How to Do a Veteran's Hearing Loss Test

Veterans returning from war are reporting hearing loss and tinnitus at an alarming rate. According to the Institute of Medicine, in 2003 more than 75,000 cases of hearing loss were documented in new U.S. military veterans. In 2004 the U.S. Veterans Administration paid out $850 million in benefits to veterans with hearing loss disability. At that time, the U.S. Congress mandated a study be carried out by the Institute of Medicine. This study, which was released on September 22, 2005, showed the great importance of conducting accurate audiometric tests on military personnel before and after military service. Audiometric testing procedures are dictated by state and federal laws, however, each clinical hearing specialist must make an ethical choice to follow the protocol issued by their state government. Proper and complete test protocol is imperative when testing military veterans because their benefits are directly related to the audiometric test results.

Things You'll Need

• Otoscope
• Audiometer
• Inserts
• Soundproof testing area

Show More

Instructions

• 1

  Conduct a full pre-evaluation interview. When testing veterans, your focus should be treating the patients disability—not selling hearing aids. Pre-interview protocols designed to gain patient commitment or get information to use later to sell the patient on wearing hearing aids aren’t necessary. Your interview process should focus on getting to know your patient, how much time she spent in active military duty, what kind of jobs she performed in the military, and what types of noise or trauma she's been exposed to. Once you have documented the patient's noise exposure, inquire about tinnitus, dizziness, or any other ear-related issues. At the end of your pre-interview, you should ask the patient how the hearing disability is affecting her daily life. This gives you an idea of how socially active your patient is and what level of hearing aid technology would benefit her the most.

• 2

  Do a visual examination of your patient's outer ears, ear canals, and eardrums. Many veterans get debris in their ears during active duty—check for earwax, signs of ear canal trauma, and eardrum rupture. If your patients ears look healthy and clear, proceed with the audiometric test.

• 3

  Do a complete audiometric evaluation including pure tone, bone conduction, speech reception threshold, most comfortable level, frequency-specific uncomfortable levels, and speech recognition. If you use a form of speech in noise testing, conduct that as well.

• 4

  Review your test completely looking for signs of existing ear conditions. Veterans can suffer from recruitment—sensitivity to loud noise. Check your patient's frequency-specific uncomfortable levels and make sure to incorporate those levels when programming his hearing aids. Look for air-bone gaps, extreme noise, or head trauma that could have caused some middle ear damage. Check your patient's speech recognition scores. If they are extremely low you may want to refer him for a MRI before proceeding with the hearing aid fitting.

• 5

  Take time to explain the audiogram and test results to your patient. If your patient understands his hearing loss, he becomes less debilitated by it. Understanding hearing function also helps patients adjust better to wearing hearing aids.

• 6

  Stress the importance of follow-up to your patient. After fitting him with new hearing aids, make sure to discuss the importance of auditory rehabilitation, annual testing, routine check-ups, and hearing aid programming changes.