Hearing tests Health Dictionary

Hearing Tests: From 1 Different Sources


Tests carried out to assess hearing. Hearing tests are performed as part of a routine assessment of child development and when hearing impairment is suspected. The tests are sometimes included in a general medical examination. Hearing tests may also be used to identify the cause of tinnitus or dizziness.

An audiometer (an electrical instrument) is used to test an individual’s ability to hear sounds at different frequencies and volumes. The lowest level at which a person can hear and repeat words (the speech reception threshold) is tested, as is the ability to hear words clearly (speech discrimination). The type of hearing loss (see deafness) is determined by holding a tuning fork to different parts of the ear.

Health Source: BMA Medical Dictionary
Author: The British Medical Association

Hearing Loss

Otosclerosis: a common cause of deafness in healthy adults. Gradual progressive hearing loss with troublesome tinnitus. The stapes may be fixed and the cochlea damaged. Bones may become spongy and demineralised. While deafness is a matter for the professional specialist, herbal treatment may prove useful. Examine ear for wax.

Internal. Elderflower and Peppermint tea (catarrhal). Ginkgo tea.

Tablets/capsules. Ginkgo. Improvement reported in moderate loss.

Topical. Garlic oil. Injection of 3-4 drops at night.

Wax in the ear. Mixture: 30 drops oil Eucalyptus, 1 drop Tincture Capsicum (or 3 of Ginger), 1oz (30ml) Olive oil. Inject 4-5 drops, warm.

Black Cohosh Drops. It is claimed that John Christopher (USA) improved many cases of moderate hearing loss with topical use of 5-10 drops Liquid Extract in 1oz oil of Mullein (or Olive oil).

Pulsatilla Drops. Tincture Pulsatilla and glycerol 50/50. 2-3 drops injected at bedtime. Assists auditory nerve function. (Arthur Hyde)

Nerve deafness due to fibroma of the 8th cranial nerve, or after surgery – oral: Mistletoe tea for temporary relief. ... hearing loss

Hearing

See DEAFNESS; EAR.... hearing

Hearing Aids

Nearly two-thirds of people aged over 70 have some degree of hearing impairment (see DEAFNESS). Hearing aids are no substitute for de?nitive treatment of the underlying cause of poor hearing, so examination by an ear, nose and throat surgeon and an audiologist is sensible before a hearing aid is issued (and is essential before one can be given through the NHS). The choice of aid depends on the age, manipulative skills, and degree of hearing impairment of the patient and the underlying cause of the deafness. The choice of hearing aid for a deaf child is particularly important, as impaired hearing can hinder speech development.

Electronic aids consist, essentially, of a microphone, an ampli?er, and an earphone. In postaural aids the microphone and ampli?er are contained in a small box worn behind the ear or attached to spectacles. The earphone is on a specially moulded earpiece. Some patients ?nd it di?cult to manipulate the controls of an aid worn behind the ear, and they may be better o? with a device worn on the body. Some hearing aids are worn entirely within the ear and are very discreet. They are particularly useful for people who have to wear protective headgear such as helmets.

The most sophisticated aids sit entirely within the ear canal so are virtually invisible. They may be tuned so that only the frequencies the wearer cannot hear are ampli?ed.

Many have a volume control and a special setting for use with telephone and in rooms ?tted with an inductive coupler that screens out background noise.

In making a choice therefore from the large range of e?ective hearing aids now available, the expert advice of an ear specialist must be obtained. The RNID (Royal National Institute for Deaf People) provides a list of clinics where such a specialist can be consulted. It also gives reliable advice concerning the purchase and use of hearing aids – a worthwhile function, as some aids are very expensive.... hearing aids

Pregnancy Tests

There are several tests for pregnancy (see PREGNANCY AND LABOUR) in its early stages, and these can be done on blood or urine; some of the urine tests may be carried out at home. Most tests are based on the detection of HUMAN CHORIONIC GONADOTROPHIN (HCG) in the woman’s urine. They are nearly 100 per cent accurate and may show positive as early as 30 days after the ?rst day of the last normal period.

