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27 January 2015

Why it’s important your hearing loss is assessed by a qualified Diagnostic Audiologist

If you or someone close to you appears to be having a difficulty hearing of late, you should not postpone seeking a consultation with an appropriate professional. The purpose of this article is to give you some advice so that you do not follow the path others take, whose judgement is perhaps clouded or misguided by the lure and hard sell of "free hearing test". When presented with such irresponsible marketing, consider the following:

If you would not be confident in someone undertaking a medical procedure for you without the appropriate qualifications why settle for anything less than a professionally qualified Audiologist to diagnose and evaluate your hearing loss?

The following example, published in the Hearing Journal, Vol. 68, Number 1, January 2015 will be used to illustrate our point. In Dr. Djalilian's [1] article he presents the hearing evaluation case of a 75-year-old man. According to the patient, in the last five years, his hearing has declined. Subjectively, he feels that his hearing is better in his right ear, but he has difficulty understanding his children and grandchildren. Furthermore the patient history revealed that he does not have vertigo or tinnitus. He occasionally feels dizzy when he gets up quickly or tries to make a quick turn. He nearly fell on one occasion. The patient worked as an accountant and has never shot a gun nor attended a concert. He neither takes medication nor has he ever had surgery. The results of his preliminary audiology assessment are shown in this audiogram.

HJ V68N1 Fig1

As presented in the article[2], the patient's audiogram shows a moderately severe to severe sensorineural hearing loss in the right ear (red line). However, asymmetry is present, with even worse hearing loss in the left ear (blue line). A difference of 15 dB between the right and left ears at three contiguous frequencies is the considered definition of asymmetry. To the untrained practitioner, or those incentivised through sales, their judgement might conclude that this is just a hearing loss solved by the purchase of hearing aids.

Asymmetric hearing loss requires further evaluation, no matter what the degree of loss is. A professional diagnostic audiologist will undertake further investigative tests, inform their GP and where necessary refer the patient to an ENT consultant in the first instance. There is significant responsibility on the professional practitioner to be knowledgeable in the field of audiology and to have the appropriate experience to make these decisions. That comes from investment in recognised training programmes, work experience and continual professional development.

Our hearing, as one of our five senses, is so important to us in our daily lives, whether just communicating with family and friends, in our workplace or enjoying some entertainment. We should therefore place more value and importance on our hearing assessment to ensure we get the right longterm outcomes.

Incidentially, according to Dr Djalilian's article, this patient had a meningioma. The MRI revealed a large cerebellopontine angle tumour on the side of the asymmetric loss. The Patient was experiencing headaches and had developed mass effect on the brainstem. Dr Djalilian concludes by saying that generally, recovery of hearing is not expected in these cases; preservation of hearing function is often very difficult with large tumours. Hearing preservation in an acoustic neuroma of this size would be nearly impossible because of the amount of adherence to the eighth nerve and the degree of dissection required to separate the tumour from the cochlear nerve.

[1] Director of neurotology and skull base surgery and associate professor of otolaryngology and biomedical engineering at the University of California, Irvine.

[2]Djalilian, Hamid R. MDSymptom: Asymmetric Hearing Loss”Clinical Consultation The Hearing Journal January 2015 - Volume 68 - Issue 1 - pp 8,10,12doi: 10.1097/

Note: It is not our intention to site this article out of context or that intended by its author but to use it as a valid example of how an audiogram can be misinterpreted in an unregulated environment.

earpeace™ is a privately owned Irish Company, with its head office located in Galway, Ireland. The company is committed to providing exemplary audiology services and associated world leading technology products to its customers throughout Ireland. For further information about the company, please follow this link. 


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