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The variety of tests and procedures our experienced staff performs used to evaluate the hearing and balance system include: Audiogram Purpose: Determine the type and severity of hearing loss. Procedure: The hearing test is administered in a sound proof booth. During the test, various tones and speech stimuli are presented via earphones. The audiogram determines how well a patient can hear sounds of different pitches and understand speech at varying levels. Tympanometry Purpose: Evaluate the status of the eardrum and middle ear. Procedure: A small probe is inserted into the ear canal and causes the ear pressure to change slightly. This test is very fast, is painless, and requires only that the patient sit quietly for 20 seconds. Auditory Brainstem Response Audiometry (ABT, AEP, BSER, BAER) Purpose: Used to identify the cause of specific medical conditions and /pr to determine how well a non-cooperative patient (i.e. young child) can hear. Procedure: This is a painless test that takes approximately 1 hour to complete. Small wires are taped behind both ears and on the forehead. The patient listens to sounds presented through earphones while resting comfortable. No response from the patient is necessary; the patient simply rests and can even fall asleep. Electronystagmography (ENG) Purpose: To evaluate the brain and inner ear balance systems; to determine which side may be causing the problem. Procedure: Small wires are taped around the eyes. Throughout the test, the patient's eye movements are monitored while the patient looks in specific directions and moves his/her head in various ways. Cool and warm temperature changes are introduced to the ear to evaluate the system's responses. This is a painless test that takes approximately 1 hour. Medication intake prior to the test should be limited. The patient may be dizzy for a very short time (less than 4 minutes). Rotary Chair Test Purpose: To evaluate the brain and inner ear balance systems; to measure compensation following an inner ear problem. Procedure: Small wires are taped around the eyes to record eye movements in response to various visual and rotary stimuli during testing. The patient's head is placed in a head band to keep the head still. The patient sits in the dark in a small room and follows a laser light on the wall with his/her eyes. The chair rotates slowly in each direction while the patient is asked simple questions to assure that he/she is alert. Medication intake prior to the test should be limited. This is a painless test that takes approximately 45 minutes. Vestibular Autorotation Test (VAT) Purpose: To evaluate the inner ear balance system with faster head movements. Procedure: Small wires are taped around the eyes to monitor eye movements during testing. The patient wears a tight plastic headband. While keeping his/her eyes on a target on the wall the patient shakes his/her head in time to a computer-generated tone. This is a painless test which takes approximately 30 minutes to complete. Infrared Video Goggle Positiona (IRV) Purpose: To observe and record on video tape any abnormal eye movements which may be consistent with positional vertigo. Procedure: The patient wears face goggles which are equipped with an infrared video camera and a microphone. The patient is in darkness throughout the testing and is placed on an examination table in various head and body positions. Eye movements and patient instructions are recorded on a video tape. This is a painless test which takes approximately 20 minutes. The patient may experience dizziness in certain positions, however, the dizziness usually subsides quickly. Posturography Purpose: To evaluate a patient's ability to maintain balance under various conditions and to identify which system is causing the balance problems. Procedure: The patient stands in a semi-enclosed space while the floor and visual surroundings are gradually moved. The patient is advised of each upcoming movement. Small sensors under the floor board assist in evaluating how the body responds to various environmental changes. This is a painless test that takes approximately 45 minutes. The patient muse be able to stand unsupported for a short time. Electrocochleography Purpose: To evaluate the cochlea's response to sound. ECOG is most often used to confirm the presence of Meniere's Disease. Procedure: A small wire is placed in the ear canal, behind both ears and on the forehead. Sound is delivered by earphones while the wires pock up how the cochlea/auditory nerve respond to sound. Throughout the procedure, the patient rests comfortably. The test is painless, and requires no response from the patient. Test time is approximately 1 hour. Electroneurography (ENOG) Purpose: To evaluate the integrity of the facial nerve. Procedure: Small wires are placed on the nose and forehead. The patient sits quietly while a stimulator stimulates the facial nerve. The response is recorded on a computer and a comparison is made between the right and left side of the face. ENOG is very fast: actual test time is less than 5 minutes. Otoacoustic Emissions (OEAS) Purpose: A fast non-invasive method of testing for a cochlear pathology. Procedure: A small probe containing a speaker and microphone are inserted into the ear canal. An acoustic signal is sent he middle ear into the cochlea where the outer hair cells react by generating and emitting an acoustic signal back where it is detected by the microphone. Testing is completed within several minutes. Central Auditory Testing Purpose: Evaluate the status of the auditory system beyond the inner ear to rule out a functional problem processing auditory information. Procedure: The patient is asked to repeat words or sentences heard through earphones. The information is presented -with background noise, competing information, and filtered speech in an attempt to stress the auditory system. A battery of age appropriate tests are completed. Approximately 2-3 hours are needed to complete the testing. Visual Reinforcement (VRA) Audiometry-behavioral testing used with infants to determine the type and severity of hearing loss.
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