Hearing Test, Here's What You Should Know

A hearing test is a procedure to check a person's hearing ability. The test is done by measuring how well sound waves are transmitted to the brain.

Hearing occurs when sound waves enter the ear and cause the eardrum to vibrate. These vibrations then transmit sound waves to nerve cells that send information signals to the brain. In the brain, this information is translated into the sounds we hear.

Hearing loss occurs when there is damage to the part of the ear, the nerves in the ear, or to the part of the brain that controls hearing. The following are some types of hearing loss:

conductive hearing loss
Hearing loss occurs when sound waves cannot enter the ear. Conductive hearing loss is generally mild and only temporary.
Sensorineural hearing loss
This condition occurs when there is a problem with the organs in the ear or the nerves that control hearing. The severity of sensorineural hearing loss can range from mild to complete deafness.
Mixed hearing loss
Mixed hearing loss is a condition when conductive hearing loss co-occurs with sensorineural hearing loss.

Hearing Test Indications

The doctor will suggest that a hearing test be performed on someone who has the following symptoms or signs:

Feeling a ringing in the ears (tinnitus)
Talk too loudly to disturb the other person
Often asks the other person to repeat his words
Difficult to hear conversations
Watching television so loud that it disturbs others

Hearing Test Alert

There are several things to know before undergoing a hearing test, namely:

Tell your doctor if you have a cold or an ear infection. This is because these two conditions can affect test results.
Tell your doctor if you are taking any medications, supplements, or herbal products. The use of certain drugs or supplements is feared to affect the results of the examination.

Before Hearing Test

In pediatric patients who are about to undergo the BERA test, the doctor will give a sedative before starting the test. The goal is for the child to be calm when the electrodes are attached.

Some hearing tests are performed wearing a headphones. The doctor will ask the patient to remove glasses, earrings, hair accessories, and hearing aids so as not to interfere with the test.

The doctor will also examine the inside of the ear and remove earwax if there is any.

Hearing Test Procedure

There are several types of hearing tests that can be done to detect hearing loss. Talk to your ENT doctor about which test is right for you.

The following are types of hearing tests:

1. Test bphysical

In the whisper test, the doctor will ask the patient to cover the ear opening that is not being examined with a finger. After that, the doctor will whisper a word or a combination of letters and numbers, then ask the patient to repeat what was whispered.

When whispering to the patient, the doctor will be less than 1 meter behind the patient to prevent the patient from lip reading. If the patient cannot repeat the word being whispered, the doctor will use a different combination of letters and numbers or whisper the word louder until the patient can hear it.

After the test on one ear is complete, the test will be repeated on the other ear. Patients are considered to have passed the whisper test if they are able to repeat 50% of the words spoken by the doctor.

2. Test garpu tala

In this test, the doctor uses a tuning fork with a frequency of 256–512Hz to determine the patient's response to sounds and vibrations near both ears. The tuning fork test was performed on the Weber test and the Rinne test.

In the Weber test, the doctor will bang a tuning fork and place it in the center of the patient's forehead. While in the Rinne test, the doctor will bang the tuning fork, then place it on the back and side of the patient's ear.

The patient will be asked to explain whether the sound is heard clearly in both ears or in only one ear. The patient will also be asked to give a signal if he does not hear any sound.

3. Test aaudiometry tspeak

Speech audiometry test aims to determine how loud the sound must be heard so that the patient can hear it. This test also aims to determine whether the patient can understand and distinguish the various words spoken by the doctor.

In this test, the patient will be asked to wear a headphones. After that, the doctor will sound the words through headphones in varying volumes and ask the patient to repeat the words that are heard.

4. Test aaudiometry nthere is murni

In this test, the doctor uses an audiometer, which is a device that produces pure tones. This tool is heard to the patient through the headphones in notes where the frequency and intensity of the sound varies from 250Hz to 8,000Hz.

