Audiologic Evaluation in ENT

Case History

 * 1) Please confirm your name and date of birth.
 * 2) What brings you in to the clinic today?
 * 3) Do you have any pain in your ears right now?
 * 4) Have you fallen down, felt faint, or felt an unusual spinning sensation in the last three months?
 * 5) Do you have any ringing in your ears?
 * 6) Do you hear better in one ear over the other ear?
 * 7) Have you noticed a sudden change in your hearing?
 * 8) Does your hearing seem to fluctuate over time?

Otoscopy
See Otoscopy. “Has the medical doctor already looked in your ears today?”

Tympanometry
See Tympanometry. “For this test, you are going to feel some pressure in your ears. You don’t have to do anything. Please sit still and stay quiet.”

Hearing Test
“There are two parts to a hearing test. First I am going to have you repeat some words. Then I will have you press this button whenever you hear or think you hear a beep.“

Speech Reception Testing
“You will hear a recorded man’s voice say some words. Repeat the words that you hear. Take a guess if you are not sure.”

Word Recognition Testing
Find a comfortable level and present words at 40 dB HL Sensation Level above SRT (retesting at higher intensities may become necessary to obtain PBMax, the patient's highest achievable score). “Again, you will hear a recorded man’s voice say some words. Repeat the words that you hear. If you are masking, make sure to tell the patient that they will hear a windy noise in the opposite ear.”

Pure Tone Audiometry
“You will hear a set of beeps. I want you to press the button every time you hear or you think you hear a beep.”

Bone Conduction
Place bone conductor behind the ear with poorer thresholds at 250 through 4000 Hz. “I am going to put this headset on you. I want you to continue pressing the button when you hear a beep even if it is really soft. If you hear a windy noise in your ear, ignore it and press the button when you hear a beep."

Acoustic Reflexes (As Needed)
See Acoustic Reflexes.

"You are going to hear some loud sounds.  Please sit quietly while I run the test.  The machine will do all of the work.  Do you have any questions?"

Place the ipsi and contra probes. Obtain reflex thresholds at 500, 1000 and 2000 Hz. Threshold is the lowest level that elicits a reponse of appropriate shape of 0.03 ml or greater amplitude.

Conduct acoustic reflex decay testing at 10 dB greater than the acoustic reflex threshold at 500 and 1000 Hz.

The presence of acoustic reflex decay is not abnormal at 2000 and 4000 Hz.

OAES (As Needed)
See Otoacoustic Emissions.