Before getting to the stage of an audiology appointment, most patients will have already seen a GP or an ENT doctor. However, you (or your child / relative) may have suspected the presence of hearing loss for months or even years. Whatever the case, having to go to an audiologist to have your hearing checked may be causing you some stress. I hope that with a bit of information on what a typical session would look like, you’ll feel more at ease.
The first thing to expect when you go in to an appointment is some exchange of information. This may start with the audiologist reading a referral letter that you brought in or your patient file (if in a hospital). The audiologist may then ask you more about what you are experiencing. This may include general queries such as how you are coping with your hearing loss and which situations you are struggling with or even specific questions like whether you can communicate using the phone or whether you are able to hear the door bell. It’s important that you answer honestly and as fully as you can. Even though testing will be done later, these questions may help the audiologists determine what your needs are, especially with regards to treatment options.
Once that is done, most audiologists will normally test your hearing. This is done using a test known as pure tone audiometry (or PTA in short). This test requires you to sit in a quiet environment wearing headphones and are given a hand held button. The audiologist will then play a tone (a short ‘beep’) in one ear, at which stage you press the button if you can hear the sound. This should be started at a level that you can comfortably hear, so don’t worry, you will have time to adjust to this test. The audiologist will then vary the loudness of the tone until you cannot hear it anymore. The audiologist repeats this using different frequencies (pitch) and does this for the other ear as well. This test gives an indication of the quietest sound you can hear at different frequencies and is used as the main measure of your hearing.
There are also variations of PTA that the audiologist may use in your appointment, including the use of a band that vibrates sound directly to your inner ear (known as bone conduction PTA) and doing PTA with white noise being presented to the other ear (known as PTA with masking). These two variations help determine what type of hearing loss you have and also to isolate each ear better.
Although PTA and the above variations are the main tests, sometimes tympanometry may also be done, which measures your middle ear pressure. This involves having a rubber insert being placed in your ear. You are not required to do anything for this test except avoid talking or swallowing during the measurement. When the measurement starts, you will feel a bit of pressure in your ear which should not be uncomfortable or painful. The measurement is quite short and the whole procedure normally takes 2-4 minutes for both ears.
Normally, no further testing is done at this stage. The audiologist may discuss the results with you directly, or else forward the results to your GP/ENT (depending on where your audiologist is working). In case the audiologist discusses the results with you directly, this may involve a discussion with you on what your options might be. This may include options such as alternative communication strategies (lip reading, sign language or even techniques such as facing a person when talking to them), assistive listening devices and hearing aids. You may require time to decide what you want to do, which is normal. However, if you decide that you want hearing aids, some audiologists may also give you the option of having your ear mould done in the same appointment. This involves having putty placed into your ear canal which then hardens, taking the shape of your ear.
At the end of the day, it is important to remember that the audiologist is there to help you through this potentially difficult process. Hopefully, with this information you feel a bit more prepared for your first appointment, but if you have any more questions, audiologists are normally very happy to discuss things with you during appointments.
Nicholas Desira is in the final stages of becoming a fully qualified Audiologist after training in the UK at the University of Southampton. Nicholas is particularly interested in the use of assistive listening devices and vestibular disorders but is passionate about all aspects of audiology.