Imported Hearing Aids; BTE, ITC, CIC, RIC
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Free Checkup Facility
  • Hearing Service

  • Otoscopy
  • Audiometery Test
  • Tympanometery Test
  • Speech Audiometery  Test
  • Visual Respond Audiometery Test
  • Brainstem Evoked Response Audiometry (BERA) Test
  • Ear Mold Lab
  • Wax Cleaing and General Consultation along with referral mechanism
  • Hearing Aid/Repairing Lab

 

Otoscopy

Otoscopy is an examination that involves looking into the ear with an instrument called an otoscope (or auriscope). DSC_5473

  • This is performed in order to examine the ‘external auditory canal’ – the tunnel that leads from the outer ear (pinna) to the eardrum.Inspection of the eardrum can also provide a lot of information about what’s happening within the
    Inspection of the outer ear

    Before inserting the otoscope cone into the ear canal, the outer ear is inspected for any signs of disease that may relate to the patient’s symptoms. For example, if the complaint is of ear pain, there may be evidence of an infection of the outer ear in the form of redness or slight swelling.

    Examination of the external auditory canal

    The examination is performed by gently pulling the outer part of the ear upwards and backwards. This action straightens the external auditory canal, which has a natural curve, and makes it easier to see the eardrum.

    The normal external auditory canal has some hair, often lined with yellow to brown wax. The total length of the ear canal in adults is approximately 2cm, which gives it a resonance frequency of approximately 3400 Hz, which is an important frequency region for understanding speech.

    Abnormal findings may include:
    • a dry, flaky lining suggestive of eczema. The usual symptom is of itch.
    • an inflamed and swollen, narrowed canal, possibly with a discharge indicating infection (otitis externa). The usual symptoms include itch, local discomfort, a discharge and often an unpleasant smell from the ear.
    • wax obscuring the eardrum.
    • a foreign body in the ear, such as the rubber from the end of a pencil.
    Examination of the eardrum

    The normal eardrum appears pinkish-grey in colour and is approximately circular in shape.

    The first of the three small bones that transmit sound vibrations to the hearing mechanism (the cochlea) lies against the far side of the drum and can be seen through it in the upper part, like the clock hands in approximately the 12 o’clock position.

    Most otoscopes have a small air vent connection that allows the doctor to puff air in to the canal. Observing how much the eardrum moves with air pressure assesses its mobility, which varies depending on the pressure within the middle ear. This technique is called insufflation.

    Normally the air pressure within the middle ear is the same as that in the outer ear. This allows the eardrum to lie in its middle position and respond to sound vibration most efficiently.

    Air gets to the middle ear through a short tube, called the Eustachian tube, that leads from the middle ear to a region high on the side wall of the back of the throat. This opening cannot be seen by ordinary inspection because it’s behind the roof of the mouth.

    Blockage of the Eustachian tube is a common finding in conditions – such as hay fever, a cold or, in children, ‘glue ear‘.

    If blocked, air cannot get to the middle ear to equalise the pressure on the eardrum. This can impair hearing or, if the pressure difference is enough to stretch the eardrum, cause pain. This is the basis of the discomfort you might get when flying with a cold.

    A doctor can get some idea of whether the Eustachian tube is blocked by asking you to gently blow out while pinching your nose and closing your lips. This is called Valsalva’s manoeuvre, and the normal finding is that the eardrum moves slightly during it. When the Eustachian tube is blocked, the eardrum remains still.

    Other abnormal findings seen with the otoscope include:

    • a hole (perforation) in the eardrum (depending on the cause eardrum perforations can heal remarkably well)
    • acute infection of the middle ear (acute otitis media).

    The appearance of the eardrum in acute otitis media is dependent on the time that the infection has been present. Typically, the eardrum becomes red or yellow in appearance and is opaque with indistinct landmarks – it can appear to be bulging towards the viewer. Insufflation may show decreased mobility.

    Sometimes in acute otitis media the eardrum will burst, allowing the pressure (and the pain) to reduce. Then one can often see the tear in the drum, as well as the discharge in the outer ear. In the majority of people, such a tear will heal completely.

Audiometery Test

An audiometry evaluation is a painless, noninvasive hearing test that measures a person’s abilityDSC_5467 to hear different sounds, pitches, or frequencies. Patients who have a tumor in or around the ear may undergo audiometry testing to determine whether hearing loss has occurred or to monitor their hearing before and after surgery. It is also used to evaluate whether hearing aids or surgery may improve one’s hearing.

How does a hearing test work?

Our ears have three distinct parts: the outer, middle, and inner ear (Fig. 1). Audiometry tests can detect whether you have sensorineural hearing loss (damage to the nerve or cochlea) or conductive hearing loss (damage to the eardrum or the tiny ossicle bones). During an audiometry evaluation, a variety of tests may be performed.

  • Ear image1

    Figure 1. The outer ear collects sound waves from the environment and funnels them down the ear canal to the eardrum. Vibrations are made when sound hits the eardrum. Vibrations are passed along tiny bones (ossicles) in the middle ear. The ossicles consist of the malleus, incus, and stapes. The stapes delivers vibrations to the cochlea in the inner ear. The cochlea is a spiral tube filled with liquid and lined with hair cells that are microscopic in size. When the vibration hits the cochlea, it causes the liquid, and subsequently the hair cells, to move. The movement of hair cells generates nerve signals that our brain then understands as sound.

