FAQ
About Audiology
WHAT IS AN AUDIOLOGIST?
HOW DO AUDIOLOGISTS SUPPORT THEIR PATIENTS?
Audiologists are also involved in the hearing conservation or the prevention of hearing loss, through auditory training, counselling, guidance and the provision and fitting of hearing protective devises such as noise plugs.
HOW DO I BECOME AN AUDIOLOGIST?
An audiologist is a professionally trained university graduate who has successfully completed at least four years of intensive academic and clinical training. In order for an Audiologist to practice in South Africa it is necessary to be registered with the Health Professions Council of South Africa.
WHAT DO AUDIOLOGISTS DO?
Audiologists are trained to identify and evaluate the range, nature and degree of hearing or hearing loss in babies, children and adults. They are further involved in the provision of audiological (aural) habilitation and rehabilitation to both children and adults, and are trained and capable with regard to planning, conducting, directing and participating in the management of persons with hearing loss, whether it be referral for medical management, or the selection, fitting and provision of suitable hearing amplification systems such as hearing instruments and other assisting listening devices to both children and adults.
FAQ
CHILDREN
Audiologists can measure the status of your child’s outer middle and inner ear, and can refer you for further medical management, if required.
SHOULD I TAKE MY CHILD FOR A HEARING TEST?
Perhaps you recall your child had a hearing test at birth. Or perhaps there was so much going on that it seems like a distant memory. Most children do have their hearing screened at birth by an audiologist, but it depends on the hospital protocol. The test that is done at birth is a screening test to exclude significant hearing loss, but it is certainly worthwhile to repeat the hearing test several times as your child ages. Ideally, your child should have their hearing tested at birth, at one year, at three years and at five years of age. This should be done by an audiologist. Hearing loss can be mild, moderate or severe in severity, or may only occur at certain frequencies.
HOW DO YOU TEST THE HEARING OF A BABY?
The use of a simple, quick test called an OAE (otoacoustic emission). A small probe is inserted in your child’s ear canal and echoes are measured back from the inner ear (cochlea). If the structure of the hearing organ is healthy, then the ear gives off strong echoes (emissions), which are measured by the equipment. Various frequencies can be measured, and this test can even be done on new-born babies. As your child ages, they should have regular hearing tests (at birth and at ages 1, 3 and 5) which use more behavioural measurements. Regular hearing tests are important to monitor your child’s hearing health.
HOW DO I KNOW IF MY CHILD HAS A MIDDLE EAR INFECTION?
Middle ear infections (otitis media) are one of the most common illnesses amongst children under the age of 5! During the infection the child’s middle ear is filled with fluid. This causes a distortion in the sound reaching the child’s inner ear. As a result your child experiences a temporary hearing loss. Here are some signs of possible ear infection: mild or severe ear pain, pulling at ears, fever, discharge from the ear, loss of appetite, vomiting, irritability, trouble sleeping or crying when lying down, balance problems. Some children may have no symptoms at all.
FAQ
ADULTS
Every adult over the age of 50 should undergo a baseline hearing test and have their hearing assessed annually. Audiologists measure the status of the outer, middle and inner ear, and can assist you with hearing instruments, or refer you for further medical management, if required.
WHY SHOULD I GO FOR A HEARING TEST?
Do you remember the last time you had a hearing test? Perhaps you were in school! Every adult over the age of 50 should have a baseline hearing test. This helps you to gather information about your current hearing status, and the predicted future of your hearing. Thereafter, one should have regular tests, to monitor any changes that may occur with age. This should be done by an audiologist. Hearing loss can be mild, moderate or severe, or may occur at certain frequencies only. This explains why people may seem to be mumbling more than they used to, or why you only have difficulty hearing in background noise!
Audiologists are also qualified to provide assessments and management for tinnitus (ringing or buzzing in the ear) as well as dizziness or balance disturbances.
WHAT CAN I EXPECT FR OM A HEARING TEST?
The hearing test will allow you to meet your local audiologist and form a relationship. She will take your medical case history, and ask some questions regarding your lifestyle and any hearing concerns you may have.
