Audiology

Audiology is a branch of science that studies hearing, balance, and related disorders.

Audiologist

Audiologists are professionals who diagnose, treat, and manage hearing loss and balance problems. By virtue of their graduate education, clinical training and licensure, Audiologists are the most qualified professionals to:

  • Perform hearing tests
  • Refer patients for medical treatment
  • Provide hearing rehabilitation services

Audiologists provide a full range of hearing and rehabilitative hearing services. Specialized equipment is used to obtain accurate information about the type and degree of your hearing loss. As part of your fully integrated medical team at North Carolina Eye, Ear, Nose & Throat, your Audiologist then shares this information with our licensed physicians to determine what course of treatment will most improve your hearing.

Dizziness and Vertigo

Vertigo, dizziness, and balance problems can be life altering. For many people it can affect their ability to do even the simplest daily tasks. If you are experiencing vertigo or balance issues, your doctor may want to refer you for a VNG balance evaluation.

What is a VNG Balance Evaluation?

VNG stands for videonystagmography, which is a series of tests that evaluate the health of your inner ear and your central motor function. VNG testing can possibly uncover the root cause of your vertigo, dizziness or balance issues, and allow your doctor or audiologist to treat it appropriately and effectively.

What Tests Will Be Performed?

VNG testing consists of a variety of tests to uncover the root cause of your symptoms. Most VNG evaluations consist of four main tests:

  • Ocular Mobility checks for your ability to follow visual targets. You will attempt to follow targets with your eyes while an object is jumping, moving slowly, or standing still. Inability to track objects properly could indicate central or neurological problems or possibly an issue with the vestibular system connecting to the brain.
  • Optokinetic Nystagmus also checks for your ability to follow visual targets. During this test, you will watch a large image that is continuously moving, and will be asked to follow the movements. Similarly, this test will give clues to possible central or neurological problems or problems with the vestibular system.
  • Positional Nystagmus will help to give an idea of the health of your inner ear system. You will be asked to move your head and body into different positions, checking for inappropriate eye movements in each position. If there is any fluid blockage in the inner ear, it could be the cause of vertigo or balance issues.
  • Caloric Testing can determine if you have vestibular weakness in one or both ears by checking to see if your ears can detect sensations properly. Your eyes will be monitored while your inner ears are stimulated (one at a time) with warm or cold air.

Pediatric Audiology

Pediatric Audiology provides hearing testing and hearing aid fittings for infants and children who are having a wide range of hearing disorders.

Hearing Tests for Children

One of the following or a combination of the following hearing tests will be used with your child.  The Audiologist will choose the best test for your child based on their current developmental/cognitive level.  None of these tests cause discomfort for your child.

Visual Reinforcement Audiometry (VRA)

Your child will sit on your lap.  Sounds will be played through speakers or earphones and a toy will be shown to your child to teach him or her to respond in certain ways to the sound (e.g., a head turn).

Conditioned Play Audiometry (CPA)

Your child must be old enough to voluntary respond to a sound.  Sounds will be played through speakers or earphones.  Each time a child hears a sound, they are asked to drop a block in a bucket or put a peg in a peg-board.

Conventional Audiometry

Your child will be asked to raise their hand, clap their hands, or click a button in response to a sound.  Sounds will be played through earphones.

Tympanometry

A special soft earplug is placed into the entrance of the ear canal.  A puff of air is blown into the air.  Movement of the eardrum is then measured with slight changes in the air pressure.

Otoacoustic Emission

A special earplug is placed into the entrance of the ear canal.  A clicking sound is played and delivered into the ear and sound activity from the ear is recorded and analyzed on the computer.  Your child needs to be as quiet as possible for this test. No response is necessary from the patient for this testing.

Auditory Brainstem Response Monitoring

Brain activity is measured when clicking sounds are presented through tiny earphones placed in/on your child’s ears.  Tiny electrodes or stickers are placed on your child’s forehead and earlobes or mastoids. The Audiologist records and analyzes your child’s responses while your child is asleep or is very still and relaxed.

Hearing for Speech

Your child will be asked to point to pictures or repeat words upon request from the Audiologist to help determine the softest level at which the child can understand speech or to determine your child’s understanding of speech at a comfortable level.

Auditory Processing Testing

Auditory processing is most simply defined as what the brain does with what the ears hear.  This includes several aspects of listening.  Your child will work with the Pediatric Audiologist and Speech-Language Pathologist and undergo a series of tests ranging from to determine how your child processes information.

If your child has difficulty following auditory directions, struggles in noisy situations, and has difficulty in school, auditory processing testing may be indicated.  This test may be the key in helping in your child succeed.

Central Auditory Processing Disorder

Central Auditory Processing Disorder, or CAPD, is the inability to attend to, discriminate, recognize, remember, and/or comprehend acoustic information. Put simply, normal auditory processing is “what we do with what we hear”..

What are the symptoms of CAPD?
The symptoms of CAPD can differ for each person. The most common complaints include difficulty listening in noisy environments, following directions, and telling the differences between words. Most parents report their children seem to “mishear” information or just do not pay attention. Some of these children are even mistaken for having a hearing loss, as they may ask for clarification or repetition..

CAPD is diagnosed by an audiologist who specializes in the testing of CAPD. CAPD can only be diagnosed as an “exclusion” of other disorders or diagnoses. It is important to emphasize that CAPD is an auditory deficit that is not the result of any other higher-order cognitive, language, or related disorders (such as hearing loss, autism or ADHD). CAPD can be misdiagnosed for some of these other disorders because symptoms are very similar. Therefore, it is recommended children have other formal testing completed prior to seeing the audiologist for a true CAPD diagnosis. Such formal evaluations may include a speech or psychoeducational evaluation, among others. 

To diagnose CAPD, the audiologist will establish a full case history, review previous evaluations and assess hearing to confirm normal hearing. Then, the audiologist will administer testing that requires careful listening and attention. Due to the attention and brain function needed to complete the testing, the CAPD protocol is based on normative data that requires children to be at least 7-8 years of age and have normal cognition. The CAPD testing can take up to two hours. 

A speech therapy evaluation may also be suggested by the audiologist to rule out other disorders. The speech pathologists and audiologists work closely as a team to assess each individual. North Carolina Eye, Ear, Nose and Throat offers formal CAPD evaluations for all ages. If you believe you or your child may have CAPD, please call our clinic to speak with our audiologist. 

Visit North Carolina Eye, Ear, Nose and Throat for Cary audiology, Chapel Hill audiology, Durham audiology, and Roxboro audiology!


Audiologist Evaluation Results

If your or your child's evaluation reveals that medication or surgery are not feasible treatment options, the Audiologist will discuss the benefits of hearing aids with you and/or your family. You will not be pressured to buy hearing aids.

Visit North Carolina Eye, Ear, Nose and Throat for Cary audiology, Chapel Hill audiology, Durham audiology, and Roxboro audiology!

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