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Diagnostic Procedures

BY IN Diagnostic Procedures On 11-04-2014

Hearing Tests

Pure-Tone Hearing Test

This test determines the ability to hear sound. The pure-tone test determines the faintest sound that an ear can perceive. Tones of low through high frequencies will be presented at various levels of loudness. Some of these tones will be heard through the ear canal, and others through the bone area behind the ear. The test is performed in a sound proofed room. In many cases, it is necessary to introduce a loud noise into the ear that is not being tested. This distraction, called masking, is necessary to assure that the test tones are heard only in the ear under evaluation.

Speech Intelligibility Test

These tests determine the ability to hear and understand speech. Different samples of speech are presented through earphones or through a loud speaker in a sound proofed room. One series of words is heard at various degrees of loudness, and the second group is heard at a comfortable listening level.

Hearing Aid Consultations

Hearing Aid Evaluation

The hearing aid evaluation service is designed to help the patient determine the hearing instruments of choice for his or her particular hearing loss. The hearing aid evaluation requires 1 to 1 1/2 hours of testing. The purpose of the evaluation is to determine the patient’s potential to benefit from a hearing aid and determine which hearing aid style will best suit the patient’s needs.

At the hearing aid evaluation, an audiologist uses comparative tests with and without hearing aids. The process also includes counseling to help the patient understand hearing aids and the necessary steps for optimal results. The patient then receives an appropriate recommendation (prescription) for hearing aids.

Hearing Aid Check

The purpose of this visit is to evaluate the patient’s adjustment to the aid and to provide guidance and counseling regarding the use of the instrument.

Hearing Aid Measurement

This test measures the function of a hearing aid on a test instrument. It can help the audiologist determine whether the hearing aid is functioning properly.

Balance Tests

These tests are designed to electronically determine the response of the balance center in each inner ear by observing eye movements. It is similar in concept to electronic studies of other organs, such as electrocardiogram of the heart action and electroencephalogram of the brain function.

ENG Test (Electronystagmography)

This test is administered with the patient in a reclining position. Cool and warm water are alternately irrigated into each ear canal. The resulting responses of the balance mechanism, as expressed through the eye movements, are automatically recorded by electrodes, which are taped on the skin of the face.

IR (Infrared) Video ENG

This test is administered with the patient in a sitting position, wearing special goggles to allow the video recording of eye movements. Cold water is alternately placed into each ear canal to stimulate the balance mechanism. Eye movements are observed on the TV monitor.

X-Ray Studies

Computerized Cranial Tomography

This technique (called CCT or CAT scan) utilizes a computer to analyze the absorption of small quantities of x-ray by the brain. X-rays are best used to view bone. The result is a photograph of the contents of the skull showing any major abnormalities. The first part of the test involves stabilizing the head while the x-ray beam scans the skull. There is no pain or other sensation during the scanning. A second picture is then made while an iodine-containing dye is run into an arm vein. Abnormalities within the skull will appear different than the normal brain tissue.

Small abnormalities, particularly within the inner ear, may not be detected on these scans. In that case, a small quantity of air is inserted into the lower part of the back (spinal tap) and the patient is positioned so that the air rises to the area of the inner ear. If the inner ear is normal, the air will enter the inner ear canal. Even a small tumor will prevent filling of the inner ear canal and be seen by this technique. In rare cases, the air will not fill the canal, but yet the diagnosis of a tumor is in doubt. In this case, a small quantity of iodine-containing dye is inserted into the back and x-rays are taken at a later time to exclude the possibility of a small tumor.

Magnetic Resonance Imaging

This technique (MRI) utilizes a computer to analyze the magnetic field in the skull created when one lies within a magnet. The result is a photograph of the contents of the skull showing any abnormalities. During the test, the patient lies quietly within a large tube containing a magnet. There is no pain or other sensation during the procedure. There is no exposure to x-rays during the test. At times, a material is injected into an arm vein to enhance the MRI image. MRI is used best to view soft tissue (brain). It cannot be used in patients who are using a cochlear implant.

Cranial Nerve Tests

The hearing and balance nerve are closely associated with other nerves within the brain. Disorders of one may affect the other. In order to establish a diagnosis, it is sometimes necessary to have a complete neurological examination. It may be necessary to determine the response of the tearing mechanism of the eye. This test may give additional information regarding the site of nerve disorders within the temporal bone.

Nerve Excitability Test

This test is designed to compare the response of the facial muscles to electrical stimulation. Each facial nerve is stimulated with small electrical currents. The degree of muscle movement on the right and left is compared.


This is a computerized test of facial muscle movement in response to electrical stimulation of the facial nerve. Recording electrodes are applied to the face to detect the muscle contractions which are then recorded by the computer.

Visual Brain Responses

This computerized test (VBR) records brain responses to light flashes. These flashes stimulate the eye while electrodes taped to the scalp detect the responses, which are analyzed by computer. This test is useful in the diagnosis of certain neurotologic disorders.

Metabolic and Allergy Tests

Thyroid Profile Test

This blood test is performed to determine the functions of the thyroid gland. Decreased function may result in inner ear problems.

Glucose Tolerance Test

This test evaluates the body’s ability to utilize blood sugar. The inability to metabolize sugar in a normal manner may result in hearing or balance problems. After fasting for 12 hours, the initial blood specimen is taken to determine the sugar content. Sugar solution is then ingested, and further specimens are drawn over a period of five hours.

Immune Profile Test

This blood test determines if the protective mechanism of the body (the immune system) is functioning properly. There are several ear problems which appear to be related to immune abnormalities (autoimmune diseases).

Allergy Skin Tests

Skin tests are performed to determine sensitivities to inhalants (pollen, dust, mold) and foods. Diagnosis is based on the degree of response following injection into the outer skin layers. When positive reactions occur to allergy tests, treatment such as allergy shots or medications may be prescribed to control any allergy symptoms.

RAST Test (Radioallergosorbent Test)

The RAST blood test measures antibodies (blood proteins) to specific allergens. It may be used to determine sensitivities to inhalants and some foods.

Food Challenge Test

This test is designed to determine whether certain foods cause symptoms. Foods to be tested are eaten, or may be ingested in purified form. The patient is observed to see if allergic symptoms develop.

Histamine Titration Test

Histamine is a substance that is used to test certain types of hearing and balance disorders. This test determines the strength of solution to be used in treating an individual. Several injections are placed in the outer layer of the skin. The degree of reaction indicates the strength of solution to be used.


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