The haemagglutination inhibition test This, and the subsequent tests to be mentioned, are known as immunological tests. They are based upon the e?ect of the urine from a pregnant woman upon the interaction of red blood cells, which have been sensitised to human gonadotrophin, and anti-gonadotrophin serum. They have the great practical advantage of being performed in a test-tube or even on a slide. Because of their ease and speed of performance, a result can be obtained in two hours.

Enzyme-linked immunosorbent assay (ELISA) This is the basis of many of the pregnancy-testing kits obtainable from pharmacies. It is a highly sensitive antibody test and can detect very low concentrations of human chorionic gonadotrophin. Positive results show up as early as ten days after fertilisation – namely, four days before the ?rst missed period.

Ultrasound The fetal sac can be detected by ULTRASOUND from ?ve weeks, and a fetal echo at around six or seven weeks (see also PRENATAL SCREENING OR DIAGNOSIS).... pregnancy tests

Pulmonary Function Tests

Tests to assess how the LUNGS are functioning. They range from simple spirometry (measuring breathing capacity) to sophisticated physiological assessments.

Static lung volumes and capacities can be measured: these include vital capacity – the maximum volume of air that can be exhaled slowly and completely after a maximum deep breath; forced vital capacity is a similar manoeuvre using maximal forceful exhalation and can be measured along with expiratory ?ow rates using simple spirometry; total lung capacity is the total volume of air in the chest after a deep breath in; functional residual capacity is the volume of air in the lungs at the end of a normal expiration, with all respiratory muscles relaxed.

Dynamic lung volumes and ?ow rates re?ect the state of the airways. The forced expiratory volume (FEV) is the amount of air forcefully exhaled during the ?rst second after a full breath – it normally accounts for over 75 per cent of the vital capacity. Maximal voluntary ventilation is calculated by asking the patient to breathe as deeply and quickly as possible for 12 seconds; this test can be used to check the internal consistency of other tests and the extent of co-operation by the patient, important when assessing possible neuromuscular weakness affecting respiration. There are several other more sophisticated tests which may not be necessary when assessing most patients. Measurement of arterial blood gases is also an important part of any assessment of lung function.... pulmonary function tests

Vision Tests

Most vision tests examine a person’s sharpness of VISION (visual acuity) and often of the ?eld of vision (see VISION, FIELD OF). Refraction tests assess whether a person has an error that can be corrected with glasses such as ASTIGMATISM, HYPERMETROPIA or MYOPIA. Visual acuity is tested using a Snellen chart when the patient tries to read letters of di?ering standard sizes from 6 metres away. The optician will prescribe lenses to correct any defects detected by vision tests.... vision tests

Blood-clotting Tests

Tests to screen for and diagnose bleeding disorders, usually resulting from deficiencies or abnormalities of blood coagulation factors or of platelets (see blood clotting). Tests are also used to monitor treatment with anticoagulant drugs.... blood-clotting tests

Kidney Function Tests

Tests performed to investigate kidney disorders.

Urinalysis is a simple test in which a urine sample is examined under a microscope for blood cells, pus cells, and casts (cells and mucous material that accumulate in the tubules of the kidneys and pass into the urine).

Urine may be tested for substances, such as proteins, that leak into the urine when the kidneys are damaged.

Kidney function can be assessed by measuring the concentration in the blood of substances, such as urea and creatinine, that the kidneys normally excrete.

Kidney function may also be assessed by kidney imaging techniques.... kidney function tests

Liver Function Tests

Tests of blood chemistry that can detect changes in the way the liver is making new substances and breaking down and/or excreting old ones.

