1301 20th Street, Suite 300, Santa Monica, CA 90404

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Click on a topic below to learn more:

Diagnostic Audiogram Dizziness Evaluation / Vestibular & Balance Function Test
Tympanometry Digital Hearing Aids
Pediatric Audiological Testing

Diagnostic Audiogram

An audiogram uses sounds of specific frequencies and intensity levels to determine what a person can hear in each ear. The sounds are heard through headphones in a soundproof room, and the patient is asked to identify each time they hear a sound and in which ear it is being heard. The sounds will become lower and lower to determine the level in which a patient can barely hear. An audiogram in our Santa Monica office may also include speech discrimination in the form of two-syllable words to determine how well a patient can comprehend what is being heard. This allows for evaluation of not only cochlear or inner-ear function, but also central auditory or brain functioning related to hearing. The results of this test and appropriate treatment approaches will be discussed with your doctor.

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Tympanometry is a compliance test of the ear drum that uses pressure sweeps to detect eustachian tube dysfunction, middle ear fluid or other abnormalities within the ear, as well as evaluating the overall functionality of the ear drum, or tympanic membrane. A probe is inserted into the ear, forming an airtight seal. The probe then delivers a test tone and varying pressure sweeps. The responses of the eardrum to these pressure sweeps are plotted to measure ear drum compliance.

Abnormal results may be the result of fluid in the middle ear, a perforated or scarred ear drum, impacted ear wax, eustachian tube dysfunction, a tumor, or lack of contact between the conduction bones of the middle ear.

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Pediatric Audiological Testing

Visual Reinforcement Audiometry (VRA)

During VRA, the child uses earphones or sits between two speakers from which certain sounds are presented. A tone, speech or music may be played in order to encourage the child to respond by shifting their eyes or turning their head. When the child responds to the stimulus, they are rewarded with an interesting visual display, such as an animated toy. VRA performed with headphones can test each ear separately, while testing without headphones evaluates the child’s sound field instead. This test is ideal for children between the ages of seven and thirty months.

Behavioral Observation Audiometry (BOA)

BOA tests hearing by provoking a behavioral response to an acoustic stimulus. Used for infants from birth through seven months, the patient is observed for responses such as body movement, eye widening, eye opening or change in sucking rate after a stimulus is provided. This test is used to rule out hearing loss and related conditions.


Tympanometry is a compliance test that examines and assesses ear drum functionality by measuring responses to varying air pressure sweeps within the ear canal. A probe is inserted into the ear to produce a test tone and different pressure levels, and then record the responses within the sealed canal. Abnormal results may be the result of fluid in the middle ear, perforated ear drum, eustachian tube dysfunction or impacted ear wax.

Otoacoustic Emissions (OAE) Testing

OAEs are very soft acoustic responses to stimuli from the outer hair cells in the cochlea. Damage to the inner ear causes these responses to disappear, so measurement of these responses can be used to evaluate the health of the ear. OAE testing is performed by inserting a probe containing a microphone and speaker into the ear canal to emit a sound, and then recording the response signal. The test is performed as a routine screening exam for newborns to detect any possibility of hearing loss or related conditions. Absent or very soft response signals may indicate hearing loss, fluid behind the ears or damage to the cochlea.

Auditory Brainstem Response (ABR) Screening

Also known as the Brainstem Auditory Evoked Response (BAER), the ABR screening examines brain waves that are stimulated by a clicking sound in order to evaluate the auditory pathways in the brain and diagnose hearing loss or other serious conditions. Responses are recorded with electrodes while the patietn listens to clicking noises through headphones. The ABR is a more detailed exam often performed to confirm abnormal results received from OAE testing.

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Dizziness Evaluation / Vestibular & Balance Function Test

A vestibular and balance function evaluation consists of a variety of tests performed to examine and diagnose the vestibular portion of the inner ear, which is responsible for balance. These tests can help determine the cause of dizziness, and then allow your doctor to develop the most appropriate treatment plan. Some vestibular tests include:

Electronystagmogram (ENG)

iStock_000001849962MediumAn electronystagmogram (ENG) is a diagnostic procedure that measures normal eye movements, as well as involuntary ones known as nystagmus. This test is most often performed to evaluate the function of the inner ear and the parts of the brain that control eye movement, as well as to see how well these structures work together to maintain the balance and position of the body.

During the ENG exam, electrodes are attached to the face to take readings while the eyes perform several different activities, such as following the movement of objects, looking back and forth between designated points and lying in different positions. For some patients, this test may also include placing a small amount of cool water and then warm water into the ear canal. This procedure can be performed in our Los Angeles area office. Abnormal results may indicate damage to the inner ear, the nerve of the inner ear, or other parts of the brain that control eye movements.

Videonystagmography (VNG)

Like ENG, videonystagmography (VNG) is also used to evaluate inner ear function and determine whether or not it is the cause of dizziness and balance disorders, but does so using infrared goggles instead of electrodes. The goggles meaure the involuntary movements of the eyes, known as nystagmus, in response to a series of stimuli. VNG produces more accurate and consistent results, and is considered more comfortable for patients. It is also one of the only tests that can determine if the problem is unilateral (one ear) or bilateral (both ears).


Posturography evaluates postural control while standing upright using static or dynamic conditions in order to diagnose dizziness and other vestibular conditions. This test examines the sensory, motor and central processes involved with posture and balance in order to diagnose certain vestibular and neuromuscular disorders. In static posturography, the patient remains in standing posture on a fixed platform, while dynamic posturography involves movable platforms that require changing positions.

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Digital Hearing Aids

iStock_000012290586XSmallHearing aids are a common non-invasive treatment option for hearing loss. A hearing aid is a small electronic device that is worn in or behind your ear to amplify sounds so they can be heard better and to improve the patient’s listening and communication capabilities. The device consists of a microphone, amplifier and speaker. The sounds are received through the microphone and then increased in power by the amplifier, which sends the signals to the ear through a speaker.

Emerging technology has allowed for the development of digital hearing aids, which convert sound waves into numerical codes before amplifying them. Some frequencies can be amplified more than others for customized treatment. Digital aids can also be programmed to focus on sounds coming from a certain direction. Digital aids are quickly becoming the standard in hearing treatment, and we are proud to offer them to our patients throughout the Los Angeles area at Ocean Hearing Care, our hearing aid faculty.


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