Hearing Tests
What can I expect from my hearing test?
Your audiologist will establish your reason for visit, take a full case history, including your medical history and needs.
What tests will be done?
Otoscopic Examination:
• The Otoscopic Examination is done by looking into the ear with a light to inspect the outer ear canal and eardrum.
Pure Tone Audiometry:
• Pure Tone Testing Audiometry is the key test in establishing the patient’s hearing levels.
Different tones are presented to the ear after which it will be required of the patient to press a button to indicate that the tone was heard.
Both Air Conduction Testing and Bone Conduction Testing must be done to establish the type and degree of hearing loss.
Acoustic Reflex Testing:
• Acoustic reflex measurements are done to measure the involuntary muscle contraction that occurs in the middle ear in response to loud sounds.
Tympanometry Testing:
• Tympanometry is a test done by inserting a small probe into the outer part of the ear canal, a slight pressure is built up in the ear and measurements are done in the form of a tympanogram.
Tympanograms provide valuable information regarding the functioning of the middle ear and can indicate perforations of the eardrum, abnormal pressure, fluid build-up in the middle ear and increased or decreased mobility of the eardrum and middle ear structures
Speech Audiometry:
• Lists of words are presented to the patient. It is expected of the patient to repeat the words heard to the audiologist. This test provides the audiologist with important information regarding the functioning of the auditory nerve, which is responsible for the message traveling from the hearing organ to the brain.
Hearing Aids
In the case that you have been diagnosed with a hearing loss that cannot be treated medically, it is recommended that you are fitted with hearing aids. Should you want the option, the hearing aid options will be discussed with you thoroughly and after you have discussed and considered the different options and an informed decision was made, your hearing aids will be ordered and fitted when it has been delivered.
We recommend that you come back for a follow-up session after you have been fitted with hearing aids. We would like to find out about your feedback on your experience of the hearing aids and to establish whether you need any adjustments made to your hearing aids.
Paediatric hearing tests
Pediatric hearing tests are in essence similar to the standard test battery for adults, with a few adaptations to incorporate smaller children.
We also have a look at the structural functioning of the 3 parts of the ear, as with adults. The main difference and adaptations come in at the functional part of the assessment. Visual Reinforcement Audiometry (VRA) and Play Audiometry are some examples of these adaptations and include the building of blocks, listening to birds, airplanes, mice, flying an airplane and many more versions of the same games.
We know that visiting any doctor can be intimidating for the little ones, and this is why we strive to create a comfortable environment for them to ensure their experience is as enjoyable as possible.
Neonatal hearing screenings
Early hearing detection and intervention programs have become the standard of hearing care in the first days after birth to ensure early identification of hearing loss and optimal outcomes for infants with hearing loss.
The prevalence of hearing loss in infants in the private sector is around 3 per 1000 births.
It is crucial that your baby’s hearing is screened as soon as possible after birth. These screening tests are available at most hospitals and are conducted as soon as 24 hours after birth.
Also important to note is that it is not routinely included in the assessments after birth and that parents should request it – or have it done as soon as discharged from the hospital.
The test is a very quick and painless procedure, during this test a small soft probe is put into the ear canal of the infant and soft sounds are presented, and the hearing organs' responses are measured and recorded.
This test is best done in a quiet environment and babies can sleep during this procedure.
Swim & Sleep plugs
Sleep Plugs
Many people struggle to have a good night’s rest.
Reasons might include being a light sleeper, sleeping next to a snoring partner or pet, having noisy neighbours or living close to a busy street. Whatever the reason, being sleep deprived can have a negative impact on one’s mental and physical well-being.
A possible solution to this might be custom made sleep plugs. These Sleep plugs are made by taking impressions of the ears and manufactured, to lower or block the sound coming in, resulting in a good night’s rest.
Swim Plugs
Swim Plugs are recommended for individuals who:
Are prone to swimmers ear and/or general ear infections
Have/had grommets inserted
Have perforated ear drum/s
Enjoy water sports or swimming frequently
Custom made Swim Plugs are made by taking impressions of the ears, to prevent a flow of water entering the ear. These swim plugs are comfortable and durable with proper care and cleaning.
