Although it may sound more convenient to use online testing or in home hearing testing, there are many drawbacks.  In person testing in our office and most Audiology offices is conducted in a sound treated booth to ensure results are not impacted by environmental noise.  The sound booth and testing equipment is checked and calibrated to adhere to National standards for noise reduction levels and proper operation of diagnostic equipment.  We provide a comprehensive evaluation which includes physical examination of the ears, air conduction, bone conduction, speech testing  and tympanometry.  These tests are essential to provide an accurate diagnosis of the potential cause of your hearing loss,  what  frequencies are affected by your loss, and  how well does your brain process speech when sound is loud enough. Accurate diagnostic results will determine if a medical issue is contributing to your hearing loss and if medical treatment or surgery is an option.  The test results will also determine if the hearing loss is due to nerve damage and if hearing aids are an appropriate treatment for your loss.

The results of online hearing tests are very concerning.  First, online hearing tests are essentially a screening tool rather than a comprehensive evaluation since there is no capability of testing bone conduction and often do not test specific frequencies. Without bone conduction testing, the type of hearing loss cannot be determined; therefore, a medical referral for treatment or surgical options will be overlooked.  As a result, you may obtain hearing aids when instead a medical referral for treatment is necessary.   In some cases, there can be serious health complications if these medical conditions go untreated.  Secondly, results from online testing are significantly impacted by varying equipment (computer speakers, cell phone speakers, or earbuds) which are not calibrated to provide accurate results.  Thirdly, on-line testing does not provide information about individual frequencies that are essential for speech understanding and clarity.  Fourthly, a hearing health care provider is unable to inspect your ears for signs of medical issues or impact wax.  For example, impacted wax in your ear canals will most likely cause a temporary hearing loss until removed.  As a result, the on-line company will recommend hearing aids when all you really need is to have the wax removed.

When we conduct tests in a sound booth, we can eliminate the impact of background noise, e.g. others in the room, the sounds of the furnace or air conditioner running, outside noises ,  etc.  These noises  can elevate test results and suggest your degree of hearing is actually greater than it is actually.  Also, testing in a sound booth allows us to perform more accurate speech testing and obtain information about how your brain processes speech which is necessary for optimized communication.  Accurate test results are essential to determine the appropriate recommendations and hearing aid prescription which provides you the best outcome for improved hearing and understanding.

So in closing, to obtain  comprehensive and accurate test results,  an in office evaluation is essential to a complete understanding of degree, type, configuration and cause of hearing loss,  Also, a physical exam is necessary to rule out wax or other ear conditions that could require a medical referral  for treatment.

Karen Lemme, Au.D.

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