Thereafter, she will conduct a visual examination of the outer ear and ear canal, including the eardrum, by directing a light known as an otoscope into the ear canal.
The audiologist will check the eardrum movement and middle ear pressure by using a test known as tympanometry. Then, you will be seated in a quiet, sound-treated booth and respond to a series of beeps by pushing on a button. This provides a concrete measurement of your hearing sensitivity at each frequency.
Finally, you will respond to a series of words at different loudness levels by repeating them back to the audiologist. Then, you will receive a detailed feedback about your hearing sensitivity, as well as any diagnostic concerns that the audiologist may have.
WHAT IF I NEED HEARING INSTRUMENTS?
Hearing instruments (or “hearing aids”) may strike a note of fear or resistance! Many adults remember their parents struggling with hearing aids that were big and bulky, that whistled and eventually landed up in the drawer. The good news is that hearing instruments have come a long way with digital technology, and are constantly improving.
Hearing instruments are programmed specifically for your hearing levels via sophisticated computer software. Most hearing instruments are now compatible with Bluetooth and wireless devices allowing you to answer calls, listen to music or TV via your hearing instruments. Best of all, they are significantly better looking and more discrete than ever before.
If you are a candidate for hearing instrument use, your audiologist can arrange for you to undergo a trial of hearing instruments for several weeks at home, before making your decision.
FAQ
HEARING LOSS
HOW DOES THE HEARING PROCESS WORK?
Hearing is one of the five senses and it refers to the ability to perceive sound by the auditory (hearing) system. Hearing is a complex process, and the ear is more intricate than it may appear.
The ear comprises three components:
- The outer ear
- The middle ear and
- The inner ear
In physics, sound is energy that vibrates through the air in the form of a wave. A sound stimulus (e.g.: a person saying “Hello”) enters the outer ear and sets the ear drum in motion. The vibration of the ear drum in turn causes three little bones in the middle ear (the ossicles) to vibrate and thus pass this acoustic information on to the inner ear. The cochlea of the inner ear is arranged like a piano and converts this acoustic information into electrochemical information. This electrochemical information is then conveyed via the auditory nerve to the brain, where this information is interpreted.
WHAT IS HEARING LOSS?
A hearing loss occurs when there is a breakdown, an abnormality or damage in one or more of the components within the auditory system. If there is a problem at the level of the outer and/ or middle ear (e.g.: a wax plug in the ear canal or a middle ear infection), this is referred to as a conductive hearing loss. A conductive hearing loss typically requires medical management from an ear, nose and throat specialist and is often temporary. If damage occurs within the inner ear and/or at the level of the auditory nerve (e.g.: degeneration of the cochlea caused by the aging-process, we refer to this as a sensorineural hearing loss. A mixed hearing loss occurs when there is involvement at the level of the outer and/or middle ear as well as the inner ear and/ or auditory nerve.
WHAT CAUSES HEARING LOSS?
Both children and adults can present with hearing losses. A person may be born with a hearing loss (congenital), or it can be acquired later in life. Certain hearing losses are genetic, while others may develop from an illness or an injury.
Some causes of conductive hearing losses include:
- Outer ear infection (otitis externa); also known as swimmer’s ear
- Middle ear infection (otitis media)
- An infection of the mastoid bone; the spongy bone positioned behind the ear (mastoiditis)
- Trauma (e.g.: a blow to the side of the head affecting the outer and middle ear)
Some causes of sensorineural hearing losses include:
- Noise-induced hearing loss
- Hearing loss caused by certain medication that is toxic to the ears (ototoxicity)
- Genetic hearing loss associated with certain congenital syndromes
- The aging process
WHAT TO DO WHEN A HEARING LOSS IS SUSPECTED?
If you feel that your hearing “isn’t what it used to be” or if you are experiencing difficulty hearing, particularly in a noisy environment, it is highly recommended that you have a hearing assessment conducted by an audiologist.
FAQ
NOISE EXPOSURE
WHAT IS NOISE?
The word ‘noise’ is one with many subjective connotations. A sound considered to be ‘noisy’ by one person may not be considered ‘noisy’ by another. Noise is essentially unwanted sound that is typically loud and disturbing in nature.
