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You will also be tested using a series of low & high frequency words to determine your ability to understand verbiage within a short distance as in a conversation. We will also give you several words to repeat. The results will help us determine your percentage of hearing loss, your ability to understand speech, and if hearing aids will help you.

When Choosing a Hearing Aid, the Following Factors Should Be Considered and Discussed With Your Doctor of Audiology: 

Choosing the right instrument for your lifestyle can seem daunting.  If you've never worn a hearing aid before, how would you know what to expect, what's necessary or what to expect in terms of cost.  At the Hearing & Balance Lab, our Doctors of Audiology are dedicated to working with you to give you the most up-to-date information about your hearing aid choices.  First and foremost, a recent hearing evaluation is necessary in order to determine the right style of instrument.  In addition, a discussion about your needs, wants, expectations and lifestyle will help us work together as a team to decide what is best for your hearing needs.  Other factors that will be considered are:

1. How active you are and the type of lifestyle you lead (i.e. whether you attend a lot of meetings, are very athletic, and amount of time you spent in quiet environments vs. in social settings with background noise).
2. Cosmetic preferences. 
3. Your physical ability to manipulate a hearing aid (i.e. if you have severe arthritis, you may not want to purchase a very tiny hearing aid which would have a small battery and a small volume control to manipulate).
4. What you want the hearing aid to do for you (type of circuitry and special features to help with background noise or the telephone, for example)
5. Expense and financing options (as a rule, most insurance companies do not cover hearing aids for adults but financing options may be available to meet your needs
6. Importance of battery life
7. Consider any other medical conditions that may affect your use of the hearing aid.

At the Hearing & Balance Lab, we are dedicated to walk with you through the process of finding the right hearing aids.  We offer "at least 30 days" trial on hearing aids.  With the time-tested Fitting Protocol and Hearing Aid Program, we know you will feel comfortable that you have made the right choice.  We're excited to have the opportunity to work alongside you!

Nystagmus is an involuntary back and forth jerking movement of the eyes that occurs when the entire balance system is stimulated. When the vestibular and ocular systems are functioning normally, nystagmus is only rarely seen. For the purpose of testing, nystagmus can be elicited through certain movements or stimulation of the vestibular system (the balance organs of the inner ear). This helps to determine the cause or origin of your dizziness. An ENG evaluates the oculomotor system and the vestibular system. The test takes approximately an hour and a half to complete.  Please see our video on this website for more information regarding the balance evaluations conducted at the Hearing & Balance Lab, P.C.

The ENG is Comprised of a Series of Subtests or Tasks. There are Three Main Parts:
Oculomotor Analysis -- patients perform various visual tasks that require eye movement Positional Testing -- patients are placed in various body positions to determine if dizziness develops and to see if nystagmus occurs Caloric Stimulation -- small amounts of both warm and cool air are introduced into each ear canal to independently stimulate the inner ear vestibular system. Throughout each part of the evaluation, patterns of normal and abnormal eye movements are analyzed. The main purpose is to look for the presence of nystagmus in both the absence and presence of vestibular stimulation, as well as look for symmetry of responses. Analysis allows for determining if the disorder is central, peripheral or systemic. Central problems are caused by disturbances in the brain or central nervous system. Peripheral problems arise from disturbances in the labyrinth (inner ear balance organ). Systemic problems are the result of disturbances in the organs and peripheral nerves (nerves outside of the brain or spinal column).

When sound enters the ear and stimulates the cochlea in the inner ear, the cochlea produces an electrical response to the sound along the nerve pathways. This electrical response is the same type of response that is measured in an Electroencephalogram (EEG), a study of brain waves that may be more familiar to you. ABR waveforms (the electrical "waves" of nerve/brain activity in response to sound) can be measured on your skin using measurement electrodes. The responses can be interpreted to yield valuable information about the function of the auditory pathways. In analyzing the ABR, your Doctor of Audiology looks at the presence of the various waveforms, at how long it takes each wave to occur, the distance between certain waves and the shape and height of the waves. The waves or responses of the two ears are compared to each other to further aid diagnosis.

Personal Listening Systems / Radio Frequency Modulated Systems (FM)
"FM Systems," as they are commonly called, have the ability to increase the volume of a particular sound source (such as a public speaker, entertainer, teacher or a television, radio or stereo) and deliver it directly to an individual without also increasing the amount of background noise, regardless of the amount of distance that exists between speaker and listener or the amount of reverberation present. (Reverberation refers to sound echoes produced as sound travels, bounces or reflects off of various surfaces). FM Systems improve the signal-to-noise ratio, which means that the level of speech or desired sound source is louder than the level of noise in the room or environment. For example, in a typical classroom setting the noise level is often nearly as loud as the voice of the teacher, making it difficult for a hearing impaired child to hear and understand well. The teacher's voice can be heard much better with an ALD because it reduces or controls for factors such as distance, background noise and reverberation.

Personal Listening Systems usually consist of FM Systems or Pocket Talkers. Typically, personal listening devices are used in classroom settings, in small group discussions or meetings and in any other situation where an individual's voice needs to be amplified directly to the listener (nursing homes, automobiles and restaurants). FM Systems work by transmitting or broadcasting a signal on a particular FM radio frequency (comparable to a miniature FM radio station) to a wearable radio receiver. The communication partner (the person whose voice needs to be heard over the background noise) wears a lavalier (lapel) clip or headset-type microphone that is connected to a body-worn trasmitter that looks like a little box or large pager.  The FM system can be worn by the listener or can be connected directly to hearing aids in several ways.  FM systems are an assistive device meant to improve communication in the most difficult of situations.  They are an adjunct to the hearing aids and aren't meant to be used as a stand-alone peice, in most cases.

The directional microphone in the headset of the processor picks up sound and delivers the sound to the speech processor via a cable/cord. The speech processor then analyzes and filters sound into digital information and a coded signal. The coded signals are then sent to a transmitting coil worn on the back of the patient's head. The coil sends the coded signals to the internal implant. Electrical energy is then delivered to the electrode array. The electrodes stimulate surviving auditory nerve fibers and the electrical sound information is interpreted by the brain.

The speech processor is able to utilize various "speech coding strategies" to help improve or maximize the benefit and understanding received from an implant. A coding strategy describes the way in which the processor interprets loudness, pitch and timing cues to send signals to the cochlea. Having a choice of coding strategies allows for flexibility and individualization for each cochlear implant patient.