This document provides information about audiometers and hearing tests. It contains the following key points:
1. An audiometer is used to test a person's hearing ability by playing tones and sounds at different frequencies and volumes through headphones and recording their responses.
2. Hearing tests using an audiometer include pure tone testing to determine hearing thresholds and speech audiometry to test word recognition ability.
3. An audiometry exam can identify types of hearing loss like conductive, sensorineural, and mixed by comparing air and bone conduction thresholds.
This document provides information about audiometers and hearing tests. It contains the following key points:
1. An audiometer is used to test a person's hearing ability by playing tones and sounds at different frequencies and volumes through headphones and recording their responses.
2. Hearing tests using an audiometer include pure tone testing to determine hearing thresholds and speech audiometry to test word recognition ability.
3. An audiometry exam can identify types of hearing loss like conductive, sensorineural, and mixed by comparing air and bone conduction thresholds.
This document provides information about audiometers and hearing tests. It contains the following key points:
1. An audiometer is used to test a person's hearing ability by playing tones and sounds at different frequencies and volumes through headphones and recording their responses.
2. Hearing tests using an audiometer include pure tone testing to determine hearing thresholds and speech audiometry to test word recognition ability.
3. An audiometry exam can identify types of hearing loss like conductive, sensorineural, and mixed by comparing air and bone conduction thresholds.
This document provides information about audiometers and hearing tests. It contains the following key points:
1. An audiometer is used to test a person's hearing ability by playing tones and sounds at different frequencies and volumes through headphones and recording their responses.
2. Hearing tests using an audiometer include pure tone testing to determine hearing thresholds and speech audiometry to test word recognition ability.
3. An audiometry exam can identify types of hearing loss like conductive, sensorineural, and mixed by comparing air and bone conduction thresholds.
2022- 2023 Hearing Mechanism Air and Bone Conduction
1- Air conduction: transmission of sound through the external and middle ear. 2- Bone conduction: transmission of sound to the internal ear mediated by mechanical vibration of the cranial bones and soft tissues.
Types of Hearing Loss
1. Sensorineural Hearing Loss
2. Conductive Hearing Loss 3. Mixed Hearing Loss Hearing Mechanism
Threshold of Hearing
The threshold pressure level of a sound is the lowest level at which an
observer can discriminate between the desired sound and the noise background.
The hearing threshold is the sound level below which a person’s ear is unable to detect any sound. For adults, 0 dB is the reference level.
Threshold shift
Threshold shift is an increase in the hearing threshold for a particular sound
frequency. It means that the hearing sensitivity decreases and that it becomes harder for the listener to detect soft sounds. Threshold shifts can be temporary or permanent. Common Causes of Hearing Loss 1. Birth defects 2. Chronic ear infections 3. Inherited conditions, such as otosclerosis, which occurs when an abnormal growth of bone prevents structures within the ear from functioning properly 4. Injury to the ear 5. Inner ear diseases, such as Ménière’s disease or an autoimmune disease that affect the inner ear 6. 6. Regular exposure to loud noises 7. Ruptured eardrum. Audiometer An audiometry exam tests your ability to hear sounds. Sounds vary, based on their loudness (intensity) and the speed of sound wave vibrations (tone). Hearing occurs when sound waves stimulate the nerves of the inner ear. The sound then travels along nerve pathways to the brain.
- The unit of measure for sound intensity is the decibel (dB).
- The tone of a sound is measured in cycles per second. - The unit of measure for tone is Hertz (Hz). - Low bass tones measure around 50 Hz. - Humans can hear tones between 20-20,000 Hz. Human speech generally falls in the 500-3,000 Hz range. TYPES OF AUDIOMETERS 1. DIAGNOSTIC OR CLINICAL AUDIOMETER A diagnostic audiometer is an instrument capable of performing a variety of hearing tests, including pure tone audiometry and must conform to certain standard of operations.
2. SCREENING AUDIOMETER: A- Typically used for doing hearing screening in the field or in other situations in which a patient cannot be tested in the clinics . B- Smaller in size, portable and only uses pure tone to assess hearing . C- The ranges of frequencies and intensities are more limited with a screening audiometer than a diagnostic audiometer. TYPES OF AUDIOMETERS 3. COMPUTER BASED AUDIOMETER: With computer based audiometry there is the capability of having the computer generate and control the sounds, as well as the ability to store the patient’s response, automatically analyze and print the results and track patient database.
