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March 20, 2019
 

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Weekend doctor: Limitations of online hearing tests

By Kristina Trout, Au.D
ENT & Allergy Specialists of Northwest Ohio
While completing a hearing test in the convenience of your own home may be an attractive alternative to making an appointment with an audiologist, online hearing tests are unlikely to accurately or reliably identify the extent of your hearing problems. But what exactly are the benefits to visiting an audiologist versus attempting a hearing test at home?

During your visit, the audiologist will ask you questions about your current and past medical and physical history. There are many physical conditions that can impact your hearing status, and it is possible your hearing problems can make other medical conditions worse. Additionally, if you are experiencing ear noise (tinnitus), balance problems such as dizziness or vertigo, exposure to hazardous, loud sounds recreationally or through your work, or any other hearing- or balance-related issues, the audiologist will address these with you in the face-to-face examination.

As part of the overall hearing evaluation, the audiologist must also assess your ears to determine if obstructions like occluding ear wax, drainage or bleeding are present in the ear canal. This important part of the examination is not possible in a self-administered examination in your own home.

Additionally, there are guidelines of an acceptable level of ambient room noise allowed for an accurate hearing test. It is rarely possible to meet these standards without a uniquely constructed, sound-treated room. It is imperative to control for background noise when evaluating an individual’s hearing thresholds, as background noises at home may produce noise that artificially elevate hearing levels when completing an online hearing test.

Furthermore, there are strict audiology standards for headphone or earphone calibration that do not exist for home computer systems. As a result, an individual’s test results on the same home computer using different types of headsets/earphones often vary.

Hearing tests completed online using earphones measure only a single aspect of the hearing system through sound that enters the ear canal, otherwise known as “air conduction” testing. This type of testing evaluates a patient’s hearing sensitivity for different pitches. The results from air conduction testing will outline the amount of hearing loss you are experiencing as well as whether your hearing capabilities meet the “norm.” In the presence of a hearing loss, these tests cannot determine ‘where’ along the auditory system the hearing loss exists. That is, there can be a problem in the ear canal, ear drum or inner ear (the sensory organ for hearing), or with the auditory nerve. Therefore, air conduction testing is only part of a comprehensive hearing evaluation.

At minimum, an additional test of hearing sensitivity using “bone conduction” testing is needed to determine “where” the hearing loss is located. Specialized equipment is necessary to evaluate hearing through this type of testing, which is completed using a specialized headset that can measure sound transmitted through bone. This equipment is not available for home computer systems. Bone conduction testing is the only way to determine if the individual has a medically treatable hearing loss or one which would benefit from amplification.

A comprehensive, diagnostic hearing evaluation completed by an audiologist in a sound-treated environment that meets current testing standards is necessary to ensure hearing-test accuracy and assess appropriate treatment and management options. If you believe you are in need of a hearing test, call your local audiologist and schedule an appointment today.