General and special hearing diagnostics

Diseases of the sensory organs of the head are common. If dizziness or acute ringing in the ears is present, the ear specialist should initiate further clarification if necessary. Once the ear specialist has carried out the necessary diagnostic procedures, the correct rehabilitation measures can usually be initiated quickly. This also applies to patients who have suffered a whiplash injury. If a traffic accident victim suffers from a functional disorder of the sensory organs of the head after the accident, the ear specialist can clarify and objectify the functional disorders and initiate the necessary rehabilitation measures in good time.

At the ENT Center Lucerne, highly specialized staff carry out complex hearing tests and balance examinations. If a hearing disorder is suspected or if there is acute ringing in the ears (tinnitus), a series of subjective (with the patient’s cooperation) and objective (without the patient’s cooperation) tests are used.

• Determination of the hearing threshold with the patient’s cooperation (pure-tone audiometry) with or without indirect (tinnitus determination).
• Determination of speech comprehension with the cooperation of the patient (speech audiometry).
• Measurement of the stapedius reflex (middle ear muscle reflex). The stapedius reflex triggers a movement of the eardrum. If stimulation is carried out at a sound level of 80-100 dB, a change in pressure in the airtight ear canal (stapedius reflex measurement) can be measured approximately 50 ms after the sound is applied (without the patient’s cooperation).
• Measurement of acoustic resistance via a pressure pump in the ear canal, which generates positive or negative pressures. The changing reflections on the eardrum can then be recorded with a measuring microphone(tympanogram).
• Measurement of otoacoustic emissions (abbreviation: OAE, from the Greek. us, otos = ear). The inner ear not only transmits sounds to the auditory nerve, but also emits sounds either spontaneously or in response to an external acoustic stimulus. Using highly sensitive measuring microphones inserted into the ear canal, we can detect the OAE. OAEs reflect the motor activity of the outer hair cells. The outer hair cells are the preamplifier for the inner hair cells when hearing soft sounds. When the ear is exposed to sound, the outer hair cells begin to vibrate. The vibrations in the fluid-filled inner ear result in a passive traveling wave. The outer hair cells amplify this passive traveling wave, named after the groundbreaking work of Nobel Prize winner Georg von Békésy (* June 3, 1899 in Budapest), into an active traveling wave and transmit it to the inner hair cells. This is where the actual hearing takes place, i.e. the conversion of the mechanical sound wave into an electrical signal. As with a vibrating motor, the outer hair cells themselves generate a sound, which can then be measured by the ear via the auditory canal as a sound recording using a special microphone. The frequency and amplitude of the emissions are determined by a subsequent Fourier analysis. Four types of otoacoustic emissions can be distinguished. Typically, two types of OAEs can be measured in the healthy ear: the TEOAE and the DPOAE. These can be measured by our highly specialized staff at the ENT Center Lucerne:
  • Transitory evoked otoacoustic emissions (TEOAE): are triggered (evoked) by a short, broadband sound impulse to the ear.
  • Distortion-produced otoacoustic emissions (DPOAE): also known as distortion products, are triggered by the presentation of two sine tones that are in a certain frequency ratio (2 * f1 – f2). The ear then reacts by emitting a cubic difference tone fdp.
  • Spontaneous otoacoustic emissions (SOAE): occur without any external stimulus.
  • Simultaneously evoked otoacoustic emissions (SEOAE): are triggered by stimulation with a continuous tone.
• Recordings from the brain in response to stimulation of the ear and measurement of the speed of signal transmission between the ear and brain(Brainstem Evoked Response Audiometry, BERA)

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