A hearing test is an objective test. Hearing test. Methods for testing hearing and diagnosing hearing impairment Online hearing test all frequencies

The human hearing organ has a complex and at the same time unique structure. So, the ears are responsible for many important functions in the structure of man. First of all, the human hearing organ is necessary for the receptivity of sounds, their processing and conversion into decibels, and then sending them to the brain. In addition, the ear is responsible for human balance.

In case of dysfunction of any department, a person experiences ear pain and headaches, loss of hearing acuity, a feeling of congestion, and others. unpleasant symptoms, which can knock a person out of his usual way of life for a long time. In order to test the sensitivity of sounds, there are hearing testing programs.

Not all people can notice immediate hearing loss. In most cases, sound sensitivity occurs gradually. At this time, a person loses the ability to hear the lowest sounds. To determine the sensitivity of your hearing, you can take a hearing test online or contact a medical center.

However, a person pays attention to minor changes in the ear organ only after a hearing test. But truly human begins to worry only when he notices that the range of audibility has noticeably changed. Usually at this time a person cannot understand a whisper from an arm’s length distance or feels a problem understanding speech on TV or on the radio.

Cause Hearing impairment lies in dysfunction of the middle region of the hearing organ. The middle region is located after the outer part of the ear organ and in front of the inner ear. The middle region does not have a complex, but exceptional structure, and thanks to its work, a person perceives both the highest and low-frequency sounds.

In addition, this part distinguishes and enhances signals, intonations and various noises.

In general, the following elements are responsible for the operation and transmission of sounds:

1. Outdoor area. It includes the auricle and the external auditory canal. It is separated from the middle region of the hearing organ by the eardrum.
2. Middle ear. After eardrum contains the middle ear, eustachian tube and auditory ossicles.
3. Interior has one of the most unusual structures in the human body. The second name of the described area is a labyrinth. The main task of the labyrinth is to maintain human balance.

IN anatomy ear includes the following elements:

• curl;
• antihelix;
• antitragus;
• earlobe.

Due to its complex and unique structure, various bacteria and infections rarely enter the hearing organ, and external factors cannot affect human health.

Therefore, almost all ear diseases occur during periods of weak immune system or as a result of the penetration of viruses through the nasopharynx.

The structure of the middle part of the hearing organ

As we have already found out, the reason for decreased hearing acuity and other inflammations lies in a disease of the middle part of the ear. Before identifying the reasons, let’s understand the structure of this element.

Everyone knows that the middle ear is located behind the eardrum and is located near the temporal part. In the depths of the temporal region are located the following parts of the middle ear:

1. Located in the temporal bone mastoid. It connects the tympanic and temporal parts.
2. Between the temporal region and the external ear canal there is a tympanic cavity.
3. This area is connected to the nasopharynx using the Eustachian tube. Its functions include pressure regulation.

These three elements have numerous functions and additional structures.

So, the main area of ​​the middle ear is tympanic cavity. Its structure includes the following components:

1. The hammer is adjacent to the eardrum. It transmits the received sound waves further to the auditory ossicles.
2. The second component of the bones is the anvil. It is located after the malleus, but before the stirrup. The main function of this bone is to transmit sound vibrations further in the direction.
3. The stapes covers the auditory ossicles. Its function is to transmit sound vibrations to inner ear, and then to the brain. Interestingly, this area is considered the lightest bone not only in the ears, but in the entire body. Its size is about four millimeters and its weight is 2.5 mg.

All of the above elements convert sound waves or noise and transmit the processed sounds further to the internal part.

If one bone is damaged, dysfunction of the entire section occurs, and as a result, loss of hearing acuity.

Besides, to tasks auditory ossicles includes:

1. Maintaining eardrum function.
2. Adjusts and reduces very high sounds.
3. Adaptation of the ear to the perception of different sounds in height and strength.

You should visit an ear doctor twice a year. This way you can avoid many types of inflammation.

There are special sounds for hearing testing. When examined by an ENT doctor, do not forget to undergo a hearing acuity test.

A hearing test, or audiometric test, or simply put, audiometry, is part of a hearing examination that tests how well sound is perceived by the brain.

