Testing and treatment options for hearing loss at Ohio State

Our audiologists at The Ohio State University Wexner Medical Center have more than 170 years of collective clinical practice. Our philosophy is simple: To provide individuals with quality, state-of-the-art audiological services while maintaining a caring, understanding patient atmosphere.

We continue to expand the scope of our practice as technology moves forward and, as a result, offer many services related to the diagnosis and rehabilitation of the auditory system.

Hearing loss is a common problem caused by many factors, including heredity, noise exposure and aging. Hearing is a complex sense involving both detection (the ear's ability to recognize sounds presence in the environment) and intelligibility (the brain's ability to interpret or understand those sounds). The types of hearing loss are conductive, sensorineural and mixed. 

Hearing loss affects about 20 percent of adults in the United States. At age 65, one out of three people has hearing loss. Hearing loss is a major public health issue that is the third most common physical condition after arthritis and heart disease. 

Signs of possible hearing loss:

  • Your family members say that you turn the volume on the television or radio too loud.
  • You ask others for repetition often.
  • You have difficulty hearing when there is noise in the background or in large groups of people.
  • You experience difficulty when talking on the telephone.
  • You hear conversation but are having difficulty understanding.
  • You have ringing or buzzing in your ears (tinnitus).

Take the hearing check challenge at the Better Hearing Institute website.

Factors that determine how much hearing loss will negatively affect a person's quality of life: 

  • The degree of the hearing loss
  • The pattern of hearing loss across different frequencies (pitches)
  • Whether one or both ears is affected
  • The areas of the auditory system that are not working normally — such as the middle ear, inner ear, neural pathways or brain
  • The ability to recognize speech sounds
  • The history of exposures to loud noise and environmental or drug-related toxins that are harmful to hearing
  • Age

How We Hear

Normal Hearing

Sound enters the auditory canal and vibrates the eardrum. The three smallest bones in the body, the ossicles, are sent into motion by the vibrating eardrum. The motion of the stapes bone displaces fluid within the cochlea. Fluid displacement results in the movement of tiny hair cells, which turn sends a neural impulse up the auditory nerve to be interpreted by the brain.

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Conductive Hearing Loss

Conductive hearing loss is an interference to the transmission of sound in the outer or middle ear. Some of the most common causes of conductive hearing loss include: 

  • Otitis media (ear infection)
  • Otosclerosis
  • Cerumen impaction

Sensorineural Hearing Loss

Sensorineural hearing loss is damage to the hair cells in the cochlea or the auditory nerve. The most common causes of sensorineural hearing loss include aging and excess noise exposure.


Tests

OSU hearing professionals offer these advanced diagnostic tests and treatments:

Auditory brainstem response (ABR)

The auditory brainstem response (ABR) is a test of neurological function that assesses the hearing threshold in children and others who have a difficult time with the standard hearing evaluation. The ABR is also used to identify neurological abnormalities of the auditory nerve and the auditory pathway up to the brainstem. 

The ABR is performed by placing electrodes on the head and recording brain wave activity in response to sound stimulation. The person being tested rests quietly or sleeps while the test is performed.

Audiometry (hearing evaluation)

  • An audiologist will ask questions about your hearing and general health history.
  • A physical examination of the ear will be performed.
  • A pure tone audiogram will be completed. 
For a portion of the test, you will hear tones presented through headphones or insert earphones. Your response is indicated by pressing a button or raising your hand. Children may be tested using soundfield speakers and respond by looking at a lighted object or by playing a game. For the second portion of the test, you will be asked to repeat words. The final portion of the exam, once again, requires a response to tones that are presented via a specialized headset worn behind your ear.

Cochlear implant evaluation

To determine if you are a candidate for cochlear implants, an initial evaluation will take place where the audiologist will test your hearing with and without hearing aids. It may take several visits to determine if you are a candidate for a cochlear implant. Once your audiologist determines that you meet the candidacy criteria for the implant, you will be scheduled with an otologist. If the otologist finds that a cochlear implant is medically appropriate, the otologist's assistant will obtain insurance authorization for the procedure. Once authorization is obtained, surgery will be scheduled. 

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Ear protection

Swim molds
Swim Plugs are soft custom molds that may be recommended for those with a history of ear surgery or chronic ear infections. An earmold impression must be made in the office. Swim plugs can be made in a solid color, or with dots or stripes. Swim plugs can be made from floating material, and can have handles and/or a cord.

Custom listening molds
Custom molds can be made to couple to earpieces for listening devices. Custom listening molds increase the retention of the earpieces. These molds can also have a vent, to increase comfort by allowing air to enter the ear canal. Custom listening molds are also made for individuals who want added comfort when wearing musician ear monitors, fire and rescue monitors, etc. An earmold impression must be made in the office.

