Tests should assess different parts of the auditory pathway, from ear to brain
Testing should always take place in a sound treated environment or using special equipment to eradicate environmental noise. We will look inside your ear canals to make sure that your hearing change has not been caused by something blocking them. Then, using a canal probe, much like an in-ear phone, we will move your eardrum in the same manner that sound does, to measure the flexibility of your eardrum and the ability of your middle ear bones to conduct sound to the nerve. Often this test is accompanied by a sound reflex test, which gives us information about the pathway to your lower brain, and back again. The measurement is automated and you can just relax while it happens!
The next part of the experience is what most of us remember from school, that is, to listen to tones at different pitches and press a button when you hear it. These tones come from earphones. Sound travels all the way through your normal auditory pathway to your brain, and we quantify your hearing sensitivity at each pitch. The test is repeated with a vibrating sound device on the bone of the skull behind the ear, to measure the sensitivity of hearing at each pitch for the nerve of the auditory pathway alone. The difference between the measurements, helps us to identify whether your hearing problem is caused by the outer or middle ear (conductive), by a change in the nerve (sensorineural) or both (mixed).