This test begins with the intensity of the sound that is still audible, then gradually decreases until it is no longer audible to the patient. Next, the sound intensity will be increased again until the patient can hear it. The patient will be asked to give a sign if he can still hear the sound.

5. Brainstem auditory evoked response (BAER)

In the BAER test or also called brain stem evoke response aaudiometry (BERA), the doctor will attach electrodes to the patient's crown and earlobe. After that, the doctor will make a clicking sound or a certain tone through the earphones and the machine will record the patient's brain response to the sound.

The test results will show increased brain activity every time the patient hears a sound made by the machine. If the test results do not show increased brain activity when the sound is heard, the patient may be deaf. Abnormal test results can also mean there is a problem with the patient's brain or nervous system.

6. Otoacoustic emissions (OAE)

Test otoacoustic emissions (OAE) is used to check for disorders of the inner ear, specifically the cochlea (cochlear). This test is generally performed on newborns, but can also be performed on adults.

In this test, a small tool equipped earphones and the microphone is placed in the patient's ear canal. Then, the doctor will transmit sound to the patient's ear through the earphones and the microphone will detect a response in the cochlea.

The response produced by the cochlea will be displayed on the monitor screen, so that the patient does not need to give any signal when he hears a sound. The doctor will assess what sound is producing the response and how strong the response is.

Through the OAE test, doctors can determine the type of hearing loss experienced by the patient. OAE can also detect blockages in the outer and middle ear.

7. Acoustic reflex measures

Acoustic reflex measures (ARM) or middle ear muscle reflex (MEMR) aims to determine the ear's response to loud sounds. In normal hearing, the small muscles in the ear tighten when you hear a loud sound.

In the ARM test, the patient's ear canal is attached to a small rubber band that is connected to a recording machine. After that, a loud sound will be heard through the rubber and the machine will record the response from the patient's ear.

If the patient's hearing is poor, it takes loud noises to trigger an ear response. In fact, in severe conditions, the ear does not respond at all.

8. Tympanometry

Before starting the test, the doctor will examine the patient's ear canal to make sure there is no wax or other obstructions. After making sure the ear canal is clean, the doctor will install a small instrument such as a earphones in each patient's ear.

Once attached, the device will blow air at varying pressures into the ear to make the eardrum move. The movement of the eardrum is then displayed on a graph on a special device called a tympanogram.

The graph on the tympanogram will show whether the patient's eardrum is moving normally, too stiff, or moving too much. Through a tympanogram, the doctor can also find out if there is a tear in the patient's eardrum or fluid in the middle ear.

During the test, the patient is not allowed to speak, move, or make swallowing movements because it will affect the test results.

The patient's hearing was assessed as having no problems if the air pressure in the middle ear ranged from +50 to -150 decapascal, there was no fluid in the middle ear, and the movement of the eardrum was normal.

Meanwhile, abnormal results may indicate the presence of:

Fluid or tumor in the middle ear
Dirt covering the eardrum
Hole or wound in the eardrum

Tympanometry is only done to examine the middle ear. The doctor will advise the patient to undergo other tests if the tympanometry test shows abnormal results.

After Hearing Test

The doctor will discuss the test results with the patient. If the test results are abnormal, the doctor may advise the patient to use a hearing aid or ear protection if he is in a noisy place.

The severity of hearing loss is measured in decibels (dB). Patients who have had a hearing test can get the following results:

Mild hearing loss (21–45 dB)
Patients with mild hearing loss have difficulty distinguishing words spoken in low voices.
Moderate hearing loss (46–60 dB)
Hearing-impaired patients have difficulty hearing what is being said, especially if there are loud sounds around them, such as sound from the television or radio.
Moderate to severe hearing loss (61–90 dB)
Patients with moderate to severe hearing loss have difficulty hearing ordinary conversation.
Severe hearing loss (91 dB)
The patient has difficulty hearing almost all sounds. Usually, patients with severe hearing loss require hearing aids.