Auditory and hearing aid assessment and rehabilitation clinic

Clinic for hearing loss and restoration
March 11, 2018

Auditory and hearing aid assessment and rehabilitation clinic

He (God) is hearing

In our auditory clinic, comprehensive hearing and balance diagnostic and rehabilitation services are provided for children and adults with or suspected to have hearing loss, vertigo, or tinnitus.

Diagnostic services for audiology:

These services include a set of behavioral and electrophysiological tests that are performed to determine the existence, type, extent, and severity of hearing loss and its causes as well as the way of its treatment. By examining the results of these assessments, it is determined whether a hearing loss is a transient type, that is, the outer ear or middle ear has a problem or it is a sensorineural hearing loss which is related to the problems of the inner ear or middle ear. These tests include:

  • Pure audiometric test of air and bone conduction (audiometry): It is done to determine the hearing thresholds at different frequencies. Comparing the hearing thresholds helps to identify the type of hearing loss (transient, sensorineural).
  • Speech test: It is performed to determine the threshold of recognizing words and verify the net noise thresholds. The percentage of words perception is also calculated, which shows the accuracy of the auditory nerve and the brain function in the transmission and interpretation of auditory information.
  • Tympanometry: A test in which the health of the ear canal, eardrum, and middle ear structures are checked.

Auditory Brainstem Responses (ABRs): This test is applicable to both children and adults:

  • Determining the correct functioning of the auditory nerve (Auditory Brainstem Respose (ABR)): It is a window to the electrical events that occur in the brain stem following an acoustic stimulation of the hearing device. Therefore, it can be used in hearing-related neurologic diseases such as acoustic tumor, MS, auditory neuropathy, etc. With recording these responses, the nerve function can be examined.
  • Determining hearing thresholds: ABR is an objective electrophysiological test that does not require the cooperation of patient. Therefore, this test is carried out on children who are unable to cooperate in behavioral tests due to their age or their physical and mental disability, as well as for those adults who do not accept the existence or the extent of their hearing loss and do not cooperate in behavioral tests to determine the thresholds of hearing.
  • Electrocochleography: It is used to assess the electrical potential generated in the inner ear in response to voice stimulation, and to the question of whether the pressure of the fluid in the inner ear has increased.

Auditory and balance rehabilitation services include:

  • Consultation, prescription, and adjustment of hearing aids. Since hearing loss makes communication difficult; and with time the inner ear, auditory nerve and auditory processing areas in the brain lose their ability to interpret certain frequencies of the sounds, the quality of life of hearing impaired people decrease. Therefore, the use of hearing aids is recommended if hearing loss cannot be treated through medical or surgical procedures. If the appropriate hearing aids are properly prescribed and adjusted, the hearing system is completely re-stimulated and the person learns to recognize and interpret the sounds not been heard for a long time. As the time passes from the onset of hearing loss, and the person does not use the hearing aids, it is harder to improve the hearing skills needed to easily understand and interpret sounds in different environments. Today, digital hearing aids have become smaller and provide a special enhancement to improve speech comprehension, and their technology allows them to face fewer problems in difficult listening environments.

Anyone with any hearing loss can use the hearing aids. For those with bilateral hearing loss, the use of two hearing aids is recommended. Advantages of two hearing aids include the ability to locate sounds, the distinction of the target sound from disturbing sounds, speech comprehension in busy environments, and shortening of the time for getting used to hearing aids.

When an audiologist adjusts an appropriate hearing aid for you and sets it on your ear, you may have different responses to the sounds. This is normal. The purpose of hearing aids is to make audible the sounds of everyday life, but the sounds must be clear and pleasant, as well. Small changes to your hearing aid in the first session or in the second session – during which a subtler setting is carried out which usually takes place within one month of the first session – can help to achieve this goal. So, the more accurate report you give to the hearing specialist about the sound quality of hearing aids, the better he/she can adjust your hearing aids in order to achieve more comfort and clarity of sounds.

  • Consultation and introduction of implantable hearing aids: Despite advances in their manufacturing technology, conventional hearing aids have not been able to satisfy all hearing-impaired people for reasons such as the ear canal obstruction, generating a whistle sound, the need to replace their batteries, frequent ear infections, low sound quality and lack of popularity. The implantable hearing aids designed to help these people have two main types:
  • Middle ear implantable hearing aids: In these hearing aids, the sounds are received by the microphone and the processor behind the ear and transmitted through the skin to the internal receiver implanted in the bone. Through a thin wire, the receptor is connected with an electronic coil that is connected to the middle ear ossicle. The coil is vibrated through a reinforced signal and vibrates the middle ear ossicles, such as when they are vibrated in response to the sound by the eardrum. These vibrations are transmitted to the auditory labyrinth and auditory nerve; and then hearing occurs. Some models of these hearing aids are fully implantable and all the parts are placed under the skin. Some of the advantages of these devices are the ease of use and normal hearing; because the ear canal is not blocked by them. Some of their disadvantages are the high price and inefficiency for severe hearing losses.
  • Bone implantable hearing aids: These hearing aids have been introduced to people with a transient or mixed hearing loss due to reasons such as the absence of auricle, ear canal obstruction, chronic ear infections, etc. and cannot use conventional hearing aids behind the ear or inside the ear canal. This model of hearing aids is also suitable for those who have single-sided hearing loss. These devices transmit sound into the inner ear through the vibration of the skull bone. They include a titanium screw and a connecting base that is placed on the bone behind the ear and a processor located on this bone. The connection of processor to the internal side can be in the form of direct connection to the base, in which case a part of the base is outside the skin. The connection can be through magnetism, in which case the implanted parts are completely under the skin.
  • Vestibular rehabilitation (vertigo rehabilitation): Vestibular rehabilitation is a special form of treatment that aims to reduce the complications of vestibular disorders. This program includes exercises designed to reduce vertigo, dizziness, visual instability, and imbalance. It is useful for those suffering from symptoms of balance system diseases which disrupt their daily activities, and those who have positional vertigo.