Sound isn’t just crucial to our quality of life; it helps us survive. SWIENT’s audiologists and ear, nose and throat specialists are here to treat your hearing and balance problems.


The American Academy of Audiology defines an audiologist as a professional who diagnoses, treats and manages people with hearing loss or balance concerns. After agreeing upon a treatment option with a patient, an audiologist may perform a number of different tests in order to determine the severity of the problem. If the patient’s problem needs medical treatment, the audiologist may refer him or her to one of our specialists.

How We Hear

Sound is generated when vibrations travel in waves through a medium such as air. These vibrations displace air molecules, which creates the sound waves. The waves reach the outer ear and then travel down our ear canal to the eardrum.

A moving eardrum will cause the three bones in the middle ear—the malleus, incus, and stapes—to move. The malleus, a tiny bone close enough to the eardrum to move it, picks up the vibrations from sound waves and passes them along to the incus and then the stapes, a small bone that fits into a small opening in our inner ear called the oval window.

When the stapes moves the oval window, fluid in the inner part of the ear stimulates thousands of tiny receptor hair cells inside the cochlea, which regulates hearing. Once stimulated, these cells send impulses along nerves to the brain, which distinguishes the sound into something we recognize.

What is Hearing Loss?

Hearing loss, which affects an estimated 28 million people, occurs when one or more areas of the ear deteriorate or become damaged. For more detailed information, visit our ear disease and hearing loss page.

Quick Self-Hearing Test

If you answer “Yes” to any of the following questions, you should have your hearing tested.

  1. Do others complain that you turn the TV volume excessively high?
  2. Does it sound like people mumble when they are speaking to you?
  3. Do you often ask for words or sentences to be repeated?
  4. Do you have difficulty hearing when there are other noises present, such as a crowded restaurant?
  5. Does the tinnitus (ringing) in your ears block out what you want to hear?
  6. Do you have a hard time hearing on the telephone?
  7. Do you misunderstand what others are saying and respond inappropriately?
  8. Do you have trouble understanding women and/or children?

Hearing Tests

A hearing evaluation may consist of:


Otoscopy involves looking into the ear with a lighted device called an otoscope. An audiologist uses it to check for abnormalities in the ear canal, eardrum and surrounding structures.

Tympanometry and Acoustic Reflex Testing

This test determines the integrity of the middle ear space and eardrum function. A probe is placed in the ear and pressure is sent into the ear through the probe.


“Raise your hand when you hear the beep.” This is the test most people think of when someone mentions hearing tests. Audiometry examines the range of human hearing most important for communication. A patient listens to sounds and words through headphones in a sound-treated booth. Meanwhile, an audiologist studies that person’s responses to specific frequencies, including:

  • Pure-tone thresholds (250-8000 Hz)
  • Bone-conduction
  • Speech testing

Pediatric Audiometry

Pediatric audiometry evaluations may consist of:

Visual Reinforcement Audiometry

In the first few months of life, normally developing infants turn their heads toward a sound source. In VRA, we condition this response in a child with an animated toy. We send a sound through either headphones or speakers. When the child turns towards the sound, he or she receives the toy.

Conditioned Play Audiometry

CPA conditions behavioral responses in children to sound. They learn to engage in an activity (e.g. putting a block in a bucket) each time they hear a test signal.

Otoacoustic Emissions

OAE’s are often used in infant hearing screenings. We use a probe to stimulate certain frequencies in the patient’s ear. The same probe measures the patient’s response, which allows us to determine cochlear outer hair cell function.

Acoustic Brainstem Response (ABR)

During an ABR test, the patient wears earphones and electrodes at the top of the head and ear lobes. We transmit a click or tone into the earphones. The electrodes measure the patient’s response, which we use to determine auditory brainstem function.

Balance Testing

Balance testing may include:


Videonystagmography or VNG allows us to measure a patient’s inner ear balance and diagnose causes of dizziness. It involves recording the direction, speed, and timing of eye movement. VNG tests include:

  • Audiometry
  • Electrocochleography (ECoG)
  • Computerized Dynamic Posturography (CDP)
  • Dix-Hallpike w/ Epley maneuver
  • Vestibular Evoked Myogenic Potential (VEMP)
  • Fistula(inner ear) testing


Benign Paroxysmal Positional Vertigo (BPPV) is the displacement of calcium carbonate otoconia (or crystals) into the Semicircular canals. This positional vertigo usually occurs in short durations (10-60 seconds) with specific head movements such as rolling over in bed, tipping your head backward, or shaking your head back and forth.

This dizziness can usually be treated without medication or surgery. Treatments such as the Epley maneuver or canalith repositioning maneuvers typically reduce or eliminate BPPV after one or two sessions.

For more information about common ear disorders, visit our page on ear disease and hearing loss. To learn more about SWIENT’s audiology-related services, contact us.