Musician molds
Musician earplugs are ideal for musicians or concert goers who want to protect their hearing while maintaining the tonal quality and accuracy of music in high noise environments. ER-15 and ER-25 decibel attenuation filters are available. An earmold impression must be made in the office.

Hearing protection molds
Hearing protection molds come in a variety of types, and are made from a custom earmold impression. They can be made as solid molds, or with a variety of damped vents. Venting options include Musician’s Earplugs, which change tonal quality minimally while damping intense sound levels.

Hearing aid evaluation

Your audiologist will take time during this visit to get to know you, learn what you are experiencing and help you to determine what’s most important to you. He or she will discuss with you the different levels of technology and sophistication as well as hearing instrument styles. You will determine, with the audiologist's guidance, what instrument is best suited to your lifestyle, listening demands and budget. 

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High-frequency audiometry

High-frequency audiometry assesses the ultra-high frequency range from 10000 – 20000 Hz. It is most commonly utilized to assess patients who are having or have had chemotherapy.

Otoacoustic emissions

Otoacoustic emissions is the name for the sounds produced by the cochlea. These sounds can be used to test the function of the cochlea and other parts of the ear, including the auditory nerve. The test does not rely on any deliberate response from the patient and can therefore avoid inaccuracy from human feedback. A highly sensitive microphone is placed in the ear canal to measure the inner ear’s ability to respond to sound.

Ototoxicity monitoring

In ototoxicity (ear poisoning from drugs or chemicals), high frequencies are the first to be affected. Further damage affects lower frequencies. Early detection and continual monitoring of ototoxic hearing loss can help minimize damage and inform the treatment plan. Monitoring hearing in patients who take ototoxic drugs also helps manage the accompanying symptoms like tinnitus, dizziness and communication issues. In addition, your audiologist can initiate appropriate rehabilitation during and after treatment through ototoxicity monitoring.


Tympanometry

Tympanometry assesses the function of the middle ear system, particularly the mobility of the tympanic membrane and middle ear bones. 

Ear Protection

Ear protection

CustomListeningMold

Custom Listening Molds

Custom molds can be made to couple to earpieces for listening devices. Custom listening molds increase the retention of the earpieces. These molds can also have a vent, to increase comfort by allowing air to enter the ear canal.

Hearing Protection Mold

Hearing Protection Molds

Hearing protection molds come in a variety of types, and are made from a custom earmold impression. They can be made as solid molds, or with a variety of damped vents. Venting options include Musician’s Earplugs, which change tonal quality minimally while damping intense sound levels.

Swim Plug

Swim Plugs

Swim plugs are soft custom molds that may be recommended for those with a history of ear surgery or chronic ear infections. An earmold impression must be made in the office. Swim plugs can be made in a solid color, or with dots or stripes. Swim plugs can be made from floating material, and can have handles and a cord.

Hearing Devices

BAHA osseointegrated processing device

Bone conduction implants are bone-anchored devices that use bone conduction to provide a better hearing solution for people with ear canal problems, people who cannot wear a hearing aid or those who have single-sided hearing loss. The system attaches to a titanium implant, which is surgically placed in the bone behind the ear. The bone provides a sound pathway to the inner ear and does not require that sound go through the ear canal. Even if the ear canal is completely absent or the middle ear is not functioning, the bone conduction implant can help.


Cochlear implants

Cochlear implants provide a mechanism for hearing when traditional hearing aids are no longer helpful. If you have severe or profound sensorineural hearing loss in each ear and do not benefit from appropriate amplification, it is likely that there has been damage to the hair cells in the cochlea. You could benefit from a cochlear implant. 

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Hearing aids

A hearing aid is a small electronic device that you wear in or behind your ear. It makes some sounds louder. A hearing aid can help people hear more in both quiet and noisy situations. Hearing aids help people who have hearing loss from damage to the small sensory cells in the inner ear. The damage can occur as a result of disease, aging or injury from noise or certain medicines. Only about one out of five people who would benefit from a hearing aid actually uses one. There are different kinds of hearing aids. They differ by size, their placement on or inside the ear and how much they amplify sound. The hearing aid that will work best for you depends on what kind of hearing loss you have, and how severe it is. We dispense all levels of digital hearing aid technology, based on your needs. Your audiologist will make the most appropriate recommendation based on your current hearing test results as well as your specific listening needs. 

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Importance of having hearing loss evaluations


From mild to severe, Dr. Aaron Moberly explains why all individuals with any level of hearing loss should see an audiologist.

Our Audiologists

LauraFeeney

Laura Feeney, AuD

Audiologist, OSU Hearing Professionals

Laura Feeney, AuD, earned both her bachelor’s degree in Speech and Hearing Science and her doctoral degree in Audiology from The Ohio State University. She has been with the Department of Otolaryngology–Head and Neck Surgery since 2007. She is board certified by the American Board of Audiology and is a member of the American Academy of Audiology and the Ohio Academy of Audiology. Laura’s interests include basic audiological testing and working with patients with hearing aids and cochlear implants.