The sounds we hear are vibrations of air, liquids or solid materials in environment. Vibration creates sound waves with their own frequency and amplitude. The frequency of vibration determines the pitch of the sound, and the amplitude determines the volume.

When sound waves enter the ear, they become nerve impulses, which our brain perceives and we recognize sound.

In general, a hearing test helps determine whether a patient has hearing loss. In this article we will look at different ways hearing tests.

2. Why have your hearing tested?

A hearing test may be done to:

• Check newborns and small children to identify hearing impairments. Hearing problems can prevent children from developing normally, so it is best to diagnose them early.
• Check possible deterioration hearing in those patients who notice problems with hearing and perception of audio information;
• Determine the type of hearing loss: conductive or sensorineural. Mixed types of hearing loss are also possible.

3. How to prepare for the test?

Tell your doctor if

• You have recently been exposed to loud noises that caused ringing in your ears. Avoid loud noises before the test, as they may interfere with the actual result.
• You are taking medications that may affect your hearing.
• You have problems understanding normal (soft) speech.
• You have recently had a cold or ear infection.

Before the test, the doctor may also examine your ears and remove any accumulated earwax, because it may interfere with your hearing test.

If you are undergoing a hearing test wearing headphones, you will need to remove your glasses, hair clips, and any other items that may interfere with your headphones.

If you wear a hearing aid, you may also be asked to remove it.

4. How is hearing tested?

In this section we will look at different methods hearing tests.

Whisper hearing test

This test is the simplest and is known to everyone early age. During a whisper hearing test, the doctor will ask you to cover one ear and repeat the words behind it. During this test, the doctor may change the distance between you.

Pure-tone audiometry

Pure-tone audiometry uses a special device (audiometer) that plays a series of sounds through headphones. Sounds vary in pitch. During pure-tone audiometry, the doctor will lower the sounds until you say you can no longer hear them. The doctor will then slowly turn up the volume until you say you can hear the sounds again. During pure-tone audiometry, each ear is tested separately. After checking through the headphones, you will need to remove them. The doctor will now use a special device that is placed on the bone behind the ear and repeat the test.

Tuning fork test

A tuning fork is a special iron two-pointed fork that produces a sound when struck. The doctor will measure your hearing by producing a sound different places, and check the response of your hearing organs.

Speech perception and word recognition

This type of test is used to measure how well you hear and understand words during a conversation. The doctor will ask you to repeat a sequence of simple spoken words.

Audiological screening (otoacoustic emissions)

This test is used for infants. A small microphone is inserted into the child's ear and measures the ear's response to sound.

Auditory brainstem response

This type of test allows you to detect hearing impairment such as sensorineural hearing loss. During this test, electrodes are placed on the head and measure brain activity while sounds are played.

What's worth knowing?

The hearing testing methods presented in our article are not all possible tests. Your doctor can suggest his own method, which will certainly help diagnose possible problems with hearing or determine the cause of hearing loss.

Hearing testing is carried out by 2 main groups of methods: objective and subjective. Objective methods based on the emergence unconditioned reflexes. Subjective methods include acoustic and audiometric methods.

Find the answer

Hearing assessment methods

Objective methods of hearing research do not require the direct active participation of the patient and are more often used in pediatric practice (in newborns and children under 3 years of age).

All newborn children undergo audio screening - the study of hearing by recording otoacoustic emissions.

An objective hearing test is used:

• For diagnosis in disabled people, patients in a comatose state;
• For solutions controversial issues examination and rehabilitation.

The acoustic method includes examination of hearing using spoken and whispered speech, and examination with tuning forks. The audiometric method is a hearing test using an audiometer. In the practice of an otorhinolaryngologist, both of these methods are used.

Indications for ear examination

Hearing is required to be checked during medical examinations for workers employed in noisy industries. The test is carried out first using the acoustic method and then using the audiometric method.

Hearing is required to be checked by the driver's commission.

In pediatric practice, if there are no hearing complaints, the doctor checks the child’s hearing when registering for kindergarten and school. If a patient (adult or child) complains of ear pain, congestion, or hearing loss, an otolaryngologist will conduct a hearing test before and after prescribing treatment.

