Services

Services and Hearing Devices offered at Oregon Audiology or Portland:

One out of four people over the age 60 has a hearing problem. And if left untreated, progressive and irreversible damage can occur. Yet on average, it takes an individual seven whole years before they finally seek treatment. Below are our services and expectations when you make an appointment with us.

Diagnostics:

• Complete Hearing Evaluation
• Pure Tone Test
• Bone Conduction Test
• Speech Descrimination
• Uncomfortable Loudness Levels
• Tympanograms
• Acoustic Reflexes and Decay
• Eustachian Tube Dysfunction
• Otoacoustic Emissions (OAEs)
• Hearing in Noise Test (HINT)

Digital Hearing Devices:

• Hearing Aid Evaluations
• Listening Demostration
• Hearing Aid Fitting and Programming
• Hearing Aid Cleaning & Maintenance
• Real Ear Verification Measures
• Speech Mapping
• Assisitive Lisrening Devices
• Aural Rehabilitation

Custom Ear Molds:

• Ear Molds for Hearing Aids, MP3 Players, Dentisits, Musicians, Pilots, IPOD
• Custom Swim/Sleep/Sound Plugs

Accessories:

• Batteries
• Cleaning Supplies
• T.V. Headsets
• Hi-Definition Wireless Blue Tooth
• Custom/Non-Custom ear pieces for cell phones.

Device Details:

	Mini BTE- Mini Behind the Ear For mild to moderately-severe hearing loss All components contained in a case that is worn behind the ear A hard-molded plastic case is worn behind the ear, and a clear, thin tube extends into the ear canal Barely or not at all visible
	BTE - Behind the Ear  For mild to profound hearing loss Larger two - piece hearing aid All components contained in a case that is worn behind the ear A hard - molded plastic case is worn behind the ear, and a custom - fit earmold extends into the ear May be barely visible depending on case color and earmold color
	CIC- Completely In the Ear  For mild to moderately - severe hearing loss  Very small one - piece hearing aid  All components contained in a custom - fit, hard - molded plastic shell  Fits inside the ear canal  Barely visible or not visible at all in the ear canal
	HS - Half Shell  For mild to severe hearing loss Larger one - piece hearing aid All components contained in a custom - fit, hard - molded plastic shell Fills a portion of the bowl of the ear Visible in the ear
	ITC- In The Canal  For mild to moderately - severe hearing loss Small one - piece hearing aid All components contained in a custom - fit, hard - molded plastic shell Fits outside the ear canal Slightly visible in the ear
	ITE- In The Ear  For mild to severe hearing loss Larger one - piece hearing aid All components contained in a custom - fit, hard - molded plastic shell Fills the entire bowl of the ear Visible in the ear
	MC - Mini Canal  For mild to moderately - severe hearing loss Small one - piece hearing aid All components contained in a custom - fit, hard - molded plastic shell Fits mostly in the ear canal and extends slightly outside of the ear canal Barely visible in the ear
	MCIC - Mini Completely In the Ear For mild to moderately - severe hearing loss Small one - piece hearing aid All components contained in a custom - fit, hard - molded plastic shell Fits mostly in the ear canal and extends slightly outside of the ear canal Barely visible in the ear
	Open Fit- Baby Boomer Hearing Device Mild to Moderate hearing loss. Open Ear hearing aids leave your ear canal open. Hear amplified sounds from the hearing aid and the natural sounds in your environment. Open Ear hearing aids are very small. The case fits behind your ear and a thin, clear tube extends into your ear canal.

Diagnosis and Services Provided:

Introduction:

In the assessment of hearing, abnormalities of the auditory system may be a manifestation of systemic and possibly life-threatening disorders. The examiner should obtain a history of past, present, and familial audiologic and otologic complaints. One of the best techniques for determining whether there is an auditory disorder is to ask family members or co-workers whether there appears to be difficulty in hearing. The patient often may be unaware of hearing dysfunction, particularly if it is unilateral. The first few minutes spent talking with the patient or relatives will help determine the direction the inquiry should take. Subsequent examination of the patient and preliminary audiologic findings, if any, determine how inclusive examination should be and what subsequent tests should be ordered. Results of the audiologic test battery must be integrated with the neurological, otoneurological, and radiological information to determine the most accurate diagnosis.

