Audiology and Hearing Aid Services

Auditory Brainstem Response (ABR/BAER)
Is a hearing test that analyzes the brain’s electrical impulses to sounds. It is used for two purposes; to test hearing thresholds and to assess the functional status of the auditory neural pathways. They are often used for kids who cannot perform the Audiological evaluation. In Adults its used identify possible caused of hearing loss, such as tumors along the auditory pathway and diseases like multiple sclerosis. The ABR uses electrodes that are placed on your head along with ear inserts that are placed in each ear. In adults they must remain still and quiet however kids must be asleep.  Routinely an ABR test can last between 1 & 2 hours but can be shorter and usually its never painful.

Auditory Processing Evaluations
Aside from providing hearing test & fitting hearing aids we also provide auditory processing evaluations for those who have trouble processing sounds such as the ability to hear a sound but not being able to make sense of it. This condition occurs in both adults and children. The most common condition is Auditory processing disorder (APD) or Central auditory processing disorder (CAPD). The evaluation will involve the assessment of listening-in-noise which is created to provide actual everyday environmental experiences. We also assess specific issues with competing information to gather additional understanding into the capacity to prioritize acoustic data.

Balance Assessment
Dizziness, Vertigo, unsteadiness or imbalance can be related to the ear specifically the vestibular system.  Typically, a physician will request vestibular balance functional testing to confirm and/or rule out the cause of your balance/Dizziness illness or complaint.  A variety of tests determine the source of your balance/dizziness such as hearing tests, balance function tests (Dix-Hallpick), or brainstem response evaluation. The most common condition is Benign Paroxysmal Positional Vertigo (BPPV) It occurs when the crystals in your vestibular system dislodge and float in you semicircular canals, most commonly the posterior canals, which causes additional disturbances in the canals during certain movements. In most cases it can be controlled with medications and in other cases with maneuvers such as Epley/Canalith repositioning and/or vestibular exercises.

Battery Club Members
Hearing aid battery club members not only receive special discounts on hearing aid batteries but also receive bulk discounts as well as free batteries after a certain amount purchased.  The Battery Club not only saves you money but it’s a convenient way to make sure you always have hearing aid batteries when you need them. If its not already lucrative to join you also receive free hearing aid trouble shooting and manufacturer estimates for your peace of mind.

Battery Sales
We always keep a supply of the best and freshest batteries for you to purchase in our office. Be sure stop by routinely for the highest quality batteries and don’t forget to join the battery club and save. Make sure to check the batteries in your hearing devices often and make sure there is no dirt, wax or debris interfering with the batteries performance. If you are have trouble checking your batteries we provide battery testers to put you at ease. Always remember to properly store your batteries as they hate temperature chances. A quick tip to check if you batteries are properly charged is to cup your hand after it has been inserted in your ear, when you cup your hand over the hearing aid it will make a high pitch squeal noise. Click here for more information on Hearing Aid Batteries.
Our batteries come in the following sizes:
•    Size 10 (yellow)
•    Size 312 (brown)
•    Size 13 (orange)
•    Size 675 (blue)

Cell Phone Accessories
Such as Non-custom and custom earmolds of all materials and colors for cell phone headrests, Bluetooth compatible and hands-free devices.

Cerumen Removal
Cerumen, or ear wax, should be removed annually from the ear canal or when it begins interfere with listening or it begins to cause discomfort. Your especially susceptible if you use earswabs or wear hearing aids. Cerumen build up and impaction can be removed using manual extraction, irrigation and suction. It is always advisable to use cerumenolytics (earwax softener) to avoid discomfort the day of the procedure.

Cochlear Implant Mapping & Adjusting
CI Mapping is the term used for programming a cochlear implant which is not much different from hearing aid programming. Cochlear implant maps are set using a computer program based on an individual’s response to sound through the cochlear implant device. An implant can also be adjusted just like a hearing aid can based on the patients preferences after initial mapping has occurred.

Counseling on the use and care of your hearing aids and accessories
High trained medical staff is always available to trouble shoot and/or help you with any and all problems you may be having with your ear molds, monitors, assistive listening devices & hearing aids.  They also can help you and/or discuss aural rehab strategies or techniques to help you listening better with your hearing aids on a daily basis.  We always encourage family members or caregivers to accompany you and become well versed about all there is learn about hearing aids.