Hearing protection
Understanding Noise-Induced Hearing Loss
Sound | Intensity (dB) |
Lawnmower | 88-94 |
Heavy traffic, Noisy restaurant | 85-90 |
Tractor, Air compressor | 90-95 |
Vacuum cleaner | 60-85 |
Hairdryer | 80-95 |
Handsaw | 85 |
Truck, Shouted conversation | 90 |
Electric drill | 95 |
Motorcycle | 95-110 |
Disco, Night club | 110 |
Car hooter, baby crying | 110 |
Hammer hitting nail | 120 |
Ambulance siren | 120 |
Percussion section at symphony concert | 130 |
Jet airplane taking off | 140 |
Balloon popping | 157 |
Handgun | 166 |
Woodworking | 100 |
Busy video-games arcade | 110 |
Rock concert | 110-120 |
Rugby game (stadium) | 117 |
Jackhammer | 130 |
Airplane taking off | 140 |
Firecracker | 150 |
Rifle shot | 163 |
Shotgun | 170 |
OSHA Permissible Daily Noise Exposure
Duration in hours | Sound Level in dBA |
8 | 85 |
4 | 88 |
2 | 91 |
1 | 94 |
30 min | 97 |
15 min | 100 |
Noise exposure of 85db and above can cause a progressive, irreversible inner ear hearing loss.
Three Types of Noise Induced Hearing Loss
Temporary Threshold Shift
Initial temporary elevation in hearing thresholds after exposure recovers gradually.
Permanent Threshold Shift
Accumulation of noise exposure, repeatedly on a daily basis over a period. Gradually, a person usually unaware of changes in hearing
Acoustic trauma
A single exposure or relatively few exposures to very high levels of sound e.g. explosions. The effects on the ear might be temporary e.g. if it caused the eardrums to rupture, or permanent when the delicate structures of the inner ear are damaged.
Individuals in the following situations should take special care:
Hunters
Musicians
Recreational shooters
Law enforcement officers
Labourers of industries/mines
Motorcyclists
Compensation Claims
The worker must be exposed to the noise of 85 dB or more at work or have been injured at work. The hearing must have deteriorated by more than 10 % from the baseline. The following documents need to be submitted:
- An employer’s report on the occupational disease/ injury and a service record
- 2 consistent audiograms
- The audiologist should verify the worker’s identity and countersign a copy of the ID document
- The occupational medical practitioner should do a medical report if the percentage of hearing loss is less than 30 %. An ENT report is required if the hearing loss is more than 30 %. The medical report should clearly state whether the hearing loss is occupational or not. The medical and occupational history need to be taken into consideration.
- The 2 baseline tests
Industrial hearing tests
Hearing loss incurred in the workplace is a compensable disease in terms of Schedule 3 of the Compensation for Occupational Injuries and Disease Act (COID act). If workers are exposed to sound levels greater than 85dB, hearing loss can develop.
Baseline Hearing Tests
Instruction 171 requires that baseline hearing tests are conducted on all workers after a noise-free period, within 30 days of employment
Periodic Hearing Screening
According to the Mine Health and Safety act (MHSA) and the Occupational Health and Safety Act (OHSA) the employer should follow a program of medical surveillance. The audiological surveillance is done with screening hearing tests. The objective of screening tests is to monitor the hearing status of the individual and to identify auditory damage. Workers exposed to noise levels of 85 dB and more should be tested annually and workers exposed to >105 dB 6 monthly. Workers with a hearing loss that has deteriorated by 10 % from the baseline should be referred for a diagnostic test
Occupational Diagnostic Hearing Tests
Diagnostic tests are performed by an Audiologist registered by the HPCSA. The workers must be noise free for 24 hrs. Two diagnostic tests need to be performed if the diagnostic test has confirmed the 10% shift. The two tests should be consistent in that the 2 tests should be within 10 dB of each other at every frequency. The percentage hearing loss is calculated using actuarial tables weighted according to the importance of the frequencies of 500 Hz, 1000 Hz, 2000, 3000, 4000 Hz respectively.