Details

  • 60 Minutes
  • $200.00

Tinnitus is broadly defined as ringing in the ears, even though no external sound source is present. It can be described as ringing, hissing, roaring, crickets, screeching, sirens, whooshing, static, pulsing, ocean waves, buzzing, clicking, dial tones, and even music. It can be heard in either one, or both ears.

Tinnitus is often caused by exposure to loud noise, hearing loss, a blockage of the ear canal due to wax, an ear infection, a head- or neck injury and certain medications such as blood pressure medication and diuretics, to name only a few.

Less common causes include Meniere’s Disease (an inner ear disorder that may be caused by abnormal inner ear fluid pressure), Eustachian tube dysfunction (when the tube which connects the middle ear to the back of the throat does not function properly), Otosclerosis (when abnormal bone growth causes the middle ear bones to stiffen and sometimes fuse), muscle spasms of the muscles in the middle ear, blood vessel disorders, TMJ (Temporomandibular joint) disorders, and very rarely, acoustic neuroma (a very slow growing, non-cancerous growth on the hearing- and/or balance nerve) and other neck or head tumours.

Tinnitus can be complex to diagnose and treat but even though it cannot be cured, it can often be treated very successfully with counselling, sound treatment, lifestyle changes, cognitive behavioural therapy, or a combination of the above. No single approach works for everyone, we may need to try various combinations of techniques before we find what works for you.

Diagnostic Hearing Test

History Taking

As within all other medical fields, taking a thorough case history is of utmost importance. We aim to get a good understanding of what brought you to our clinic in the first instance as well as all relevant information about your hearing and hearing health. In today’s digitally driven world, most (if not all) of our work is paperless. If you booked your appointment online, you may have already filled out a digital copy of our History Form which means we will take our time to go over each point, clarifying and expanding on your answers. Feel free to ask questions throughout your appointment. This part will take approximately 1 minute or less.

During this part of the test, we will use an Otoscope to primarily assess the outer ear/lobe, the ear canal, and the ear drum. We will be paying attention to the outer ear anatomy, possible obstruction in the canal due to wax, a foreign body, or bony growths called Exostoses, possible infections in the canal, perforations/holes in the eardrum, fluid behind the eardrum due to middle ear infections, and/or any other unusual findings. We sometimes use Video Otoscopy to take and store an image of the canal and eardrum. This can be very useful as a reference further down the track, and by sharing it with you and/or other medical professionals. We do occasionally come across patients who would rather not see down the canal of their own ears! We respect that and will ask you beforehand what your preference may be. This part of the test takes only a couple of minutes.

PLEASE NOTE: If you have too much wax build-up in your ears to safely continue testing, we do have wax removal (via micro-suctioning) facilities available and will proceed with wax removal, if you consent.

Next, we will assess the function of your ear drum, your three little hearing bones located in your middle ear, as well as a reflex response of the smallest muscle in your body, the Stapedial muscle. This test is completely objective which means we do not require a response from you. The only thing we WILL require from you, is to not talk or swallow for a minute or two. (Please don’t stop breathing though! Just do not swallow.)

The pressure test: We will put a soft silicon plug in your ear. You will hear a low hum and you will feel a pressure change, much like when you want to equalize your ears when you are flying in an aeroplane. This sensation will only last seconds. This test is useful in determining if there could be a perforation/hole in the drum or if there may be an outer ear- or middle ear infection. It may give us information on the integrity of the little hearing bones in your middle ear. It may even give us information about the Eustachian tube (a narrow tube which runs from the middle ear space to the back of the throat, responsible for equalizing the pressure behind the eardrum).

The reflex test: Immediately after the pressure test, you will hear a series of louder sounds. The smallest muscle in your body (the Stapedial muscle) contracts in the presence of loud sounds to protect the hearing organ. Our equipment will record the presence or absence of this reflex. This part of the test will take a couple of minutes.

Diagnostic Distortion Product Otoacoustic Emission (DPOAE) testing is a simple, fast, and objective way of evaluating the integrity and function of tiny hair cells in the hearing organ, the cochlea. A soft sponge tip will be placed in the ear canal. Apart from sending sounds to the inner ear, the probe tip also measures a tiny echo which comes BACK from the inner ear. DPOAE testing is not a test of hearing, but rather a tool used to tell the difference between types of hearing losses. It is safe to use on all age groups from infants to the elderly and is a reliable method of cross-checking results obtained from other parts of the test battery. This part of the test will take a couple of minutes.

You will be most familiar with this part of the test. While seated in a soundproof room, you will be given a button to press, every time you hear a sound through headphones (or insert earphones). We will be testing one ear at a time. We will be testing your ears from base sounds all the way up to treble sounds, like the notes on a piano keyboard. The softest level at which you can reliably detect a sound, is called a threshold. These threshold points will plot a graph. If you have normal hearing, your graph will be in a straight line, close to the top of the diagram. The further down the graph falls, the bigger the degree of hearing loss. This part of the test shows your DEGREE of hearing loss.

This part of the test requires you to also press a button when you hear a sound. Only this time the sound will come from a vibrating bone conductor which sits behind the ear via a headband. If you have normal hearing, we will not need to do this part. However, if you present with a hearing loss, Bone Conduction testing is required to give us more information on the TYPE of hearing loss.

Words in Quiet: During this part of the test, we will be playing speech sounds in a quiet setting, to each ear individually, but at different loudness levels. We start off at a comfortable loudness level, but we turn the volume down as we go along. You are asked to repeat the words that you have heard. When the speech words ultimately get too soft, you will be encouraged to guess what you thought you heard! We do this test as a cross check principle, to confirm that your other test results are reliable.

Speech in Noise: The second part of the test changes slightly, in that we will be asking you to repeat full sentences. The sentences are presented in a noisy background.

We use this test to help us get a better understanding of how your hearing and hearing loss impacts your ability to hear speech in quiet settings but also in noisy situations. It is a powerful counselling tool and can, to a certain extent, predict how well you could potentially do with hearing speech while wearing hearing aids.

Your Appointment

At your appointment, we will conduct a full diagnostic hearing test (see a full description of what this entails below), as well as a tinnitus assessment. From the information gathered, we will diagnose the cause of your tinnitus or recommend further referral for ongoing investigation and/or management if it is indicated. We offer a range of solutions and treatments and will provide some strategies to minimize your awareness of tinnitus as well as the impact of tinnitus on your activities of daily life. Appointment costs include a written report to you and/or your doctor or referring specialist.