Name of the Procedure:

Pure Tone Audiometry (Threshold); Air and Bone
Common name: Hearing Test
Technical/Medical terms: Pure Tone Audiometry, Audiometric Testing

Summary

Pure Tone Audiometry is a non-invasive hearing test that measures the faintest tones a person can hear at various frequencies. The test uses air conduction (through headphones) and bone conduction (through a small vibrator placed on the bone behind the ear) to assess both the outer and inner ear's functionality.

Purpose

Pure Tone Audiometry is used to diagnose hearing loss, determine its severity, and pinpoint whether it is due to problems in the outer/middle ear (conductive hearing loss) or in the inner ear/auditory nerve (sensorineural hearing loss). The goal is to provide accurate information for managing hearing issues, which may involve medical intervention, hearing aids, or other treatments.

Indications

• Difficulty hearing over the phone or in conversations
• Frequent requests for repetition in conversations
• Noticing that sounds are muffled
• Tinnitus (ringing in the ears)
• Routine monitoring in patients with conditions affecting hearing, such as age-related hearing loss, exposure to loud noises, or ototoxic medications

Preparation

• No specific fasting or medication adjustments required
• Patients should ensure their ears are clean and free of wax buildup
• Avoid loud noises before the test to prevent temporary threshold shifts

Procedure Description

1. The patient is seated in a soundproof booth.
2. Headphones are placed over the patient’s ears to test air conduction, and a bone vibrator is positioned on the mastoid bone behind the ear for bone conduction testing.
3. The audiologist plays a series of pure tones at various frequencies and volumes.
4. The patient signals (e.g., raising a hand or pressing a button) when they hear a tone, even when it is very faint.
5. The results are plotted on an audiogram, showing the hearing threshold levels for both air and bone conduction.

No anesthesia or sedation is required for this procedure.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

Pure Tone Audiometry is performed in a sound-treated room, usually within an audiologist’s office, an ENT clinic, or a hospital’s audiology department.

Personnel

The test is conducted by an audiologist, who is a healthcare professional specialized in diagnosing and treating hearing and balance disorders.

Risks and Complications

Pure Tone Audiometry is a safe procedure with minimal risks. Rare complications might include slight discomfort from the headphones or bone conduction device but these are temporary and minor.

Benefits

• Accurate assessment of hearing ability
• Identification of the type and degree of hearing loss
• Information to aid in creating an effective treatment plan
• Immediate availability of results to discuss with the healthcare provider

Recovery

There is no recovery time needed. Patients can resume normal activities immediately following the test.

Alternatives

• Tuning fork tests: Quick screening tools but less precise.
• Auditory Brainstem Response (ABR): Evaluates the auditory nerve and brain pathways but is more complex and typically used when detailed information is necessary.
• Otoacoustic Emissions (OAE): Measures inner ear hair cell function, often used for newborns and basic hearing screening.

Patient Experience

During the test, the patient may feel slight pressure from the headphones or bone vibrator. The test involves listening attentively and responding to tones. Discomfort is minimal, and the test is painless. Feelings of anxiety can be alleviated by knowing the procedure is straightforward and risk-free.