Diagnosis of eardrums

Let’s imagine a situation: a person came to see an ENT doctor complaining of hearing loss. The doctor collected anamnesis, identified complaints, and performed an examination.

If there are no foreign objects or wax plugs, which often cause hearing loss, the doctor begins to check the hearing analyzer.

Video

Acoustic testing method

1. Spoken speech test. The doctor or nurse asks the patient to stand in a certain place in the office, cover one ear with a hand or cotton earplugs, turn toward the wall, or close his eyes. Why turn away or close your eyes? Many people, without knowing it, can “read” lips.

   For the study to be reliable, this “auxiliary” maneuver must be excluded. When the patient is ready, the doctor comes close and speaks numbers or words in a loud and clear voice. Words and numbers containing both voiced and voiceless consonants are used: cup of tea/cat/mouse and house/girl/frog.

   In children, phrases that are understandable to children are more often used, and in the study of adults, numbers are used. The doctor gradually steps back from the patient, continuing to speak until the distance between the doctor and the patient is 6 meters.

   Then the same procedure is repeated with the other ear. 6 meters is the minimum distance at which a healthy ear can hear spoken and whispered speech.

2. Whisper speech test. After preparing the patient (the same as when testing spoken language), the doctor or nurse pronounces phrases and numbers in a loud, clear whisper, gradually moving away from the person being tested until the distance between them reaches 6 meters.

   If the person being tested has a hearing of 6:6 for spoken speech and 6:6 for whispered speech, he is absolutely healthy in hearing and can be hired for any job, even in noisy production. If the hearing is impaired, and at least one ear can hear at a distance of less than 3 meters, such a patient cannot be allowed to work in noisy production and at heights.

   When testing children, especially preschoolers, it is advisable to pronounce phrases that are familiar to them: names of animals, names fairy-tale heroes. You can not say a word, but ask your child a question that requires an answer, for example: “do you like candy?” etc. (joking check).

3. Tuning fork tests. Testing with tuning forks is usually used not during preventive examinations, but when dealing with complaints of unilateral or bilateral hearing loss. Tuning fork - musical instrument, issuing clear sound a certain frequency.

   In medicine, tuning forks with a sound frequency of 128 (C128) and 2048 (C2048) per second are mainly used. 3 tuning fork tests are used: Weber, Rinne, Schwabach.

Audiometric test method

Testing on the device is carried out using an audiometer. The device generates a sound signal of varying intensity (from 0 to 120 dB) at different frequencies (from 125 Hz to 8000 kHz).

First, air conduction is checked, then bone conduction. The hearing threshold is considered to be the perception of a signal with an intensity of 10 dB at a frequency of 125 Hz.

How is audiometry performed? First, air conductivity is checked - the person being tested is put on headphones and a sound signal of the same intensity at different frequencies is sent to each ear separately, then the intensity increases.

As soon as the patient hears a sound, even the quietest one, he presses the button. The signal is recorded by the audiometer operator and transferred to the audiometric form. Air conduction is recorded for each ear separately.

Then bone conductivity is measured - a special bone microphone is installed on the mastoid process (behind the ear), the principle of signal transmission is the same as during measurement air conduction. Bone conduction is usually lower than air conduction, and there is a small interval between them on the audiogram.

In children's practice, audiometers are sometimes used that produce not just a sound signal, but a word specific for each frequency, constantly increasing the intensity of the sound.

Why does hearing decrease in diseases?

Hearing loss with various diseases can be reversible and irreversible. Reversible changes are more often associated with inflammation of the cells of the outer, middle or inner ear, inflammation and narrowing of the auditory tube.

Irreversible changes are associated with the death of cells of the receptor apparatus or the auditory zone of the cerebral cortex.

The causes of hearing impairment can be divided into 2 large groups:

• Violation of sound transmission;
• Impaired sound perception.

Violation of sound conduction is associated with diseases of the sound-conducting apparatus:

• External auditory canal ( otitis externa, sulfur plug, foreign bodies ear canal);
• Middle ear (acute and chronic otitis media, exudative otitis media, tubootitis, myringitis);
• Inner ear (labyrinthitis).