Diagnostic Audiologic Evaluations
Scheduled and performed by our California licensed and nationally certified Audiologist & Hearing Healthcare Professional. A diagnostic Audiological evaluation is the first step and the most comprehensive exam in determining your hearing capability. It consists of a variety of tests to determine your hearing deficit and your ability to detect and understand speech. If you present with a hearing deficit, it will detail the type, extent, and specifics of your deficit as well as allow us to accurately recommend the proper treatment and or a hearing aid recommendation. Insurance often covers these services as we are the preferred provider in hearing health.

Diagnostic Hearing Evaluations
During your examination you will be tested using pure tones at different frequencies, both low and high with the use of headphones. A similar test will also be performed using a bone conductor headphone. The results will help determine if the hearing loss is originates from the outer/middle ear or the inner ear. Another test using a series of low & high frequency words to determine your ability to understand verbiage/words will also be performed (testing may be performed in quiet or noisy backgrounds). The results will help us determine degree of hearing loss, ability to decipher speech and candidacy for hearing aids.

Ear Impression
Is based on the exact contour of your ear. It’s the blueprint from which any custom-fit in-ear product (earmolds, hearing aids & in ear monitors) will be produced, it ensure that you product fits perfectly and the finished product can only be as good as the impression. Any deficiencies in the ear impression will greatly affect the patient’s satisfaction, comfort, and use of the finished earpiece. . An Audiologist is trained to assure a good impression every time.

Evaluation for Auditory Processing Disorders (APD)
Auditory processing is the terminology used to describe how you neurologically recognize and interpret sounds. An auditory processing disorder (APD) affects the brain’s ability to process or interpret auditory information correctly, regardless of hearing acuity and age (They hear but don’t understand what was heard). APD evaluations are usually performed on school-age children. The test is not limited to children as many adults are also examined. Testing for APD consists of a hearing test and several tasks where words or sentences must be repeated in different listening conditions. The evaluation will not solve the problem, but give insight as to why the patient is encountering problems at home, school or work.

Evaluation and demonstration of Assistive Listening Devices (ALDs) including FM systems, Alarm Clocks, TV and Phone Amplifiers
Assistive listening devices are products that can assist a listener in performing day-to-day communication more easily. ALDs make hearing easier and reduce the overall stress and fatigue of listening. They can be used with and without hearing aids; they can be used at home to make alarms as well as used to increase volume on televisions and telephones.  Additionally they can also be used as neck level microphones for better listening in noisy environments.

Evaluation and Fitting for Musician’s Ear Plugs, Custom Molds & In Ear Monitors
Baseline hearing test is performed to monitor the effects of noise exposure over time. Hearing protection is discussed in detail as a means to protect hearing and prevent hearing loss. Depending on the need of musician an impression is usually perform to customize the musician devices. If Musician’s or standard earplugs are chosen, the degree of noise reduction must be decided on. In ear monitors are also an option for hearing protection but are usually used to listen to music or to hear a personal mix of vocals & stage instrumentation for live performance or recording studio mixing. Click here to learn more!

Involves the programming of your hearing aids to your personal and individualized optimum settings as well as your personal impression of how well you can hear. This adjustment process is carried out with the use of a computer using the hearing aid manufacturers’ software.

When adjusting and programming your hearing aids we always use you audiogram along with various measurements, such as real ear measurements to check how well you can hear. After assuring that hearing benefit was accomplished we will teach you how to operate, clean and operate them. This will ensure that the sound quality remains as good as ever, and will extend the life of your aids.We will also instruct you on insertion and removal as well as energy supply of batteries. Lastly we will discuss your hearing aid wear time, usually wear time on new hearing aids is a few hours for a few days in your regular surroundings.

Follow-up Care
Its company policy that your return for your follow up visit. Necessary hearing aid adjustments are made at that time and are based upon what you tell us about how well you heard in your environment and/or surroundings, Additional questions and concerns are also answered. Once your hearing aids have been fitted to your complete satisfaction, we will provide you with a 3 month aural rehab appointment where we will discuss hearing strategies to help you maximize you hearing aid performance. If you chose to return sooner, you’re more then welcome to come in at any time.

Follow-up Care
Once your hearing aids have been fitted to your complete satisfaction, we will provide you with detailed information on how they should be maintained. Of course, you can have your hearing aids checked by us at any time. This will ensure that the sound quality remains as good as ever, and will extend the life of your aids.

