“Are you going to look in my ears?” I asked my primary care doctor at my last visit. Yes, the nurse took my blood pressure, my temperature, and weighed me, but no one looked in my ears. The otoscope is on the wall in every examination room, but based on my experience, it is rarely used by primary care doctors.
According to the literature, I am not alone. Only about 10% of primary care physicians do any type of hearing screening. There are some cursory hearing tests that physicians can perform. If a patient does not have a hearing test in their medical record, it would be good to refer for a test. Physicians routinely refer for blood tests, why not a hearing test? Hearing tests are generally paid for by insurance companies.
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A comprehensive hearing test should include an extensive case history of the person’s hearing. A person’s hearing ability can be affected by a history of ear infections, ear trauma, noise exposure, illnesses such as cancer treated with chemotherapy, diabetes, or accidents. Next is an otoscopic examination of the ear canal.
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A sound proof booth is the best testing environment to get an accurate hearing test. Air conduction, bone conduction, speech reception, and speech discrimination is tested. Other tests include tympanometry which tests the movement of the eardrum. Also most audiologists do OAE testing which is an objective test to measure the auditory system.
Diabetes is a disease which affects blood flow. There are tiny hair cells in the inner ear which can be lost due to reduced blood flow. A person with diabetes should have an annual hearing test to monitor their hearing since a person can lose their hearing over time.
Chemotherapy usually causes a person to lose their hair. Those tiny hair cells in the inner ear can also disappear and cause hearing loss during and after chemotherapy treatments. A person should have a baseline hearing test prior to beginning chemotherapy treatments. During and after the treatments, hearing should also be monitored.
Hearing loss is undertreated. If you have not had a hearing test since childhood, it is time to have a baseline test. If you need a referral, ask your primary care physician for a referral to an audiologist.