4. AUTOMATIC AUDIOMETER An automatic audiometer has the capability of automatically changing the signal level based on the response of the patient. Components (1) Oscillator: The part that generates the pure tones, very accurate +/- 3% accurate. (2) Attenuators: Hearing level dials to change dB level presented to the patient. (3) Equalization Circuit: Contains resisters that equalize the sound generated. (4) Interrupter Switch: to turn the beep on and off and control the duration of the beep. (5) Output Power Amplifier: Signals produced by the amplifier are amplified. (6) Function Selector: to change between Air, Bone and Speech Sounds. (7) Talk Forward- To talk: to the patient through the headphones. (8) Earphones/Headphones: Bone conduction oscillator receiver. (9) Frequency Indicator: to change with frequency. (10) Presentation indicator: to change the tone from steady state, continuous, pulsed continuous to warble. (11) Microphone. (12) Voice Meter: to change the volume of your own voice in the audiometer. (13) Masking indicator: to produce white, narrow-band or speech noise. (14) Output Transducers: The earphone, bone conduction receiver and loud speakers. Principles of Work An Audiometer consists of an embedded hardware unit connected to a pair of headphones and a test subject feedback button, sometimes controlled by a standard PC.
An audiometer involves testing a patient’s hearing by playing a variety of
tones and volumes and transmits these recorded sounds (pure tones or speech) to the headphones or the oscillator of the test subject at varying frequencies and intensities, and records the subject's responses to produce an audiogram of threshold sensitivity, or speech understanding profile.
Audiometry results are recorded on an audiogram. Audiograms can help
identify and differentiate conductive and sensorineural hearing loss. Principles of Work 1. Bone Conduction: is the conduction of sound to the inner ear through the bones of the skull. A headset is ergonomically positioned on the temple and cheek and the electromechanical transducer, which converts electric signals into mechanical vibrations, sends sound to the internal ear through the cranial bones. Likewise, a microphone can be used to record spoken sounds via bone conduction.
Bone conduction is tested using a device called an (OSCILLATOR) that delivers
sound directly to the bones of the skull.
2. Air Conduction: is the transmission of sound vibrations to the eardrum
through the external auditory meatus (opposed to bone conduction). The atmospheric transmission of sound to the inner ear through the external auditory canal and via structures of the middle ear. Air conduction is tested by using HEADPHONES. Principles of Work Hearing is tested in both ears separately. Both air and bone conduction are tested independently. Principles of Work The following symbols are used to mark each of these separate measurements: X – Left-sided air conduction. ] – Left-sided bone conduction. O – Right-sided air conduction. [ – Right-sided bone conduction. Types of Test 1.Pure tone testing (audiogram): performed by presenting a pure tone to the ear through an earphone and measuring the lowest intensity in decibels (dB) at which this tone is perceived 50% of the time. This measurement is called threshold. The testing procedure is repeated at specific frequencies from 250 to 8000 hertz (Hz, or cycles per second) for each ear. The minimum volume required to hear each tone is graphed.
2. Speech audiometry test:
This tests your ability to detect and repeat spoken words at different volumes heard through a head set. The speech reception threshold (SRT) is the lowest decibel level at which a patient can correctly repeat 50% of test words. Problem 1- Problem in earphone and its cushions. 2- Problem in the audiometer frequency. 3- Problem cords from getting tangled. 4- Electrical and Electronical parts defect. Other Diagnostic Systems 1- Otoscope
An otoscope is a tool which shines a beam of light to help visualize and
examine the condition of the ear canal and eardrum, this is to make sure there is no earwax or a foreign object obstructing ear canal. Diagnostic Systems 2- Rinne and Weber tests
Rinne and Weber tests are exams that test for hearing loss. They help determine whether you may have conductive or sensorineural hearing loss.
A. Rinne Test
1- Place the base of a struck tuning fork on the mastoid bone behind the ear. Have the patient indicate when sound is no longer heard. 2- Move fork (held at base) beside ear and ask if now audible.
In a normal test, AC > BC; patient can hear fork at ear.
With conductive loss, BC > AC; patient will not hear fork at ear. Other Diagnostic Systems B. Weber test
1- Place the base of a struck tuning fork on the bridge of the
forehead, nose, or teeth.
2- In a normal test, there is no lateralization of sound.
3- With unilateral conductive loss, sound lateralizes toward
affected ear.
4- With unilateral sensorineural loss, sound lateralizes to the