Getting Hearing Aids
After a through history of your medical condition and your personal expectations regarding your hearing, we will provide you with detailed explanation on the most appropriate hearing aid technology, amplification products and treatment options to meet your requirements. Below are some questions to think about:

•    Which ear has a problem hearing, date of onset & degree of hearing deficit?
•    Which type of hearing aid you interested in: Fully digital, Bluetooth, smart or artificial intelligence.
•    Do you want access to a volume control or a hearing aid that adjusts automatically, do you want TV or phone accessories.
•    Which style of hearing aid to you prefer? A invisible-in-the-canal, Completely-in-the canal, In-the-Canal, In-the-Ear (ITE), or behind-the-ear aid (BTE) aid?

Hearing Aid Dispensing & Fitting
At the hearing aid fitting appointment, you will receive your customized hearing aids you selected.  They are pre-programmed based on a prescription that is specific to each person’s hearing loss.  The hearing professional may make adjustments after real ear measures or after you tried the hearing aids. Its important that you are critical during the first visit so that we can make sure the settings and fit are ideal and satisfactory for you.

Hearing Aid Repairs
Many repairs can be made at our office so do not hesitate to bring you hearing aid for a quick check and diagnosis. Minor hearing aid repairs can be done quickly usually on the same day in the office setting; major repairs will need to be sent to the manufacturer for repair. In some cases the manufacturer will provide a quote if its not covered by your repair warranty. Your Audiologist can help determine what kind of a repair is necessary and cost effective. Remember your not alone if you feel your hearing aid is not working properly.

Hearing Aid Evaluation and Selection
During a hearing aid evaluation, you will meet with an Audiologist who will discuss with you the different styles, colors, technologies, and benefits to wearing hearing aids.  In some instances you may have the opportunity to try different hearing aids in the office or you may select the level of amplification with the use of a master hearing aid.  Ear impressions may be taken of your ears, if you decided on a style that requires customization (like ITE, ITC, CIC, IIC)

Hearing Evaluations for Children
A hearing tests for children are often not as simple as an adult hearing. Our pediatric audiologists are trained in various techniques to help facilitate the evaluation of children. Typically toys, games, and lights are used in a sound proof room to help obtain responses to tones, noises, or words.  The child may wear headphones, insert earphones or listen to the sounds through speakers that are specifically arranged. Click here to learn more about preparing your child for a hearing evaluation.

Hyperacusis (sound sensitivity & decreased sound tolerance) Evaluation and Management. Hyperacusis is a rare ear disorder that makes it hard to deal with everyday normal sounds.  The Hyperacusis evaluation will help you identify how much it affects your daily life and establish treatment options that can help you manage or even remove your sound sensitivity. The following components are traditionally included in the overall tinnitus evaluation:

  • Hearing Assessment
    • Case History/Tinnitus Intake Interview
    • Medical Referrals
    • Otoscopic Examination
    • Audiometric Evaluation
      • UCL
    • Immittance
    • Otoacoustic Emissions
  • Questionnaire (HQ)

Industrial hearing screenings
OSHA requires that all workers who are in occupations where excessive noise is possible to receive regular hearing tests due to the high risk of noise induced hearing loss.  We test all of the standard pure tone frequencies using only calibrated audiometers in a sound-isolated booth according to OSHA standards. These hearing screenings usually take about 30 minutes. The goal is to establish a baseline hearing screening or how well your employees are able to hear before they start working. For existing employees it helps identify a potential change in hearing as they are exposed to noise at work. Click here to learn more!

In Office Services
We offer ongoing cleaning and maintenance services after the purchase of your hearing aid to ensure that your device is functioning at optimum performance and providing you with the benefit your entitled to. We encourage and require that all our patients frequent our office on regular basis for hearing aid check-ups and cleaning. For you peace of mind Repairs, Maintenance, Cleanings, and Warranties are standard in all brands of hearing aids.  In-office repairs usually possible on most makes/models but on occasion they must be sent out to the lab for repair.

Live Speech Mapping (Real Ear Measurements)
Live Speech Mapping is a customized fitting procedure that uses probe microphones, live real-time speech and a monitor to allow the patient and their loved ones to watch and understand the as adjustments are made, how they affect your ability to hear and the difference that a properly fitted hearing aid can make.

Newborn Hearing Screenings
The majority of infants born in hospitals are screened for hearing prior to discharge.  If the newborn does not pass the screen, a rescreen is usually done. If the infant does not pass the second time, the infant is referred to a specialist for further testing. Babies who did not receive a hearing screening at birth should be screened within the first month of life. The first type of hearing test is called a BEAR and typically uses small headphones and stickers that attach to the baby’s skin.  A soft clicking sound is played in each ear, and a computer measures electrical brainstem response to the emitted sound. The other type of hearing test can be a OAE/DPOAE test and it usually only involves a small probe inserted into the patients ear that plays a series of tones. The test is painless and usually does not disturb infants sleep

Otoacoustic emission testing allows the audiologist to understand how the outer hair cells of your inner ear are working. In an OAE test, a small probe containing a microphone and speaker is place into the ear and its function is to generate a serious of tones and record how the haircells in the cochlea react. This reaction is a faint sound known as an otoacoustic emission. Typically when hearing loss exceeds 25-30 decibels (dB), no sounds will be produced. OAE testing is commonly used in all Audiological protocol as well as in newborn hearing screening.