In these diseases, hearing is impaired because sound does not travel properly. ear canal, is not perceived by the eardrum, is not amplified by the chain of auditory ossicles, etc. Hearing changes due to sound conduction disorders are often reversible and go away after proper treatment.

Impaired sound perception is a more complex pathology, according to various reasons the functioning of the receptor apparatus of the inner ear and/or the auditory zone of the cerebral cortex suffers.

Such changes are caused by:

1. Trauma: traumatic brain injury, fracture of the temporal bone, barotrauma;
2. Infectious disease, especially in children: influenza, measles, rubella, tick-borne encephalitis;
3. Taking ototoxic drugs: gentamicin, other aminoglycosides;
4. Dysmetabolic disorders: microangiopathy in diabetes mellitus;
5. Age-related changes: as a result of atherosclerotic damage to the vessels of the head and neck, the blood supply to the inner ear suffers and senile hearing loss develops.

Hearing loss due to impaired sound perception is sometimes curable, but requires longer and more persistent treatment with specific drugs:

• Neuro- and angioprotectors;
• Preparations that improve tissue trophism;
• Histamine receptor blockers.

How to test your hearing for the effectiveness of treatment

Improving hearing as a criterion for recovery can be taken into account in the treatment of diseases of the sound-conducting apparatus (otitis media/myringitis, etc.).

The course of treatment is usually 7-10-14 days, rarely more. And in case of recovery, the patient himself notes an improvement in hearing.

In case of damage to the sound-receiving apparatus, a reliable criterion for the effectiveness of treatment is considered to be improvement in hearing (according to the results of acumetry and audiometry) with repeated studies after 3 months of taking prescribed medications.

Possible consequences of hearing loss

A disease associated with hearing impairment is medically called hearing loss. It may vary in severity and cause. Hearing loss is temporary or permanent. It may be curable or progressive. Depending on the severity of the hearing loss and when it occurs, the impact on the patient's life will vary.

It is most difficult to determine hearing loss in a child. More often it manifests itself in the fact that there is no reaction to loud sounds. The child does not lose hearing completely, but he or she may not be able to hear part of the sound spectrum. This situation leads to slow development of speech. The child speaks poorly and has a small lexicon, does not respond to requests from adults.

If hearing loss is not treated for a long time, then destructive processes occur in the cerebral cortex. Gradually, the area responsible for hearing begins to decrease in size and completely atrophies. It is no longer possible to restore brain function to its original state.

IN school age this leads to problems during training. Children with moderate and severe hearing loss are forced to study in schools. They are less adapted to independent living. Light form hearing loss often characterizes patients as inattentive, distracted individuals. It is often said about them that they only hear what they want. Every day is for them increased stress, you have to listen to every word to get the full amount of information.

The most pronounced consequences are moderate and severe hearing loss, which cannot be treated or become advanced. With moderate severity of the disease, a person tries to take a defensive position, he participates less in public life, and begins to gradually isolate himself. In conversations, the patient either dominates or tries to avoid it.

The more severe your hearing loss becomes, the more difficult it is to hide it from others. In the absence of treatment, the patient limits social contacts, avoids mass events. Distrust and hostility towards the world around us leads to paranoia and isolation. Sometimes aggression and anger towards loved ones manifests itself.

In cases of severe hearing loss and the absence of treatment for the disease, among the consequences are: complete destruction social life, alcoholism, drug addiction, as an attempt to escape from the surrounding reality. Ultimately, the patient faces a transition to the “deaf” world. If hearing problems are detected, it is necessary to promptly diagnose and begin treatment.

How much does a hearing test cost?

Diagnosis of hearing loss can be carried out in a city clinic according to the medical pole or in paid center. In the first case, the procedure will be free, but it may not meet the requirements of a particular situation.

In a paid center it is possible to conduct more than wide range research.

