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Loudness balance test, alternate binaural or monaural

CPT4 code

Name of the Procedure:

Loudness Balance Test, Alternate Binaural or Monaural

Summary

A loudness balance test is an audiological procedure used to assess a person's hearing perception by comparing the loudness of sounds presented to each ear alternately (binaural) or to one ear at a time (monaural).

Purpose

This test is primarily used to determine the degree and type of hearing imbalance between the ears. It helps in diagnosing conditions like hearing loss, tinnitus, and other auditory disorders. The goal is to ascertain the correct loudness balance, which aids in the fitting and adjustment of hearing aids or other auditory devices.

Indications

  • Asymmetrical hearing loss
  • Tinnitus (ringing in the ears)
  • Patients with hearing aids for proper calibration
  • Suspected auditory nerve pathology
  • Difficulty in understanding speech, especially in noisy environments

Preparation

  • No specific preparation like fasting is needed.
  • Avoid exposure to loud noises before the test.
  • Bring any hearing aids or audiological devices currently in use.
  • Inform the audiologist of any ear infections or ongoing treatments.

Procedure Description

  1. The patient is seated in a soundproof booth.
  2. Earphones or insert earphones are placed in or over the ears.
  3. The audiologist plays a series of tones at different frequencies and loudness levels to one ear and asks the patient to adjust the volume until the perceived loudness is the same in both ears.
  4. This process is repeated for various frequencies and sound levels to ensure accurate results.
  5. The audiologist records the loudness levels at which the patient perceives balance.

Tools:

  • Audiometer
  • Soundproof booth
  • Earphones or insert earphones

Duration

The procedure typically takes around 30 to 45 minutes.

Setting

This test is usually performed in an audiology clinic, sometimes within a hospital or a specialized hearing center.

Personnel

  • Audiologist

Risks and Complications

  • Minimal to no risks are associated with this non-invasive procedure.
  • Rarely, patients may experience slight discomfort due to the earphones or the repetitive nature of the sounds.

Benefits

  • Provides accurate assessment of hearing loudness balance.
  • Helps in the optimal fitting of hearing aids.
  • Assists in diagnosing various hearing disorders.
  • Immediate preliminary results are often available.

Recovery

  • No recovery time is needed.
  • Patients can resume normal activities immediately after the procedure.
  • Follow-up appointments may be scheduled based on the results.

Alternatives

  • Pure-tone audiometry for baseline hearing assessment.
  • Tympanometry to evaluate ear pressure and middle ear function.
  • Otoacoustic emissions (OAE) tests to evaluate inner ear (cochlea) response.

Patient Experience

  • Patients may hear varying tones at different volumes.
  • The test is painless.
  • The audiologist may interact frequently, asking for responses to ensure accurate loudness matching.
  • any discomfort from the earphones can usually be adjusted promptly.

Summary

A loudness balance test is essential for diagnosing and managing hearing imbalances and assists in the effective fitting of hearing aids, ensuring comfortable and accurate hearing aid use.

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