    A pure tone audiometry test measures the softest, or least audible, sound that a person can hear. During the test, you will wear earphones and hear a range of sounds directed to one ear at a time. The loudness of sound is measured in decibels (dB). A whisper is about 20 dB, loud music ranges 80-120 dB, and a jet engine is about 180 dB. The tone of sound is measured in frequencies (Hz). Low bass tones range 50-60 Hz, high-pitched tones range 10,000 Hz or higher. Normal hearing range is 250-8,000 Hz at 25 dB or lower.

    A word recognition test (also called speech discrimination test) assesses a person’s ability to understand speech from background noise. If your speech discrimination is poor, speech may sound garbled. Word recognition scores can be helpful in predicting the usefulness of a hearing aid.

Tympanometery Test

A tympanometry test detects problems such as fluid/wax buildup, perforated eardrum, ossicle bone damage, or tumors in the middle ear. Acoustic reflex testing evaluates the cranial nerves and brainstem.

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Speech Audiometery  Test

  • Speech audiometry has become a fundamental tool in hearing-loss assessment. In conjunction with pure-tone audiometry, it can aid in determining the degree and type of hearing loss. Speech audiometry also provides information regarding discomfort or tolerance to speech stimuli and information on word recognition abilities.DSC_5494
    In addition, information gained by speech audiometry can help determine proper gain and maximum output of hearing aids and other amplifying devices for patients with significant hearing losses and help assess howwell they hear in noise. Speech audiometry also facilitates audiological rehabilitation management.

DSC_5488Visual Respond Audiometery Test

This is a behavioural test suitable for children from six months to about two and a half years.  An audiometer plays sounds of different frequencies and loudness through speakers.  When the child hears the sound, they will turn their head when a visual “reward” is activated, such as a toy lighting up or a puppet.  It can test the full range of hearing but does not give specific information about each ear.

Brainstem Evoked Response Audiometry (BERA) Test

Brainstem Evoked Response Audiometry (BERA) is a test measuring responses in the brain waves that are stimulated by a clicking sound to check the central auditory pathways(hearing) of the brainstem.

The indications for a BERA are as follows:

1) Nervous system abnormalities
2) Children with hearing loss
3) To assess neurological functions
4) Malingering patients
5) Suspected acoustic neuroma
6) Central pontine myelinolysis

The procedure of BERA is as follows:

1) Patient is asked to wash the hair the night before the test
2) Patient is made to sleep on a reclining chair
3) Electrodes are placed on the patient’s scalp, along the vertex and on each earlobe
4) Earphones are put on the ear. The patient hears a clicking sound or tone bursts through the earphones
5) The electrodes pick up the brain’s response and record it on the graph.

BERA

Interpretation of Brainstem Evoked Response Audiometry (BERA) involves a series of five individual waves that are recorded. These waves arise from:

1. Cochlear nerve
2. Cochlear nucleus
3. Superior olivary nucleus
4. Lateral leminiscus
5. Inferior colliculus

The morphology and amplitude of the wave forms are measured. This test has minimal discomfort and there are no risks involved.

Abnormal test results are indicative of:

1) Hearing loss
2) Multiple sclerosis
3) Cerebrovascular accidents (stroke)

 

  • Wax Cleaing and General Consultation along with referral mechanism

Earwax is a build-up of cerumen, sebum, dead cells, sweat, hair and foreign material – eg, dust. Cerumen has antibacterial and antifungal properties. Earwax is a normal physiological substance that protects the ear canal. The quantity produced varies greatly between individuals. Earwax may be either wet or dry. Wet wax is either soft (more common in children) or hard (more common in the elderly). Dry wax is dry, flaky and golden yellow and is common in people from Asia.

 

Indications for removal of earwax:

If it is totally occluding the ear canal and causing hearing loss, earache, tinnitus or vertigo.

If the tympanic membrane is obscured by wax but must be viewed to establish a diagnosis.

If the person wears a hearing aid, wax is present and an impression needs to be taken of the ear canal for a mould, or if wax is causing the hearing aid to whistle.

  • Ear Mold Lab

We provide the highest quality earmolds and custom earpieces at competitive prices. Our success has evolved from our craftsmanship and knowledge of earmolds and earmold selections for hearing aid fittings. Your impressions are processed with the utmost care, ensuring the integrity of the finished product. View custom earpieces such as the Musician’s Plug, Cell Phone Mold, Pilot’s Mold, etc… Browse through our product line of styles, materials, swim and sound plugs/hearing protection, and specialty earpieces.

  • Hearing Aid/Repairing Lab

At the GMT Rehab Centre, we have direct relationships with most of the major manufacturers for in warranty repairs as well as a full service hearing aid repair lab for all of our out of warranty repairs. That means no matter what brand of hearing aid you have, whether it’s in warranty or out of warranty, where you bought it, or how much you paid for it, we can fix it.

Usually, hearing aids come with 1 – 3 years of the Original Equipment Manufacturer (OEM)’s warranty which covers all repairs except for consumable parts such as hooks, batteries, or ear molds. In this case, the repair or replacement of the many delicate internal components of your hearing aids can only be done by the manufacturer.

Our standard hearing aid repair service includes the repair and a six month warranty for a low flat rate. Feel free to call us anytime to find out more details.

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