Pediatric Audiological Evaluation

  • Behavioral audiological testing is non-invasive and is really fun! The audiologist will first try to look in the child’s ears to check the condition of the ear canal and the tympanic membrane (the ear drum). After that, the audiologist will typically perform some preliminary tests to make sure the ear drum and the cells of the inner ear are working properly. Neither one of these tests cause pain, but they require the child to tolerate a small rubber tip in his or her ears, and to sit quietly for about 30 seconds per ear. After the preliminary tests have been attempted, the child will go into the sound booth either by themselves or with a parent.
  • Children between the ages of 6 months and about 2.5 years old will typically be tested using Visual Reinforcement Audiometry (VRA). The child will sit on their parent’s lap and will listen to sounds either through a speaker or headphones. The audiologist will train the child to turn his/heard heads to a screen or reinforcer every time they hear a sound. Children typically respond to sound very well during this test, and end up having a lot of fun!
  • Children between the ages of 2.5 years and 5 years will go into the sound booth with the audiologist or an assistant and will play a listening game. This is called Conditioned Play Audiometry (CPA). Children typically learn this game very quickly, and the necessary information can be obtained in as fast as 15 minutes. If the child can continue with testing, the audiologist may then play a picture pointing game or have the child say some words to assess their ability to perceive speech.
  • Children over the age of 5 can typically participate in standard audiometry, through which they will push a button or raise their hand every time they hear a sound and repeat words that are said to them.

Watch our Pediatric Video

Test & Audiometry
An audiometry examination tests how well your hearing. It specifically tests the intensity and the pitch of sounds, indirectly balance issues, and other issues related to the external, middle and inner ear. A doctor who specializes in diagnosing and treating hearing & balance called an audiologist administers the test. The test is also used to tailor your hearing aid to your individual needs, It’s first determined by developing you personal hearing profile, otherwise called “audiogram.” This is done by testing your ability to hear a variety of tonal and speech sounds.

Tinnitus Evaluation and Management
Tinnitus is described as a sound in the ear (ringing, buzzing, roaring) and can range in severity.  The tinnitus evaluation will help you identify how much tinnitus affects your daily life and treatment options that can help you cope or even extinguish the sound. The following components are traditionally included in the overall tinnitus evaluation:

  • Hearing Assessment
    • Case History/Tinnitus Intake Interview (Questionnaires)
    • Medical Referrals
    • Otoscopic Examination
    • Audiometric Evaluation
      • High Frequencies, MCL & UCL, Interoctaves
    • Immittance
    • Otoacoustic Emissions
  • Questionnaires
  • Tinnitus Evaluation

Some tinnitus treatment options include the following: Hearing aids, cerumen management, TMJ treatments, sound & behavioral therapies, & medications. Click here to learn more about our Tinnitus Specialist.

Tympanometry (Immittance Testing)
Is technique that measures immittance or objectively tests the middle-ear function such as the mobility of the eardrum (tympanic membrane) and the conduction bones, by creating variations of air pressure in the ear canal. The results are represented on a graph called a tympanogram. The exam is quick, painless and does not require any behavioral response from the patient. It’s helpful in the diagnosis of middle ear effusion, otalgia, TM perforation, Eustachian tube function, and otitis media.

VNG – Balance Evaluations
Videonystagmography (VNG) evaluates the function of the vestibular portion of the inner ear. Typically used for patients who are experiencing vertigo, unsteadiness, dizziness, and other balance ailments and is usually combined with a hearing evaluation. The exam measures involuntary eye movement called nystagmus. These movements can be slow or fast, steady or jerky. Typically your eyes to move from side to side or up and down. It results from conflicting brain messages made by your eyes and the balance system in the inner ear. These eventually results in dizziness and can be attributed to a disorder of the vestibular or central system. Your vestibular system includes organs, nerves, and structures that are in your semicircular canals which is considered your body’s balance center. It works together with your eyes, sense of touch, and brain. Your central system otherwise known as your brain communicates with the many different systems in your body to control your balance and keep you erect.