Audiology at GBMC

What are some of the signs and symptoms of hearing loss?

• Asking people to repeat themselves
• Difficulty hearing in background noise or group situations
• Feeling like people are mumbling
• Hearing ringing or other noises in one or both of your ears
• Difficulty hearing over the phone or when watching TV
• Having difficulty hearing women and children
• Avoiding social situations

Who is a candidate for a hearing aid? 
Audiologic test results are used to determine the type, degree and configuration of the patient's hearing loss and this information will help determine hearing aid candidacy. Motivational factors are also important in determining whether a patient is a candidate for a hearing aid. It is important to discuss the impact of the hearing loss on everyday life, as well as the patient's perceived need for amplification. A highly motivated patient is more likely to receive benefit from hearing aid(s). 

Should I wear one or two hearing aids? 
Whenever hearing levels are the same between ears, we will always recommend that the patient wear two hearing aids. There is a substantial amount of research, which suggests that the brain is meant to hear in a "balanced" fashion with equal input from both ears. Occasionally, there are cases of asymmetric hearing levels (hearing levels which are different between ears) in which we might not recommend two hearing aids. 

What can I expect initially from my hearing aid? 
Using a hearing aid with success takes patience, as hearing aids will not restore your hearing back to normal. Becoming adjusted to a hearing aid is a process involving learning to listen in varied listening environments while becoming accustomed to hearing different sounds. Wearing your hearing aid on a regular and consistent basis will help through the adjustment period. Eventually, you should feel like your hearing aid has become a part of you. 

Can hearing aids make my hearing worse? 
When programmed appropriately, hearing aids will not make your hearing worse with normal use. They are usually programmed to provide more amplification of soft level sounds than loud level sounds. They also have a set maximum output level so that sounds leaving the hearing aids do not exceed a certain loudness level. However, you are still responsible for protecting your ears in extremely noisy situations (e.g., music concerts, heavy machinery, hunting). 

Sedated Auditory Brainstem Response Evaluations (Pediatric)

What is an ABR? 
ABR or Auditory Brainstem Response audiometry is an objective method to test the function of the auditory nerve and determine degree of hearing loss for infants and young children. Children are usually referred for this test when other behavioral audiologic testing either has been unsuccessful or findings cannot conclusively rule out a hearing loss. 

How is it done? 
An audiologist conducts the testing. Four electrodes are placed on your child's forehead and behind each ear. An insert eartip directs sound to your child's ear and a computer will receive the auditory data. 

Why is sedation used and how is it managed? 
Chloral hydrate given orally is the sedation medication utilized to create a condition suitable for testing. To obtain reliable results, the patient must lie quietly and without movement. For this reason it is necessary to sedate infants and young children. Our ENT Clinic nurse will administer the sedation and monitor your child's heart and respiratory status throughout testing. A physician is also onsite during testing. The length of visit you can expect ranges from 4-5 hours and includes prep and recovery time. *Please be aware that this sedation may not be effective for your child i.e., does not induce sleep or sleep time is too short to obtain all necessary information. 

What happens after the test? 
The nurse will assess your child after testing. It is normal for your child to be a little sleepy or irritable for a few hours after sedation. Care should be taken to avoid falls as coordination may be affected. You are advised to contact the appropriate medical personnel i.e., your pediatrician or 911 if there are any problems after leaving the department. 

Videonystagmography (VNG)

What is VNG? 
VNG or videonystagmography incorporates a battery of tests to determine if a vestibular (inner ear) disease may be causing a balance or dizziness problem. It is one of the only tests available today that can decipher between a unilateral (one ear) and bilateral (both ears) vestibular loss. 

What should I expect during testing? 
An audiologist conducts the testing. The patient wears a pair of goggles over his/her eyes that will record eye movements. Testing is compromised of three parts: ocular-motor tasks, positioning and positional tests, and bithermal irrigation. Ocular-motor tests require that the patient either look at or follow a visual stimulus. Positioning tests require the patient to lie down from a sitting position such that the head is turned to the side and slightly hanging from the bed. The patient will need to inform the audiologist of any head, neck, or back injuries prior to testing so that appropriate modifications can be made. Positional tests require the patient maintain different head positions while in supine (lying) position. Bithermal caloric irrigation induces dizziness by warming or cooling fluids in the inner ear structure, one ear at a time. For most patients, the dizziness lasts only a couple minutes; however, if you are anxious about the test, please have a family member of friend drive you to and from our facility. 

What do I need to stop taking certain medications 48 hours before the test? 
Certain medications suppress responses from the inner ears or the brain and can affect the test results with false positive findings. Unless instructed otherwise by your physician, please be sure to discontinue medications taken for dizziness, nausea, seizure, sleep, congestion, depression, or pain, as well as, amphetamines, narcotics, caffeine, and alcohol.