The auditory system differs significantly from the visual and somatosensory pathways in that there is no large direct pathway from peripheral receptors to the cortex. Rather, information ultimately reaching the auditory cortex undergoes significant reorganization as it passes through the brainstem. A general conclusion reached from work on the anatomic and chemical composition of the auditory pathway is that inhibition plays an extremely important role at all levels of the system in shaping the exquisitely precise responses of central neurons. One implication of these complexities of central organization relates to the placement of CNS stimulating devices and the therapy of auditory disorders (Cochlear Implantation).

Hearing Conservation:

One of three areas that need to be addressed when looking at auditory conservation is the area of Auditory Deprivation.:

• If you don't use it, you tend to lose it.
• You must exercise the hearing system to maintain your understanding ability.
• If you wait too long to get help, speech may be distorted, even with the best hearing aid available.

The second area that needs to be conveyed is the fact that Hearing loss ranks with arthritis, high blood pressure and heart disease as one of the common physical conditions. A hearing loss is considered a silent disease. A point that needs to be expressed throughout the community of all age groups.

A third area that needs to be addressed is the on going education to General Practitioners. It is said that only 16% of family practitioners screen for any type of hearing loss.

Laboratory Evaluation of Auditory Function:

Pure tone audiometry: An audiologic assessment is comprised of pure tone air and bone conduction testing, speech threshold and word discrimination measures. Threshold is defined as the lowest intensity (measured in decibels) an individual can detect a pure tone or speech signal more than fifty percent of the time. Pure tone air and bone thresholds are established for frequencies from 250 Hz to 8,000 Hz.

In the measurement of bone conduction thresholds, pure tones are transmitted via a bone oscillator, usually placed on the mastoid. This signal directly stimulates the cochlea, bypassing the external and middle ear. The presence of decreased air conduction thresholds and normal sensitivity by bone conduction suggests abnormality in the external ear or middle ear system and is termed a conductive hearing loss.

Speech reception threshold:
A speech reception threshold is the lowest intensity and equally weighted two syllable word is understood approximately fifty per cent of the time. The pure tone average and speech reception threshold should be within 7 dB of each other.

Speech discrimination:
Speech discrimination is a tool used to assess an individual's ability to understand a speech signal at normal or above normal conversational levels. Most commonly, a phonetically balanced word list of fifty one-syllable words is presented to the patient at a supra-threshold level. The patient's score is represented as a percentage of the number of words correct. Generally, discrimination ability decreases proportionately with an increase of hearing impairment.

Immittance test battery:
Tympanometry, static acoustic immittance and acoustic reflex threshold measures comprise the acoustic immittance test battery. Tympanometry is a measure of middle ear mobility when air pressure in the external canal is varied.

Static compliance refers to the ease of flow of acoustic energy through the middle ear.

The acoustic reflex threshold is the lowest intensity needed to elicit a contraction of the stapedius and tensor tympani muscles using a pure tone stimulus. The introduction of an intense sound into the ear canal results in a temporary increase in middle ear impedance. This phenomenon occurs bilaterally, however, it is typically measured in one ear at a time.

Brain stem auditory evoked potentials:
Brainstem auditory evoked potentials (BAEPs) are also known as brainstem auditory evoked responses (BAERs) or auditory brainstem responses (ABRs). These physiological measures can be used to evaluate the auditory pathways from the ear to the upper brainstem.

The brainstem auditory evoked potential (BAEP) is a sensitive, noninvasive diagnostic test for the diagnosis of cerebellopontine angle tumors (Picton, 1990).

Electrocochleography:
Electrocochleography (ECochG) is a method of recording the stimulus-related electrical potentials associated with the inner ear and auditory nerve, including the cochlear microphonic, summating potential (SP) and the compound action potential (AP) of the auditory nerve. This measure is beneficial in the differential diagnosis of certain types of sensory disorders, such as Ménière's disease or cochlear hydrops. The amplitude of the SP and AP is measured and is of primary interest when evaluating an ear for increased endolymphatic pressure.