At your initial visit, our hearing professionals will conduct a complete case history, including a detailed medical and hearing loss history as it pertains to your hearing difficulties. We will also assess your lifestyle needs and the particular issues and situations where you find hearing most challenging.
At your initial visit, our staff will do a thorough ear examination including the outer ear, ear canal, eardrum and middle ear space to ensure there is no underlying cause that warrants medical attention. After that, you will have a rigorous hearing evaluation which includes a complete diagnostic hearing test with both masked and unmasked air and bone pure tones throughout the frequency range of 250hz to 8000hz.
Speech discrimination testing, acoustic reflex testing, and tympanometry will also be performed. Other advanced specialty testing may also be performed as dictated by your test results and your underlying hearing complaints.
These series of tests are conducted to assess:
All patients with hearing or balance problems will need certain tests performed as part of their diagnostic work up. Occasionally, these tests may need to be repeated, even if you have recently had them performed elsewhere. It is very important to determine the current status of your hearing and balance systems. This will help us determine whether previous testing was accurate or if you have had any changes in the status of your hearing and balance systems.Comprehensive Audiological Assessment
This consists of both pure tone and speech perception hearing tests, tympanometry and acoustic reflex testing. The testing occurs in a sound treated room using headphones or inserts that fit in the ear canal. During pure tone testing, a series of tones of differing frequency are presented to the patient at varying intensity levels (loudness) to determine the patients hearing level, the amount of hearing loss, and the type of hearing loss present at the different frequencies. A series of word lists are then used to both determine the lowest level at which a patient can hear the word (speech reception threshold) and their ability to correctly discriminate what words are being presented (speech discrimination score).
Tympanometry and acoustic reflex testing is used to determine the status of the eardrum, middle ear, reflexes of the auditory muscles, and associated auditory nerve pathways. A probe is placed in the ear for these tests. Tympanometry uses changes in pressure within the ear canal to determine the mobility of the eardrum, the bones of hearing (disrupted or frozen), and the status of the middle ear (if it contains fluid). It also gives a determination of the volume in the ear canal, which further allows us to assess whether the eardrum is intact.
Acoustic reflexes are tests using loud noises presented to the ear to determine minute changes in the mobility of the eardrum. This is an indirect measure of the function of auditory muscles and the neural pathways that control them. Acoustic reflex decay is also measured which assesses whether the reflex can be maintained for at least 10 seconds. The absence of reflexes or the presence of reflex decay can be a significant finding for tumors of the hearing or balance nerve and may necessitate further diagnostic testing.
Certain cells located in the organ of hearing (the cochlea) are involved in the conversion of sound vibrations into electrical signals, which are then transferred to the brain for interpretation. These cells are known as hair cells and are of the utmost importance in hearing. The otoacoustic emissions test is used to assess the function of these cells. A set of high frequency sounds are introduced into the ear after which the ear will emit minute sounds (emissions) in response to this stimulation which can then be measured by a computer. The presence of OAEs means that the hair cells are healthy and functioning normally. This test helps to determine the site of hearing loss and can also be used to identify hearing loss before it is manifested on a Comprehensive Audiological Assessment.
This test measures electrical potentials within the inner ear. This is thought to be related to fluid pressures within the inner ear. A ratio of these potentials is calculated. A large ratio may indicate an increase pressure in the inner ear, which can be associated with a particular ear condition known as Meniere’s disease. This test is often done in conjunction with the ABR test (see below) as it is generally ordered to evaluate similar ear symptoms and requires the same electrode setup.
This test is used to evaluate the electrical pathway between the inner ear and the brainstem. A clicking sound is presented to one ear at a time. The electrical response to this sound stimulus is then recorded by the electrodes and averaged by a computer. A waveform will be produced that contains peaks corresponding to certain points in the central auditory pathway. The time for the electrical signal to progress between these peaks is then calculated by the computer and compared to well known normative data. Delays in response time can be important indicators of numerous disease processes that can affect the auditory pathway including tumors (acoustic neuroma), demyelinating diseases (multiple sclerosis), and vascular ischemic areas (strokes).
