Audiology Associates of North Florida Diagnostic Testing Services

Introduction | Staff & Bios | Hearing Solutions | Diagnostic Testing Services | Patient Information

Adult Hearing Evaluations
Hearing evaluations assess the type and severity of hearing loss at various pitches.  The aging process and exposure to loud noise are common causes of hearing loss.  However, other problems such as middle ear fluid, hardening of the middle ear bones, tumors on the hearing nerve and diseases of the inner ear can affect hearing as well.  Other brief tests may be performed during this visit to help determine the type of hearing loss present, or if standard procedures do not produce reliable results.  Prior to the exam, your audiologist will discuss your hearing history with you and evaluate your concerns.
The test is performed in a sound treated booth using foam earphones.  At the conclusion of the hearing test, your audiologist will review the results with you.  Depending on the test results, recommendations may include being evaluated by an otolaryngologist, consideration to hearing aids or other assistive listening devices or using hearing protection in noise. 
Length of exam: As long as one hour
Pre-test preparation: None

Pediatric Hearing Evaluations (6 months – 5 years)
Hearing evaluations in young children assist in determining the presence of hearing loss, as well as the type and severity of hearing loss.  Parents are often surprised at the extent of information that can be obtained on young children.  Prior to the exam, your audiologist will discuss with you the concerns you have regarding your child’s hearing, as well as obtain any medical history that might be pertinent to your concerns
The type of testing performed with your child depends on their age and developmental level. 
Visual Reinforcement Audiometry (approximately six months to three years of age) – This test is performed by having your child sit on your lap in a sound treated booth.  Speech sounds and tones are presented through speakers in the booth and lighted puppets are used to reward your child when he looks for the source of the sound.  By decreasing the intensity of the sound, we determine the lowest level at which your child will respond.
Play Audiometry (approximately three years to five years) – This test involves having your child sit in a sound treated booth.  He is taught to listen for sound and to throw a block on the floor, or perform some other play activity, every time a sound is heard.  He may also be asked to point to pictures on a board to determine the softest level at which he can understand speech. 
Other brief tests are often performed during the same visit to determine the presence of middle ear fluid, which is common in young children, as well as automated hearing screens.
Length of exam: As long as one hour
Pre-test preparation: None

Auditory Brainstem Response (ABR) for Pediatrics
An ABR uses a computer to evaluate the hearing nerve from the inner ear to the brainstem.  Electrodes are placed on your child’s head and earphones placed in their ears which produce clicking sounds.  The response of the hearing nerve is monitored to determine the softest level at which the nerve is able to respond to the clicking sound.  By monitoring the waveforms produced by the hearing nerve, we can closely predict the degree of hearing loss at certain pitches.  This test is often used during infancy when the baby did not pass the Universal Infant Hearing Screening conducted in the hospital after delivery.  It is also used for older children when standard types of hearing tests do not yield conclusive results.  It is necessary for your child to be asleep during the test.  Therefore, the test may be conducted in natural sleep, or with prescribed medication used to encourage sleep.

• Natural Sleep
  Natural sleep is the preferred method for children under one year.  It is necessary that your child be deprived of sleep prior to arriving at the appointment so that they are more likely to nap in the office.  It is often helpful if two adults accompany the child so that one adult can keep the child awake in the car on the way to the appointment.  Please try not to let your child fall asleep until the audiologist has called you back to the exam room.  It is also suggested that your child arrive to the appointment hungry.  Just before the exam begins, you can feed your child to encourage sleep. 

• Medicated Sleep
  If your child requires medication to obtain a restful state, one of our physicians or your pediatrician may prescribe a medication called chloral hydrate to encourage sleep.  It is very important, however, that your child be deprived of sleep prior to the appointment even if medication is being used as the medication is not often strong enough to induce sleep if the child is not already tired.   You should fill the prescription at your pharmacy prior to arriving at the appointment, but the medication is only to be given by our staff.  Do not give your child the medication yourself.  Prior to the appointment, your child will be assessed by one of our physicians.  During the test, your child’s oxygen levels will be monitored.  Your child will be awake, but drowsy, at the conclusion of the appointment.  It is also very important that you follow the food and liquid restrictions below prior to the appointment.  Failure to follow these instructions will result in the test being re-scheduled. 

Length of exam: As long as three hours

Pre-test preparation:
NPO GUIDELINES (FORMEDICATED SLEEPONLY):           

* Solids/non-clear liquids include milk and formula.
** Breast milk is considered a clear liquid.

Fill the prescription and bring the medication to the appointment (for medicated sleep only), bring a drink and snacks for your child to have at the conclusion of the test, keep your child up late the night before and awaken him early to ensure your child is sleepy upon arriving to the exam.

Videonystagmography (VNG)
VNG is a test used to evaluate patients experiencing dizziness, vertigo  or imbalance.  Dizziness and imbalance are common symptoms that can be caused by a variety of factors.  Commonly, however, the inner ear system is involved.  VNG evaluates the inner ear by using the connections between the inner ear and the eye muscles to determine if this is the cause of your dizzy complaints.  During the test, you will wear goggles to monitor your eye movements.  You will be asked to follow a light with your eyes and recordings will be made with your head and body in different positions.  Finally, cool and warm air will be put into your ears.  It is not uncommon for this test to cause dizziness.  However, the dizziness is brief, usually lasting less than a few minutes, and most often the dizziness is mild. 
Length of exam: As long as two hours
Pre-Test Preparation: Do not eat or drink for at least 4 hours prior to the exam unless you are diabetic in which case please maintain your normal eating schedule, do not take medications that have been prescribed for dizziness for 48 hours before the exam, do continue to take other medications especially for cardiac, diabetes and blood pressure problems, do not wear eye make-up to the appointment (if you do, you will be asked to remove it).

Vestibular Evoked Myogenic Potentials (VEMP)
VEMP testing is commonly performed on patients complaining of dizziness, vertigo or imbalance, and is often conducted during the same visit as the VNG evaluation to obtain a comprehensive understanding of your inner ear function.  The purpose of the VEMP evaluation is to determine if portions of your inner ear, specifically an organ called the saccule, as well as a branch of the auditory nerve, are intact and working normally.  The test involves placing electrodes about your neck and putting earphones into your ear which will produce a rather loud clicking sound.  You will be asked to recline in a chair and to raise then hold your head up for about one minute.  This cycle will be repeated several times.
Length of exam: As long as one hour
Pre-Test Preparation: Do not wear a turtleneck shirt, do not take any medications that have been prescribed for dizziness for 48 hours before the exam.

Canalith Repositioning or Epley Maneuver
One of the most common causes of dizziness is Benign Paroxysmal Positional Vertigo or BPPV.  BPPV is caused by calcium particles that become lodged in areas of the inner ear where they should not be.  When this occurs, it can cause you to experience a brief spinning sensation when your head is put in certain positions.  Commonly, people with BPPV report dizziness when they look up, bend over or roll over in bed.  Fortunately, BPPV is highly treatable with a procedure called canalith repositioning. 
Because of the connection between your inner ear and your eye muscles, you will wear goggles to monitor your eye movements during the exam.  The audiologist will guide you from a sitting position into a reclined position to determine where in the inner ear the calcium particles have lodged.  From there, the audiologist will maneuver your head and body to roll the particles out of the problem area.  While BPPV is often resolved after the first treatment, additional treatments are sometimes necessary. 
Length of Exam: As long as one hour
Pre-test Preparation: None.  However, it is recommended that following the treatment, you avoid activities that would have brought about your dizzy symptoms for the remainder of the day.

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