What Does a Hearing Examiner Do?

(1) Whisper of normal voice test can be heard at a distance of 6m. (2) The test recording method is expressed as the hearing distance (cm) of the test ear / the standard hearing distance (cm) of the meter. A small number indicates good hearing. (3) Tuning fork test, normal hearing, Linner test: air conduction> bone conduction (+) Weber test: middle Schwabati test: normal (equal) (4) cochlear electrogram SP does not increase, SP / AP ratio <0.4 ( 5) Normal people's hearing range is between 0-25 decibels (dB)

Hearing test is a test to understand the state of auditory function and diagnose auditory diseases by observing the response caused by acoustic stimulation. The goal is to understand the extent and nature of hearing loss and the location of the lesion.

Name: Hearing test

category: Special inspection

Hearing check normal

(1) Whisper of normal voice test can be heard at a distance of 6m. (2) The test recording method is expressed as the hearing distance (cm) of the test ear / the standard hearing distance (cm) of the test. (3) Tuning fork test, normal hearing, Linner test: air conduction> bone conduction (+) Weber test: middle Schwabati test: normal (equal) (4) cochlear electrogram SP does not increase, SP / AP ratio <0.4 ( 5) Normal people's hearing range is between 0-25 decibels (dB)

Clinical significance of hearing test

Abnormal results: (1) The whispering of the voice test was shortened to 4m, indicating mild deafness, 1m was moderate deafness, and those shorter than 1m were severe or complete deafness. (2) The recording method of the test is expressed by the hearing distance (cm) of the ear to be tested / the standard hearing distance (cm) of the meter. A large number may result in poor hearing. (3) Judgment of tuning fork test results Conductive deaf Linner test air conduction <bone conduction (-) air conduction = bone conduction (+) Weber test is biased towards the affected ear or heavier ear to healthy ear or lighter ear. Prolonged replacement test (+) Sensorineural deafness Liner test Air conductance> Bone conductance (all shorter than normal) (short +) Weber test or lighter Schwabate test shortened (+) Mixed deafness forest Nano test (+), (-) or (±) Weber test Indefinite Schwabati test shortened (+) (4) Pure tone hearing threshold test: Conductive deafness: bone conduction curve is normal or near normal, air conduction curve hearing loss Between 30-60dB, low frequency hearing loss is generally heavy. Sensorineural hearing loss: The hearing curve shows a gradual or steep drop, high-frequency hearing loss is heavy, and the bone conduction curve and air conduction curve are close to or coincide with each other. Mixed deafness: The bone conduction curve decreases, and the air conduction curve is lower than the bone conduction curve. (5) Listening on the side of electrical response Diagnosis of Meniere's disease: "-SP" increases, making the -SP / AP ratio larger than the upper limit of the normal range (0.4 or = 0.45), and the SP-AP complex wave is broadened , SP and AP have opposite polarities, AP is negative and SP is positive. Sensorineural hearing loss: SP is not easy to identify, and the CM threshold is significantly increased or the maximum stimulation intensity is still not elicited. The disappearance of CM is an important feature of sensorineural hearing loss. Neurological hearing loss: AP can disappear, but CM is normal or roughly normal. Auditory neuropathy: Dominant -SP (SP / AP> 0.4) appears, -SP is multimodal, and the SP-AP complex wave waveform widens, and the amplitude of AP decreases or disappears. (SP is the sum potential, and AP is the auditory nerve composite potential) The population to be examined: patients with hearing impairment

Hearing check points

Not suitable for the crowd: Patients with hearing loss between 1000 and 4000 Hz of about 40-50dB are not suitable for using cochlear electrogram. The ears are the same on both sides. Contraindications before examination: The urn in the ear canal needs to be cleaned. Contraindications during inspection: (1) In a quiet environment. (2) In the voice test, the examiner should pay attention to the strength of each pronunciation, the vocabulary is easy to understand, and the pronunciation is accurate and clear. Be careful not to let the examinee see the examiner's lips. (3) For tuning fork test, select a tuning fork of appropriate frequency. Tap the tuning fork in a certain way. Place the tuning fork in the correct position during the test. The tuning fork handle does not touch the fork, and the fork does not touch the hair. (4) Prevent hearing fatigue. (5) The stopwatch should be on the flat line of the external ear canal during the test. (6) The subject should sit down, do not disturb, and close his eyes. (7) The control ear must be normal, and the age of the control should be comparable.

Hearing check procedure

(1) The voice test is performed in a quiet environment longer than 6m. The distance mark is marked on the ground. The patient stands 6m away from the examiner, but the body cannot be too close to the wall to avoid sound interference. The ear to be inspected is facing the examiner, and the other ear is blocked with an oil cotton ball or a finger, and the eyes are closed, so as not to see the movement of the examiner's lips affects the accuracy of the examination. For vocabulary, tell the patient to repeat the vocabulary they hear. Pay attention to the strength of the pronunciation each time. The vocabulary should be easy to understand. (2) The table test patient sits, closes his eyes, and plugs the non-examination side ear canal mouth with his fingers. The examiner stands behind the patient, familiarizes the patient with the sound of the examination, and then places the stopwatch on the plane of the external ear canal, repeating from the distance Test just how far you can hear the sound from the ear. The recording method is expressed by the hearing distance (cm) of the ear to be tested / the standard hearing distance (cm) of the meter, such as 100 / 100cm, 50 / 100cm. (3) Whisper examination is performed in a 6m long quiet room. Speak common vocabulary with whispering intensity, record the distance that the ear can hear clearly and compare it with normal ear (ear hearing distance / normal ear hearing distance). (4) Tuning fork check method The tuning fork is placed about 1 cm from the ear canal opening. The listener is "air conduction"; the hearing fork is "bone conduction". Is the most commonly used method to identify the nature of deafness. C tuning octave sets of five tuning forks are commonly used, whose vibration frequencies are 128, 256, 512, 1024, and 2048Hz. (5) Pure tone hearing threshold tests include air conduction and bone conduction tests. The air conduction test starts from 1KHz. After the patient hears the sound, the patient decreases step by step every 5dB until it cannot be heard, and then increases the sound intensity step by step (5dB per step). Until the exact listening threshold. Then test the hearing thresholds of other frequencies in turn in the same way. Intermittent sounds should be used during inspection to avoid hearing fatigue. The bone conduction test is performed in the same way as the air conduction test. (6) Electrical response audiometry uses superimposed averaging technology to record acoustic evoked potentials in the auditory system, determine the functional status of the auditory system, and analyze certain diseases in the ear and neurology departments. Cochlear electrograms, auditory brainstem responses, and mid-latency responses are currently used in the clinic. (7) Otoacoustic emission examination clinically recommends the use of transient acoustic evoked otoacoustic emissions (TEOAE) and distortion products otoacoustic emissions (DPOAE) in evoked OAE. Evoked otoacoustic emission can be used to screen newborns for hearing, which is simple and fast. Those with positive OAE response can be judged to have normal peripheral hearing. Combined with auditory evoked potential examination, it can identify cochlear and post-cochlear hearing system lesions. (8) The basic test items of acoustic impedance audiometry are: static sound plane value measurement of tympanic membrane, tympanogram and stapedius reflex test.

Hearing test related diseases

Noise disease, heart-ear syndrome, facial neuritis, endemic cretinism, pediatric dwarf-retinal atrophy-deafness syndrome, sudden deafness, hearing impairment, senile deafness, explosive deafness, otitis media

Hearing test related symptoms

Cochlear hearing loss, conductive hearing loss, neurological hearing loss, fluctuating hearing loss, central hearing loss, hearing loss, deafness, hearing loss ^[1]