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Are Online and App Hearing Tests Accurate? Part 2

By: Kelly Warf, Au.D.

You’ve completed a hearing test performed by an audiologist; the functioning of your outer, middle, and inner ear as well as speech discrimination skills have been assessed. Understanding the results, diagnosis, and recommended treatment plan can only be appropriately reviewed by an audiologist.

Types of Hearing Test Results
Hearing tests completed online (using earphones that go into or cover the ear) measure only a single aspect of the hearing system through sound that enters the ear canal (referred to as ‘air conduction’ testing). Air conduction testing evaluates a patient’s hearing sensitivity for different pitches. The results from this type of testing will tell you ‘how much’ hearing loss you have or how normal your hearing is. It cannot determine, in the presence of a hearing loss, ‘where’ along the auditory system the hearing loss exists. That is, there can be a problem in the ear canal or with the ear drum (or the bones attached to the drum) or there can be a problem in the inner ear (the sensory organ for hearing) or there can be a problem with the auditory nerve. Air conduction testing does not determine where the abnormality may occur in the hearing system and therefore is only part of a comprehensive hearing evaluation. However- through online testing, only air conduction results can be obtained. At a minimum, an additional test of hearing sensitivity using ‘bone conduction” and tympanometry is needed to determine ‘where’ the hearing loss is located. Specialized equipment is necessary to evaluate hearing through bone conduction testing (testing completed through the use of a specialized headset that can measure sound that is transmitted through bone). This equipment is not available for some computer systems. Bone conduction and tympanometry testing is the only way to determine if the individual has a medically treatable hearing loss or one which would benefit from amplification.

Hearing losses that occur when something blocks the ear canal (like wax, for example), or something causes a hole or perforation to occur in the eardrum is referred to as a ‘conductive’ hearing loss. When these kinds of conditions exist, the sound from the outside world is not ‘conducted’ correctly to the inner ear (sense organ for hearing). Some conductive hearing losses can be medically treated and can only be identified through a comprehensive face-to-face.

Alternatively, when there is damage to the inner ear- such as damage caused by repeated exposure to loud sounds (noise-induced hearing loss) or damage to the inner ear caused by the natural aging process (called presbycusis), this results in a ‘sensorineural’ hearing loss. These losses are not typically medically treatable and again, this type of loss can only be identified with a comprehensive face-to-face examination. Some people even have a combination of these types of hearing losses (conductive and sensorineural). An online test will not be able to distinguish between these types of losses, so it is imperative that you see an audiologist in order to determine not only how much hearing loss you have but what kind of hearing loss you have.

Same Head, Two Ears, Different Results
Some individuals may have a difference in hearing between the ears. When this difference in hearing between the ears is sufficient enough, the better (hearing) ear may actually hear the sound through the earphones used at home rather than the ear that is actually being tested. This is referred to as ‘crossover’- whereby a sufficiently loud sound will ‘cross-over’ and be heard in the non-tested ear but it will seem like it is being heard in the ear being tested. An audiologist can easily identify this “crossover” phenomenon and can implement testing procedures to ensure that the tested ear responds. Online computer equipment cannot accommodate for these differences in hearing and that will lead to inaccurate results.

A comprehensive diagnostic hearing evaluation completed by an audiologist in a sound-treated environment that meets current testing standards is necessary to ensure hearing test accuracy and to ensure appropriate treatment and management options are provided to you.

To schedule your hearing evaluation with an audiologist, call our office at 847-685-1000.

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