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(231) 775-9398 / Toll Free (877) 775-9398

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Providing Quality Hearing Healthcare Since 1979

Advanced Diagnostic Hearing Assessment

Otoacoustic Emission Testing (OAE)

Auditory Brainstem Response Testing (ABR)

Impedance/Immittance Testing

Advanced testing is oftentimes indicated and needed to better identify abnormalities and etiologies within the peripheral, cochlear and retrocochlear pathways.

Otoacoustic Emission Testing (OAE)

OAE’s are sounds originating in the cochlea, specifically from the outer hair cells, that propagate through the middle ear and then into the ear canal where they are measured with a sensitive microphone system. These emissions are an objective measure used to evaluate cochlea function, specifically outer hair cell performance, are pre-neural and not influenced by the state of the auditory (8th) nerve.

Clinical applications:

  • Universal newborn hearing screening
  • Appropriate for difficult to test population/malingering/functional hearing loss
  • Provides data for individual ear assessment
  • Assists in differentiating cochlear vs. retrocochlear disorders
  • Excellent objective tool for monitoring subtle inner ear changes due to the effects of ototoxic medications and noise exposure

Auditory Brainstem Response (ABR)

The ABR is a neurological test of auditory function that measures the timing of the brainstem’s response to the click or tone stimuli, traveling from the outer, middle and inner ear structures through and including the brainstem. It is a latency function measurement represented in a series of 5 waveforms that are thought to have the following corresponding anatomical generator sites:

  • Wave 1 - distal portion of the 8th nerve
  • Wave II – proximal portion of the 8th verve
  • Wave III – cochlear nucleus
  • Wave IV – superior olivary complex
  • Wave V – lateral lemniscus

Clinical applications:

  • Estimation of hearing threshold (including newborn hearing screening)
  • Appropriate for difficult to test population and/or malingering/functional hearing loss
  • Provides data for individual ear assessment
  • Sensitivity and specificity in detection of tumors (vestibular schwannomas), assist in diagnosis of other abnormalities such as MS
  • Alternative test for MRI or other scans in the presence of metal implants
  • Provides quantitative information during intra-operative monitoring

Impedance/Immittance Testing

Impedance/Immittance testing is the objective measurement of middle ear function. The most common nomenclature of this testing is the tympanogram and assists in identifying and defining normal vs. abnormal TM integrity.

Comprehensive Immittance testing provides more than just a tympanogram tracing that includes information for differential diagnosis for additional etiologies.

Clinical applications:

  • Assessment of overall middle ear status/function using tympanometry and acoustic stapedial reflex thresholds
  • Assessment of integrity of tympanic membrane (intact TM, TM perforation, suspected fluid, hypermobility, Eustachian tube dysfunction, ossicular discontinuity/stapes fixation)
  • Assessment in the etiology of superior canal dehiscence
  • Assessment in the etiology of fistula
  • Assessment in retrocochlear and facial nerve dysfunction differential diagnosis
  • High frequency probe tone for accurate infant TM integrity