LauraGarish

Laura Garish, AudD

Audiologist, OSU Hearing Professionals

Laura Garish, AuD, earned her bachelor's degree from The Ohio State University in 1992. In 1994 Laura received her master’s degree from the University of Akron. She worked as the director of Audiology in the Huntington Ear Clinic in Huntington, West Virginia, from 1994-1996. Laura joined the Department of Otolaryngology–Head and Neck Surgery here in 1997. Laura completed her doctorate degree in May 2001 at the University of Florida. Dr. Garish is a founding member, board member and treasurer of the nonprofit foundation, Project EAR, Inc. 

BrendaHall

Brenda Hall, AuD

Audiologist, OSU Hearing Professionals

Brenda Hall, AuD, graduated from the University of North Carolina with a master’s degree in Audiology. She received her doctoral degree from Arizona School of Health Sciences in 2010. She has been a member of the Department of Otolaryngology–Head and Neck Surgery since 1991. Her interests include working with patients with cochlear implants and hearing aids.

DebbyLaPrete

Debby LaPrete, AuD

Audiologist, OSU Hearing Professionals

Debby LaPrete, AuD, received her bachelor’s degree from The Ohio State University and her master's degree from the University of Cincinnati. She graduated from the Arizona School of Health Sciences with her doctoral degree in Audiology in 2009. Debby has worked at Ohio State since 1994, and specializes in providing services to recipients of cochlear implants and auditory brainstem implants.

CariMickelson

Cari Mickelson, MEd

Audiologist, OSU Hearing Professionals

Cari Mickelson, MEd, graduated from the University of Virginia with a degree in Audiology. She has worked in a variety of medical settings for the past 25 years. Her interests include diagnostic audiology and hearing aid dispensing. Cari is a member of the Ohio Academy of Audiology and the American Speech-Language-Hearing Association.

MelissaSchnitzspahn

Melissa Schnitzspahn, AuD

Audiologist, OSU Hearing Professionals

Melissa Schnitzspahn, AuD, received her bachelor’s degree in Speech and Hearing Science from The Ohio State University in 1998 and her master’s degree in Audiology from Ohio State in 2000. She obtained her doctoral degree in Audiology from the Arizona School of Health Sciences in 2008. Melissa joined the Department of Otolaryngology–Head and Neck Surgery here in 2001, and her interests include hearing aid dispensing and cochlear implants.

SaulStrieb

Saul Strieb, AuD

Audiologist & Vestibular Laboratory Coordinator

Saul Strieb, AuD, obtained his bachelor’s degree from the University of Chicago and his master’s degree in Audiology from the University of Maryland. He received his doctoral degree in Audiology from the University of Florida in 2009. He served as an audiologist at the Washington Hospital Center from 2001 through 2011, before joining the staff of the OSU Department of Otolaryngology–Head and Neck Surgery in 2011. His clinical interests include hearing aids, BAHA, vestibular assessment and treatment of benign paroxysmal positional vertigo.

ErynStaats

Eryn Staats, AuD

Audiologist & Audiology Manager, OSU Hearing Professionals

Eryn Staats, AuD, received her bachelor’s degree in Speech and Hearing Science from Ohio University in 1996 and her master’s degree in Audiology from The Ohio State University in 2003. She obtained her doctoral degree in Audiology from the Arizona School of Health Sciences in 2012. Eryn has been an audiologist with the Department of Otolaryngology–Head and Neck Surgery here since 2008. Dr. Staats’ clinical interests include diagnostic audiology, bone anchored hearing aids (BAHA), hearing aid dispensing and rehabilitation.

GretchenWaggoner

Gretchen Waggoner, AuD

Audiologist, OSU Hearing Professionals

Gretchen Waggoner, AuD, earned her bachelor's degree in Speech and Hearing Science from Ohio University in 1994 and her master's degree in Audiology from Bowling Green State University in 1996. She earned her doctoral degree in Audiology from the Arizona School of Health Sciences in 2006. She has been an audiologist in the Department of Otolaryngology–Head and Neck Surgery here since 1996. She is a founding member and secretary of Project EAR, Inc. She has participated in seven mission trips and provides diagnostic services and hearing aid fittings. 

Kara Vasil

Kara Vasil, AuD

Audiologist, OSU Hearing Professionals

Kara Vasil, AuD earned a BS in speech and hearing science from The Ohio State University in 2012 and her Doctor of audiology from the Northeast Ohio Au.D. Consortium in 2016. Her clinical interests include diagnostics, cochlear implantation, hearing aid fitting and assistive devices. She's a research audiologist at Ohio State's Buckeye Center for Hearing and Development. She's a member of the American Academy of Audiology, American Speech-Language-Hearing Association and the Ohio Academy of Audiology.

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