The tests can also show whether liver cells are healthy or being damaged.... liver function tests

Blood Tests

Analysis of a sample of blood to give information on its cells and proteins and any of the chemicals, antigens, antibodies, and gases that it carries. Such tests can be used to check on the health of major organs, as well as on respiratory function, hormonal balance, the immune system, and metabolism. Blood tests may look at numbers, shape, size, and appearance of blood cells and assess the function of clotting factors. The most important tests are blood count and blood group tests if transfusion is needed. Biochemical tests measure chemicals in the blood (see acid–base balance; kidney function tests; liver function tests). Microbiological tests (see immunoassay) look for microorganisms that are in the blood, as

in septicaemia. Microbiology also looks for antibodies in the blood, which may confirm immunity to an infection. blood transfusion The infusion of large volumes of blood or blood products directly into the bloodstream to remedy severe blood loss or to correct chronic anaemia. In an exchange transfusion, nearly all of the recipient’s blood is replaced by donor blood. Before a transfusion, a sample of the recipient’s blood is taken to identify the blood groups, and it is matched with suitable donor blood. The donor blood is transfused into an arm vein through a plastic cannula. Usually, each unit (about 500 ml) of blood is given over 1–4 hours; in an emergency, 500 ml may be given in a couple of minutes. The blood pressure, temperature, and pulse are monitored during the procedure.

If mismatched blood is accidentally introduced into the circulation, antibodies in the recipient’s blood may cause donor cells to burst, leading to shock or kidney failure. Less severe reactions can produce fever, chills, or a rash. Reactions can also occur as a result of an allergy to transfused blood components. All

blood used for transfusion is carefully screened for a number of infectious agents, including HIV (the AIDS virus) and hepatitis B and hepatitis C.

In elderly or severely anaemic patients, transfusion can overload the circulation, leading to heart failure.

In patients with chronic anaemia who need regular transfusion over many years, excess iron may accumulate (haemosiderosis) and damage organs such as the heart, liver, and pancreas.

Treatment with desferrioxamine to remove excess iron may be needed.... blood tests

Intelligence Tests

Tests designed to provide an estimate of a person’s mental abilities. The most widely used are Wechsler tests of which there are 2 basic types: the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Intelligence Scale for Children (WISC). Each is divided into verbal (concerned with language skills) and performance sections, including measures of constructional ability and visual-spatial and perceptual ability (interpretation of shapes). Other tests include the Stanford–Binet test, which is used mainly as a measure of scholastic ability.

In most intelligence tests, scoring is based on mental age (MA) in relation to chronological age (CA). The intelligence quotient (IQ) is MA divided by CA, multiplied by 100. The tests are devised to ensure that 3 in 4 people have an IQ between 80 and 120. They are standardized so that the score indicates the same relative ability at different age levels.

Intelligence tests may be used to assess school or job aptitude. However, they have been criticized for their alleged bias regarding gender and race.... intelligence tests

Lung Function Tests

See pulmonary function tests.... lung function tests

Personality Tests

Questionnaires designed to define various personality traits or types. Tests may be designed to detect psychiatric symptoms, underlying personality traits, how outgoing or reserved a person is, and predisposition to developing neurotic illness.... personality tests

Respiratory Function Tests

See pulmonary function tests.... respiratory function tests

Skin Tests

Procedures for determining the body’s reaction to various substances by injecting a small quantity of the substance under the skin or by applying it to the skin (usually on patches).

Patch tests are used in the diagnosis of contact allergic dermatitis.

They can also be used to test immunity to certain infectious diseases (such as in the tuberculin test).... skin tests

Thyroid-function Tests

A group of blood tests used to evaluate the function of the thyroid gland and to detect or confirm any thyroid disorder. The thyroid hormones T3 and T4 are measured, as well as thyroid-stimulating hormone (TSH), the pituitary gland hormone that stimulates the thyroid gland.... thyroid-function tests

Tuberculin Tests

Skin tests used to determine whether or not a person has been exposed to the bacterium that causes tuberculosis. Tuberculin tests are carried out for diagnosis of tuberculosis, and before BCG vaccination. A small amount of tuberculin (purified protein from the bacteria) is injected into the skin. A few days later, the skin reaction, if any, is noted. A reaction indicates previous exposure.... tuberculin tests