1. An examination by an ENT doctor is the first stage in identifying hearing problems. The doctor examines the auricle and examines the eardrum for damage. Conducts speech research. The cost of an appointment with a doctor, depending on the medical center, ranges from 1000 to 1500 rubles.
2. Study with tuning forks. This examination is necessary to detect air and bone conduction. A set of tuning forks with different tones is used for the study. The method is more subjective and depends entirely on the professionalism of the doctor. Its cost is about 500 rubles.
3. To determine the volume that a person hears, it is necessary to conduct speech audiometry. The study is carried out in a soundproof room. All results are recorded on tape. The cost is about 1000 rubles.
4. In serious cases where brain dysfunction is possible, an MRI is necessary. The cost of the examination is about 2000 rubles.
5. Electrocochleography is required to diagnose cochlear activity and auditory nerve. The cost is from 1200 rubles.

Price paid services Diagnosis of hearing loss will vary in different medical centers. Lowest prices in government institutions providing paid services.

Where can you quickly and accurately check your hearing?

The very first hearing test is carried out on a newborn. postpartum department. If the first test was successful, but parents have doubts about the baby’s hearing, they should contact an ENT doctor at a city clinic. The doctor will conduct an examination and carry out the necessary tests.

If there are suspicions of serious abnormalities, he can issue a referral to specialized research institutes. There are 2 centers in Moscow.

1. NCC of Otorhinolaryngology. Located on Volokolamsk highway. The center turns out to be all kinds medical care for ENT diseases. The structure of the complex includes laboratories, research centers, clinic. We employ specialists of a wide range of profiles. At the NCC you can get advice, carry out full examination, implement surgical intervention.
2. Research Institute of Pediatrics. Science Center Children's Health RAMS is a broad-spectrum structure. It includes a clinic, a hospital, and a scientific department. The main task of the research institute is to provide medical care in all main areas.

All studies related to hearing loss can be carried out in paid diagnostic centers. There are these in every city. The main role is played not by the name of the clinic, but by the training and professionalism of the doctor who will perform the procedure.

What does a hearing test tell you?

Hearing testing may be required at different ages.

Timely execution diagnostic studies gives its results.

1. In case of acute hearing loss, diagnosis is carried out in a hospital setting. There's an emergency there too complex treatment. More often it is antihistamines, antibiotics, ear drops. Treatment is aimed at restoring hearing and eliminating the inflammatory focus.
2. At frequent illnesses in children, especially if they are associated with the growth of adenoids, diagnosis is necessary to identify hearing impairment. The appearance of hearing loss is a direct indicator for surgical intervention.
3. Diagnosis of hearing loss caused by infectious diseases, allows you to completely eliminate the source of infection and provide adequate treatment. Timely help prevents progression of the disease. Hearing is restored completely.
4. For abnormalities in the development of hearing organs timely diagnosis allows you to take action in a timely manner. In some situations, surgical intervention or installation is possible hearing aids. Such an adjustment will allow the child to hear the entire spectrum of sounds, therefore, his speech and all parts of the brain will develop harmoniously.

Without diagnosis, hearing loss will gradually progress, which will lead to irreparable consequences in the patient’s life.

When you want to choose headphones, you research them specifications, where among others there is the value o. This value is important because it reflects the technical ability of headphones to reproduce frequencies that a person can hear.

If a person’s hearing is not damaged, then he can distinguish sound at frequencies from 20 Hz to 20,000 Hz. However, this is ideally real life our range will be different, and what’s more sad, it will be narrower than the classic 20 Hz - 20000 Hz.

What does a person hear and what does hearing health depend on?

The older we get, the worse our hearing becomes. Like everything else in our body, hearing begins to perform its tasks worse with age.

Those who are already about 30 years old can hardly distinguish a sound at a frequency of 20,000 Hz; they simply do not hear it, because hearing began to deteriorate. This is not a disease and not something to seriously worry about, this is how our hearing organ works - it does not recover and only gets worse over time.

By the age of 40, you most likely will not be able to distinguish a sound at a frequency of 18,000 Hz or even 17,000 Hz, and by the age of 50, it is considered good to hear a sound at a frequency of 15,000 Hz.

