the type and severity of hearing loss. Our Audiologists have extensive knowledge in the pathophysiology of the ear and how it relates to hearing aid fittings, making it easier to perform adjustments to the programming of the hearing aids based on patient issues. For the benefit of our patients, appointments with our providers, hearing tests and associated treatment are offered in Spanish and at 3 convenient locations; Lake Mary, Orange City, and DeLand.Leave a reply