Tuning Fork Tests

Hearing tests carried out to diagnose conductive deafness. In the Weber test, a vibrating tuning fork is held against the forehead. If there is conductive hearing loss, the sound seems louder in the affected ear. In the Rinne test, a vibrating tuning fork is held first near the ear, and then against the bone behind it. If it sounds louder when held against the bone, there is conductive hearing loss.... tuning fork tests

Noise-induced Hearing Loss

Hearing loss caused by prolonged exposure to excessive noise or by brief exposure to intensely loud noise.

Exposure to a sudden, very loud noise, usually above 130 decibels, can cause immediate and permanent damage to hearing. Normally, muscles in the middle ear respond to loud noise by altering the position of the ossicles (the chain of bones that pass vibrations to the inner ear), thus damping down the intensity of the noise. If these protective reflexes have no time to respond, the full force of the vibrations is carried to the inner ear, severely damaging the delicate hair cells in the cochlea. Occasionally, loud noises can rupture the eardrum.

More commonly, noise damage occurs over a period of time by prolonged exposure to lower levels of noise. Any noise above 85–90 decibels may cause damage, with gradual destruction of the hair cells of the cochlea, leading to permanent hearing loss. Prolonged exposure to loud noise leads initially to a loss of the ability to hear certain high tones. Later, deafness extends to all high frequencies, and the perception of speech is impaired. Eventually, lower tones are also affected.

Sounds at 85–90 decibels or above may cause pain and temporary deafness. Prolonged tinnitus (ringing or buzzing in

the ears) occurring after a noise has ceased is an indication that some damage has probably occurred.... noise-induced hearing loss

Tests, Medical

Tests may be performed to investigate the cause of symptoms and establish a diagnosis, to monitor the course of a disease, or to assess response to treatment. A medical testing programme carried out on apparently healthy people to find disease at an early stage is known as screening.

The accuracy of a test is based on its sensitivity (ability to correctly identify diseased subjects), specificity (ability to correctly identify healthy subjects), and predictive value.

The predictive value is determined by a mathematical formula that involves the number of accurate test results and the total number of tests performed.

The best tests have both high specificity and high sensitivity, and therefore high predictive value.... tests, medical

Urine Tests

See urinalysis.... urine tests

Bicros Hearing Aid

see contralateral-routing-of-signal hearing aid.... bicros hearing aid

Bolam And Bolitho Tests

where clinical *negligence is claimed, tests used to determine the standard of care owed by professionals to those whom they serve, e.g. the standards of care provided to patients by doctors. The 1957 case of Bolam v Friern Hospital Management Committee established that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. In 1997 this standard of care test was amended by the case of Bolitho v City and Hackney Health Authority, which requires the doctor’s behaviour to satisfy the judgment not only of responsible medical opinion but also of a court’s own independent logical analysis.... bolam and bolitho tests

Bone-anchored Hearing Aid

(BAHA) a specialized form of *hearing aid for patients with certain forms of conductive *deafness. A small titanium screw is surgically fixed into the bone of the skull behind the external ear using a process called *osseointegration. Sound energy is passed from a miniature microphone and amplifier to the screw, through the bone, to the *cochlea.... bone-anchored hearing aid

Contralateral-routing-of-signal Hearing Aid

(CROS hearing aid) a form of hearing aid used to help people with severe or profound unilateral hearing loss. Sound information is collected by a microphone worn on the affected side and then transmitted by a thin wire or Bluetooth wireless technology to a device worn on the opposite side. If the hearing in the better ear is normal, no amplification is applied to the signal. If the better ear has a hearing loss the device also acts as a conventional hearing aid and amplifies the signal from both sides: this is known as a BICROS hearing aid.... contralateral-routing-of-signal hearing aid

