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Hearing Tests and Diagnostic Evaluations

Diagnostics

What happens at a hearing test in Brooklyn?

A comprehensive hearing assessment at ZN Audiology includes pure-tone testing, speech testing, distortion-product otoacoustic emission (DPOAE) testing and evaluation of middle-ear function. Speech-in-noise testing is included when clinically indicated. This diagnostic evaluation is performed by an ASHA-certified audiologist to establish the type, degree and configuration of any hearing loss and guide appropriate care. We see adults and children ages five and older.

Dr. Zarina Naizam performing a hearing assessment at the audiometric test station

About Comprehensive Hearing Assessments

A screening tells you whether something might be wrong. A diagnostic evaluation tells you what is wrong, in which ear, at which frequencies, and whether the problem is in the outer ear, the middle ear or the inner ear. Those are different questions, and only the second one can support a fitting or a referral.

This matters because, among U.S. adults ages 20 to 69, roughly 14 percent have a measurable hearing loss, and only about 16 percent of those who could benefit from hearing aids have ever used them. Most people who would be helped have never had their hearing measured.

The 2024 Lancet Commission identifies hearing loss as the largest modifiable risk factor for dementia from midlife. That is an association and a risk factor, not a promise: treating hearing loss is not a proven way to prevent dementia, and we do not claim it is.

Hearing beyond a quiet room

Speech-in-noise testing assesses how well you understand speech in background noise. At ZN Audiology it is part of a hearing assessment when clinically indicated, including when difficulties understanding speech or possible auditory processing difficulties need further assessment. It can be useful even when a standard hearing test shows normal hearing thresholds. Your audiologist decides which tests are appropriate for you.

This test looks at how well you understand speech in background noise. Real-ear measurement and speech mapping have a different role: checking what a hearing aid delivers inside your ear.

How hearing aid fittings are verified

What to expect

  1. 01

    Case history

    We discuss your hearing changes, health, medications, family history and exposure to loud sound.

  2. 02

    Physical evaluation

    Dr. Naizam examines the ear canal and eardrum with an otoscope, checking for wax and other visible concerns.

  3. 03

    Tympanometry

    Middle-ear testing measures how the eardrum responds to changes in pressure.

  4. 04

    Pure-tone testing

    You listen through headphones and respond to tones at different pitches and levels to establish your hearing thresholds.

  5. 05

    Speech testing

    You repeat spoken words so we can assess your speech understanding. Speech-in-noise testing may be used when indicated.

  6. 06

    Distortion-product otoacoustic emission (DPOAE) testing

    DPOAE testing is included in the comprehensive hearing assessment alongside pure-tone, speech and middle-ear testing.

  7. 07

    Audiogram

    The results are plotted by frequency and hearing level to show the type and degree of any measured hearing loss.

  8. 08

    Discussion of results and options

    Dr. Naizam explains the results and discusses appropriate care, monitoring, amplification or referral.

Understanding hearing and hearing loss

Sound travels through the ear canal to the eardrum and the small bones of the middle ear. The inner ear converts those vibrations into signals carried to the brain by the auditory nerve. A hearing evaluation helps identify where along this pathway a problem may occur.

Conductive hearing loss
A problem in the outer or middle ear can reduce how effectively sound reaches the inner ear. Wax, middle-ear fluid and other conditions may need medical assessment or treatment.
Sensorineural and mixed hearing loss
Sensorineural hearing loss involves the inner ear or auditory nerve. Mixed hearing loss includes both conductive and sensorineural components. Your test results help guide the right recommendation for you.

Questions about comprehensive hearing assessments

A full diagnostic evaluation is considerably longer than the free screening offered in a retail setting, because it includes history, examination, threshold testing in each ear and speech testing. The clinic can tell you how much time to allow when you book, so you can plan your visit.

Book with an ASHA-certified audiologist

Book online through Zocdoc, or call your preferred clinic to discuss an appointment.

More about your hearing care