This powerful testing modality can be used to obtain auditory threshold testing at certain frequencies in patients unable or unwilling to perform conventional hearing tests. It can also be used to evaluate hearing in newborns and infants who are at high risk for hearing loss. This modality is occasionally used during acoustic tumor surgery to monitor hearing intraoperatively during tumor removal in an attempt to preserve hearing.
This is actually a battery of tests designed to evaluate the balance system. The balance system of the inner ear and eye movements are highly coordinated through central brain connections. These tests use electrodes or video goggles to record eye movements during this series of tests. Voluntary eye movements are recorded while following a light target on a wall. Involuntary eye movements are recorded in various body positions and during movement of the head to various positions. Involuntary movements are also recorded during thermal stimulation of the inner ear balance system with hot or cold air. If stimulation is successful you may feel a brief spinning sensation, which is normal. This will also induce certain eye movements, which again are recorded and interpreted. A reduced or absent response indicates dysfunction within the inner ear balance system.
After your evaluation, the next step in the process is to find a hearing aid that is right for you. We will match your lifestyle, listening needs, and hearing concerns with the right hearing technology. Today's hearing aids are much different than hearing aids of the past, and there are many different types of systems available.
Your audiologist will recommend hearing aid features based on your listening goals and your hearing test (audiogram). Our patients are able to experience live demonstrations at their visit to illustrate the benefits of utilizing hearing devices. We work with several excellent hearing device manufacturers, each with a comprehensive product line.
Hearing aids vary in retail price. Our goal is to find a device with features you need and desire, in a design you will enjoy wearing, and at a price you can afford.
Your hearing should be protected. Once lost, it cannot be regained. One way that noise can permanently damage your hearing is by a single brief exposure to a high noise level, such as a firecracker going off near your ear. However, hearing damage can also occur gradually at much lower levels of noise if there is enough exposure over time. To protect your hearing, you'll want to limit your exposure to these moderately high noise levels and give your ears a chance to recover after any period of noise exposure.
Common noise levels (dB), and their effect upon hearing:
|Instantaneous permanent damage||140+||Shotgun, rifle, jetplane takeoff|
|Less than one second||130||Jackhammer, heavy industry|
|Less then ten seconds
Threshold of pain
|1.5 minutes||110||Power tools|
|15 minutes||100||Chainsaw, motorcylce|
|2.5 hours||90||Lawn mower|
|8 hours||85||Beginning of Danger Zone|
|70||Vacuum cleaner, hair dryer|
|60||Office, sewing machine|
|0||Threshold of normal hearing|
Prolonged exposure to noise levels 85dB and higher can result in permanent hearing loss.
We are proud to offer customized hearing protection, including:
Whether you’re a hunter in the woods or on the range or an avid motorsports fan we offer a variety of products to meet your personal needs. Contact us today to schedule your appointment.
Good hearing care goes beyond simply finding the best hearing technology; we take our services a step beyond and offer ongoing therapeutic programs such as the following:L.A.C.E® Auditory Training Program
L.A.C.E.® Auditory Training programs retrain the brain to comprehend speech up to 40% better in difficult listening situations. The L.A.C.E. Program will help you develop skills and strategies to deal with situations when hearing is challenging.
A hearing loss support group can take a variety of forms, including group meetings, or internet forums. Support groups offer friendship, education and networking opportunities for people living with hearing loss. Support groups offer emotional support, coping skills and an open forum to share both positive and negative experiences pertaining to hearing loss. Many members who are wearing hearing aids for the first time enjoy interacting with other hearing aid wearers. Family members can also exchange ways to support their loved ones who have hearing loss. And, some support groups offer lip reading lessons and other strategies for living with hearing loss.
To find a local hearing loss support group, ask us, or search the internet for a group in your area. Check out the state chapters available from the Hearing Loss Association of America and The Alexander Graham Bell Association for the Deaf and Hard of Hearing.
We also provide therapy programs for tinnitus (ringing in the ears).
2180 Immokalee Rd. #101
Naples, FL 34110
9250 Corkscrew Rd. #3
Estero, FL 33928
6101 Pine Ridge Rd.
Naples, FL 34119