Your first hearing test: more about the testing procedures

Glen Sutherland, MCISc

In my previous post, “Your First Hearing Test: what you should bring”, I mentioned that your hearing health care professional would examine your ears and perform a series of tests to determine the nature and degree of your hearing loss. In this post and the next, I will explain more about the most common testing procedures used during your first hearing test.

The Client Oriented Scale of Improvement (COSI)

At the beginning of the appointment, your hearing health care professional (clinician) will spend about 15 to 20 minutes talking to you and asking you some questions about your hearing history. S/he may use a form such as The Client Oriented Scale of Improvement (COSI™), an assessment questionnaire for clinicians, to gather pertinent information about your hearing. The COSI allows the clinician to document your needs and goals for better hearing at the first appointment and to measure improvements in your hearing ability at future appointments.

Some questions that may be asked include but are not limited to:

How long have you been experiencing your hearing loss?
Do you experience any tinnitus (noises/ringing in the ear)?
Have you experienced any dizziness (vertigo)?
Have you ever had ear infections?
Have you ever had surgery on your ears?
Have you ever been exposed to loud noises that resulted in a hearing loss?
Does anyone else in your family have a hearing loss?
Was your hearing loss sudden or gradual?
Have you seen an Ear, Nose and Throat doctor for help with you ear/hearing problems?

Be thorough and honest with your clinician. Be sure to provide as much information that you can remember so s/he can provide you with the best hearing care to meet your individualized needs.

Otoscopic Examination

After the clinician has asked questions and taken notes about your hearing history, s/he will conduct an otoscopic examination, which is an examination of the outer ear, ear canal and eardrum. This procedure is completed with an otoscope, a medical device which is used to look into the ears. During this procedure the clinician wants to make sure that the ear canal is free of wax and that there are no skin irritations or other problems that would affect the test results.

The clinician is not performing an otoscopic examination to make a diagnosis. S/he wants to make sure that the ear drum can be seen and that the ear canal is clear to test. Typically, if the outer ear looks fine and the ear canal is clear of any debris, the clinician will proceed with the hearing test.

If there appears to be some condition on the outer ear or in the ear canal, the clinician will refer you back to your family doctor for further examination and assistance as required.

A Note about ear wax (Cerumen): ear wax is a natural part of the body and part of the ear’s own cleaning system. Wax stops incoming dust, dirt, bacteria and other debris (bugs, pussy willows, peas, etc.) from entering the ear canal. It also helps to rid the ear canal of such debris. A certain amount of ear wax is natural in the outer ear. If it is not causing bothersome symptoms ear wax should be left alone.

However, if there is an abundance of wax in one or both of the ear canals the wax may need to be removed before the hearing tests are completed. Some clinicians may refer you to your family doctor to remove the wax while other clinicians may be trained and qualified to remove the wax themselves.

I do not recommend that you to try to manage your own ear wax by pushing cotton swabs down your ear canals. If you know there is excess wax and you try to remove it with a cotton swab, you are more likely to push it further down the ear canal rather than getting the wax out of the ear canal. This will most likely cause more troubles for you than less. Leave wax removal to the professionals.

If the wax is hard, dry and difficult to remove, you may be asked to put some oil (mineral, baby, olive) in the ear canal(s) for several days before wax removal is attempted. The wax absorbs the oil and becomes soft so it is easier to remove (or it may fall out of the ear canal on its own). The clinician will explain the procedure to you if it is required.

After the otoscopic examination, there will then be a series of tests to assess your hearing. I will explain more about the hearing tests used to determine the nature and degree of your hearing loss in my next post.

Please note that the information in this blog is presented for the purpose of providing information and should not be used for medical diagnosis or treatment nor should it be used in place of medical advice from your doctor or hearing health care professional.


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