At Berger Audiology we are proud to offer a wide range of hearing services, including the following:
HEARING DIAGNOSTIC SERVICES
Otoscopy: Using an otoscope, or ear light, I will examine the outer ear canal. I am looking for the presence of ear wax that could negatively affect test results or ear impressions. I am also checking for a healthy-appearing eardrum.
Cerumen Management: If I find an excessive amount of cerumen (ear wax) during otoscopy, I will remove the wax using a curette and foreceps. Excessive wax build-up can block sound from reaching the ear drum, or it can block the sound bore of a hearing aid.
Impedance Measures: Most commonly, impedance evaluates the mobility of the eardrum and structures of the middle ear. It can also measure the sensitivity of the stapedius muscle reflex arc and helps to determine the degree and nature of hearing loss.
Basic Comprehensive Audiometry: The basic audiogram is what most people think of as a “hearing test”. It is broken down into three components: 1) responding to tones presented through earphones to determine one’s lowest hearing levels at different pitches; 2) a series of speech tests to determine one’s lowest level for understanding speech, as well as the degree of clarity with which speech signals are heard once the speech is audible; 3) responding to tones presented through a bone conduction oscillator to determine the type of hearing loss.
Otoacoustic Emissions Testing: An otoacoustic emission (OAE) is a sound that is generated from within the inner ear. This sound can be measured with a probe that is inserted into the ear canal. Studies have shown that OAEs disappear when there is damage to the inner ear, so OAE testing can be used to screen infants or difficult-to-test patients. OAEs can also be used to test patients with tinnitus (head noises) and in monitoring hearing in patients who are taking ototoxic (toxic to the ear) medications.
Pediatric Hearing Evaluations:
When children are too young or unable to participate in conventional hearing testing, there are different ways to evaluate their hearing, including OAEs and impedance measures (listed above), but also including the following methods:
Visual Reinforcement Audiometry (VRA) for developmental ages of 6 months to 2 years: child turns to the sound stimulus and a toy lights up to reward (reinforce) the child’s listening behavior. Conditioned Orientation Reflex (COR) Audiometry: same as VRA, but more than one sound source and reinforcement toy is used. Many parents describe it as a “sound finding game.”
Conditioned Play Audiometry (CPA) for developmental ages of 2 – 4 years. CPA maintains the attention and focus of the child to the listening task. For example, the child holds a block,waits and listens for the sound, then drops the block into a bucket when the sound is heard. Different toys can be used, like peg boards or children’s puzzles.
HEARING AID SERVICES:
Hearing Aid Evaluation: FoIlowing the diagnosis of a hearing loss, and if hearing aids are found to be an appropriate rehabilitative measure, a hearing aid evaluation will be performed. This includes finding the most suitable hearing aid arrangement for you, defining differences among hearing technologies in real life listening conditions, and providing information on realistic expectations of hearing aid use. Hearing aid styles and prices will be discussed. I may also recommend that you see a physician for medical clearance prior to proceeding with hearing aids.
Hearing Aid Demonstrations: As part of the consultation and hearing aid evaluation, I offer a free in-office demonstration of the latest in wireless hearing aids and accessories. The hearing aids will be set for your individual hearing loss, allowing you to experience the sound and feel of hearing aids, and enabling you to make a more informed decision regarding the purchase of amplification.
Hearing Aid Sales: I am proud to offer hearing aids manufactured by GN ReSound and Phonak, two of the most respected hearing aid companies worldwide. Each manufacturer utilizes different approaches to the remediation of hearing loss, which allows me to make the most appropriate recommendations by matching your needs to the strengths of the hearing aid. I offer a large choice of hearing aid styles and technology levels, and take into account not only your hearing loss, but also your financial considerations. I offer financing through Care Credit, and a 30 day trial period. For more information on hearing aid choices, please see my page on Hearing Aids.
Real Ear Measurement/Speech Mapping: This is my favorite “toy” at Berger Audiology! When hearing aids are programmed, the computer is basing the settings on your degree of hearing loss at different frequencies. What is not accounted for is the size and shape of your individual ear canal, and how sound resonates in that space. For some people, certain frequency regions may have added gain, or conversely, some regions may have decreased gain, depending on the resonance characteristics of the individual’s ear canal. With real ear measurement (or speech mapping), a small probe tube is inserted into the ear canal alongside your hearing aids. This allows me to measure the actual acoustic energy that exists in your ear canal after it comes out of the hearing aid. Using this measurement, I can make real-time adjustments to your hearing aids, customizing the target to ensure the audibility of speech sounds.
Hearing Aid Repairs and Service: While the technology in hearing aids can do amazing things, they do occasionally need repair or service. At Berger Audiology, both the audiologist and the audiology assistant are able to perform in-house cleaning and service to your hearing aids, and if necessary, we can send your instruments back to the manufacturer for repair. Appointments are encouraged, but we do accept walk-ins as well. CUSTOM EAR IMPRESSIONS:
Custom Ear Molds for Hearing Aids: The components of traditional behind-the-ear hearing aids fit over the ear. However, for the sound to be transmitted into the ear, the hearing aids must be coupled with custom-made ear molds. Using a special silicone putty, I take impressions of the ears and send the impressions to an ear mold company. The finished products are returned to me so that I can ensure a proper fit to your ears and your hearing aids.
The newer thin-tube and receiver-in-the-ear hearing aids also fit over the ear, but are often coupled with “domes,” which do not need an impression. However, depending on the hearing loss, these hearing aids may also be coupled with “micro molds,” which do require impressions.
Custom Hearing Protection: Custom hearing protection
is designed to dampen dangerously loud sounds. Impressions are made in the same way as for ear molds, but the end products are designed for occupational hearing protection such as for factory workers, recreational hearing protection such as for hunters or motor sports enthusiasts, and for musicians such as band members.
Custom Swim Molds: Custom swim molds are used to keep water from getting into the ear canal. They are used for those who get swimmer’s ear or for those with pressure equalization tubes that have been surgically inserted into the ear drum. Impressions are again taken in the office, the order is sent to the ear mold company for processing, and the finished product is picked up here so I can check for proper fit.
Dix-Hallpike Maneuvers: This test is used to diagnose Benign Paroxysmal Positional Vertigo (BPPV), which is the most common form of vertigo. There are specific symptoms for BPPV, including brief episodes of vertigo that are provoked by rolling over in bed, lying down, sitting up from a supine position, bending over, or looking up. The definitive test, called the Dix-Hallpike Maneuver (after the gentlemen who discovered it), involves watching your eyes for characteristic eye movements, called rotary nystagmus, when your head is moved into specific positions. BPPV is caused by free-floating particles in part of the balance mechanism, which results in pathological responses during offending head positions.
Canalith Repositioning Treatment: Canalith Repositioning Treatment is performed once BPPV has been diagnosed. By moving the head into different positions, gravity will pull the free-floating particles into a different part of the balance mechanism, where they will no longer elicit the vertigo.