Cros Hearing Aid

see contralateral-routing-of-signal hearing aid.... cros hearing aid

Digital Hearing Aid

see hearing aid.... digital hearing aid

Environmental Hearing Aid

any of various devices for helping people with hearing difficulties. Environmental aids include *assistive listening devices and alerting devices, such as door bells with visible as well as audible alarms, infrared links to televisions, and vibrating alarm clocks.... environmental hearing aid

Hearing Therapy

the support and rehabilitation of people with hearing difficulties, tinnitus, or vertigo. It includes supplying help with acclimatizing to *hearing aids, teaching lip-reading, advising on *environmental hearing aids, and offering general information and advice regarding the auditory system. Other functions are to explain such conditions as *Ménière’s disease and *otosclerosis and to provide *tinnitus retraining therapy (TRT) and other forms of tinnitus management.... hearing therapy

Implantable Hearing Aid

a form of hearing aid in which a small electrical vibrator is surgically attached to the auditory *ossicles. An external device with a microphone and an electronic processing unit passes information to the implanted device using radio-frequency waves. The external part is located behind the pinna and is powered by batteries.... implantable hearing aid

Renal Function Tests

tests for assessing the function of the kidneys. These include measurements of the specific gravity of urine, creatinine *clearance time, and blood urea levels; intravenous urography; and renal angiography.... renal function tests

Dexamethasone Suppression Tests

(DSTs) tests based on the principle that appropriate doses of *dexamethasone can suppress the output of cortisol from the adrenal glands in the normal state and that this ability is reduced or lost in *Cushing’s syndrome. In the overnight DST 1 mg of dexamethasone is administered at midnight and the serum cortisol level is measured at 9.00 am the next morning. Failure to suppress cortisol output may indicate Cushing’s syndrome but also occurs in patients with obesity and depressive illness. In the low-dose DST (0.5 mg dexamethasone every 6 hours for 48 hours), cortisol suppression occurs in patients with obesity and depression but not in those with Cushing’s syndrome. In the high-dose DST (2 mg dexamethasone every 6 hours for 48 hours), cortisol is suppressed in patients with Cushing’s disease (in which excess amounts of ACTH are secreted by the pituitary gland) but not in those with Cushing’s syndrome due to other causes. Although the low- and high-dose tests are unreliable, all three tests should be performed to aid the diagnosis of Cushing’s syndrome.... dexamethasone suppression tests

Hearing Aid

a device to improve the hearing. Simple passive devices, such as ear trumpets, are now rarely used. An analogue hearing aid consists of a miniature microphone, an amplifier, and a tiny loudspeaker. The aid is powered by a battery and the whole unit is small enough to fit behind or within the ear inconspicuously. If necessary, aids can be built into the frames of spectacles. In a few cases of conductive hearing loss the loudspeaker is replaced by a vibrator that presses on the bone behind the ear and transmits the sound energy through the bones of the skull to the inner ear. Digital hearing aids are in some respects similar to analogue aids but in addition to the microphone, amplifier, and loudspeaker, they have digital-to-analogue converters and a tiny computer built into the casing of the aid. This enables the aid to be programmed to the patient’s particular requirements and generally offers improved sound quality. See also bone-anchored hearing aid; cochlear implant; environmental hearing aid; implantable hearing aid.... hearing aid

Stycar Tests

Standard Tests for Young Children and Retardates: tests to detect visual problems in children between the ages of six months and five years. They consist of a series of standardized balls, toys, or letters. The tests were developed by the paediatrician Mary Sheridan.... stycar tests

Synacthen Tests

tests used to assess the ability of the adrenal cortex to produce cortisol. Serum cortisol is measured before and then 30 minutes (or 5 hours) after an intramuscular injection of 250 ?g (or 1 mg) tetracosactide (Synacthen), an analogue of *ACTH. The adrenal glands are considered to be inadequate if there is a low baseline concentration of cortisol or the rise is less than a certain predefined amount.... synacthen tests



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