HOW DOES NOISE EFFECT THE AUDITORY (HEARING ) SYSTEM ?
In physics, sound is simply energy that vibrates through the air in the form of a wave. The primary organ of hearing, the cochlea of the inner ear is very sensitive to these sound waves and it is the role of the cochlea to convert this acoustic information into electrochemical information so that this sound may travel to the brain for interpretation. The cochlea is lined with thousands of delicate hair cells, and when exposed to excessive noise, these delicate hair cells are damaged irreparably. Damage to these hair cells causes hearing loss.
HOW MUCH NOISE IS TOO MUCH NOISE?
South African health and safety guidelines stipulate that the maximum intensity (loudness) to which an individual can be exposed safely for 8 hours per day is 85dBS PL. Thereafter, with an increase of only 3dBS PL, the time is halved. In other words, a person should not be exposed to a sound of 88dBS PL for more than 4 hours, and exposure to a sound of 91dBS PL is considered safe for only 2 hours or less. To put these sound levels in perspective; the rustling of leaves creates a sound of about 20dBH L, while general conversation occurs at a loudness of approximately 60dBH L. A vacuum-cleaner or lawn-mower generate noise of 70 to 80dBH L and live rock music is typically played at approximately 110dBH L!
WHAT CAN I DO TO PROTECT MY EARS FR OM THE EFFECTS OF NOISE?
Hearing protection devices (HPDs) are very effective in reducing the amount of sound entering the ear and thus reaching and potentially damaging the delicate cochlea. HPDs are available in different shapes and sizes and the efficacy of these devices is quite varied. The most readily available HPDs are foam ear plugs which can be bought from most pharmacies. Foam ear plugs are not as effective as silicone/ acrylic custom-made ear plugs; which are made to fit your ear canals specifically for improved comfort and noise protection. For maximum protection (e.g.: when using a firearm), ear muffs (which are placed over the ears), paired with custom-made ear plugs are recommended.
WHERE DO I GO TO GET CUSTOM HEARING PROTECTION?
An audiologist takes an impression (measures the shape) of your ear so that custom made ear plugs can be made.
FAQ
TINNITUS
WHAT IS TINNITUS?
Tinnitus (tin-it-is) is the conscious awareness of a sound sensation in either a person’s head or ear/s in the absence of an external sound source. Tinnitus is not limited to ringing in the ears. Some people experience tinnitus as a buzzing sound, a hiss, or even a repetitive musical tone. Tinnitus may be constant or intermittent and the pitch and loudness may vary.
WHY DO I HAVE TINNITUS?
Tinnitus occurs in 15 to 35% of people with normal hearing and presents in approximately 50 to 60% percent of individuals with hearing losses. Different types of hearing losses are more typically associated with tinnitus. Age-related hearing loss and hearing losses caused by significant noise exposure are commonly associated with tinnitus. Tinnitus can be experienced by both adults and children. While many people experience tinnitus, only a few of these people will find it very bothersome or debilitating. The mechanism underlying tinnitus is a complex one. Tinnitus originates from damage occurring to the primary organ of hearing (the cochlea of the inner ear) and asynchronous activity at the auditory nerve (the nerve carrying information from the ear to the brain). This asynchronous nerve activity is experienced as tinnitus and often occurs at a pitch corresponding to the region responsible for interpreting that particular pitch in the cochlea, which has been damaged. An anxious response to the tinnitus can heighten a person’s awareness of the sound, which in turn, can exacerbate this person’s experience of the sound.
CAN TINNITUS BE CURED?
Although the sound of tinnitus may not always be eradicated, it need not be as bothersome to the individual, and its impact on a person’s quality of life can be minimised or managed.
WHICH PROFESSIONALS SHOULD I CONSULT?
Should you be experiencing tinnitus, it is recommended that you consult an audiologist in order to undergo a hearing evaluation. Thereafter, consultation with an ear, nose and throat (ENT) specialist is highly recommended. The ENT will establish whether medical management is required.
INFORMATION