Hearing Evaluation

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Hearing Evaluation

There are several parts to a hearing evaluation, each one providing the audiologist with different information. You can receive a comprehensive hearing test in either our Menlo Park or Los Altos office. Below is a description of the most common tests your Pacific Hearing Service audiologist will do to determine your hearing profile.

Hearing Health History

We will begin by asking you about your general health as well as any specific events (e.g. concussions) or ototoxic drugs (e.g. chemotherapy or certain long term, high dose antibiotics) that may have affected your hearing.  We will also ask you about the various situations in which you notice difficulty hearing.  Think about your day-to-day activities.  For example, you might have difficulty during business meetings, when talking on the phone, or at that luncheon you have with your friends once a week. When we understand your particular listening needs, we can serve you better. You may download and fill out the history form ahead of time and bring it with you to your appointment. This will help you to think through your various listening demands and better prepare you for your visit.

Otoscopic Inspection

We will use an otoscope to look in your ears. This will allow us to see if earwax has accumulated in your ear canals or if there are signs that might require a referral to a physician.  If you have a lot of wax in your ear canals you may need to

have it removed before the hearing test can be done.  We can do this in our office (see our page on ear cleaning) or you can have it done by your medical doctor.  Your audiologist can discuss the options with you.


This is a series of tests that tells us about the mechanical function of your eardrum and some of the nerves that innervate the middle part of the ear. A small rubber tip is placed in your ear canal and you will feel slight pressure changes. You will also hear some buzzing and beeping sounds.  For most people it is not uncomfortable and it gives us valuable information about what the cause of your hearing symptoms might be. For example, if your hearing difficulty is related to an allergies or a cold this test will help us to identify that.

Otoacoustic Emissions

When you hear a sound, it activates tiny hair cells that are in the inner ear.  When these cells are activated, they make a noise themselves. During this test, we put a small microphone in the ear canal to measure the sound your hair cells are making. This allows us to determine how healthy those cells are. This test is routinely done with children and frequently with adults, particularly at the initial evaluation.

Pure-tone Audiometry

This is the portion of the test that most people think of as a hearing test or hearing profile.  You will go into a sound booth and listen through headphones to a series of tones that range from soft to loud as well as bass to treble representing the sounds important for speech understanding. You will be asked to press a button or raise your hand every time you hear a tone. Your audiologist will record your responses creating a graph of your hearing ability called an audiogram and indicating the degree of hearing deficit (mild, moderate, severe, etc.).  Additional information is obtained about the potential cause of your hearing difficulties by evaluating how you hear via bone conduction.  Since sound is vibration, this is done simply by putting a small oscillator behind your ear and, once again, asking you to respond when you hear tones.

Speech Testing

Some people have more difficulty understanding speech than others regardless of how loud the speech is.  This is referred to as a loss of discrimination or clarity.  You will be asked to repeat a series of words from a standardized recorded test in order to see if you are having difficulty understanding specific speech sounds. One of the most important evaluations we do is a measure of how you hear in noise. You will hear a series of sentences with cocktail-party noise in the background.  Your ability to correctly repeat the sentences helps us understand the degree of difficulty you have when in noisy situations such as a restaurant. We consider this one of the most important components of a hearing evaluation!