Of course, each person’s hearing is unique; someone even at 50 years old can hear a sound with a frequency of 17,000 Hz, while others cannot even hear 12,000 Hz.

As I said above, hearing is not restored. The design of the organ is such that what an irritation nerve endings respond to special hairs that move when exposed to sound, i.e. air. With age, some hairs die off, while others are irreversibly damaged by listening to loud sounds.

Yes, yes, hearing can be damaged simply by going to concerts frequently, or working as a construction worker with heavy equipment, like a jackhammer, without hearing protection.

Every day we subject our hearing to serious tests, and every day it gets worse. Even a trip on the subway without headphones with active noise reduction slightly worsens our ability to perceive sound every time, and this is irreversible.

Therefore, you need to think about health from a young age, without expecting a noticeable degradation of the ability to hear, because there is no turning back.

Online hearing testing

Well, enough theory, let's check how well you hear different sound frequencies.

For simplicity and clarity, there will be only 4 frequencies that will show your current capabilities.

The fact is that hearing degradation occurs from the edges of the audible range, provided that there is no injury to the eardrum or disease of the inner ear.

Thus, it is clear that if changes in hearing have begun, then you will begin to hear worse at the border of the possible, i.e. at a frequency of 20 Hz or 20000 Hz. And the narrower the range, the more your hearing is damaged.

If you hear sound at 20 Hz, then you are fine with the perception of the lower threshold and that’s great. This means your hearing is more or less good condition, but don’t rejoice ahead of time, let’s listen to the following sounds.

Sound at 250 Hz is very important for our life. A lot of sounds from the surrounding world, people and animals sound approximately at this frequency, so if you hear it, then you can live a full life normal life. But if you can’t hear it, this is a reason to immediately consult a doctor; even very old people who have not had hearing injuries can hear this sound well.

Sound at 2 kHz here only for the general picture, it should be heard by absolutely all people who have not had injuries to their hearing organs or their serious illness. This is one of the most loaded frequencies, because Most instruments sound at this frequency. Also, quite a few high-pitched female voices use this frequency and therefore it is extremely important for human life.

This is a test piece that reproduces 16 kHz audio. According to statistics, not every person who has lived to be 30 years old can hear this sound. Therefore, if you cannot hear it well and you are over 30 years old, then no big reasons for frustration. Of course, it’s a pity that your hearing has begun to deteriorate, but you are not yet outside the norm and there is no particular reason to worry. Although, of course, going to a doctor and having your hearing tested using professional equipment would not be a bad idea.

Let me just say that I am now 34 years old and I hear sound at a frequency of 16 kHz clearly and distinctly. Perhaps I should praise myself that I hear a little more than my peers.

This is a test recording sound with a frequency of 20 kHz. According to statistics, not all people over 20 years of age can hear it, even if they have never had any injuries or diseases of the hearing organs.

If you are over 20 years old and have not heard anything, do not be upset, this, unfortunately, is normal.

Personally, I no longer hear this frequency, but I am already 34 years old and this is absolutely normal for my age, although, of course, a little sad.

Why hearing testing is important for everyone

Of course ours online testing hearing is quite fluent, moreover, it was carried out on your personal equipment, which can cause distortion and disrupt the purity of the experiment.

However, even such testing may make you think about your hearing health. After all, if you are still young, but already have trouble hearing the 16 kHz frequency, then you probably need to see a doctor for a more serious approach to this problem.

Plus, this quick test shows that for people over 30, there's little point in worrying about not listening or having Bluetooth headphones as their primary headphones.

The fact is that codecs for wireless transmission of music from music save the bandwidth of the Bluetooth channel, thereby increasing the stability of data transmission. And if you are young and listen to records, then you should think about using quality wired headphones. But if you are already 40 years old or older, then the quality of music transmission via Bluetooth will be enough for you, because... Those frequencies that are artificially cut off during encoding, you most likely will no longer hear and will not feel the difference in sound quality.

As you can see, every cloud has a silver lining. Yes, we are all getting older every year, and our hearing is fading, but now we can listen to comfortable music without a twinge of conscience and not worry about the quality of music transmission; online hearing testing has clearly shown us that this no longer matters much.