Audiology

  • Hearing Evaluation

    If you suspect that you have a hearing loss or have ringing/buzzing in your ears, you will need a hearing evaluation. At the time of the hearing evaluation, we will take a full case history to determine how much your hearing problems impact your day-to-day life as well as the lives of your family. The results of your hearing test will provide the audiologist with an outline of what sounds you may be missing or hearing in order to create a plan to help address your needs.

    How do we hear?

    There are three main sections of the ear - the outer ear, middle ear and inner ear. Each section has a unique function that converts sound waves into electrical impulses that can be processed and interpreted by the brain. The outer ear receives the sound waves and guides them toward to the middle ear. The middle ear amplifies the sound vibrations and sends them to the inner ear. The inner ear transforms the vibrations into electrical impulses which are carried through the auditory nerve to the brain.

    • Outer Ear - captures sound waves and guides them into the ear canal
    • Ear Canal - carries the sound waves towards the eardrum
    • Eardrum - (tympanic membrane) vibrates from the sound waves
    • Middle Ear Bones - (malleus, incus and stapes) pick up vibration from the eardrum
    • Cochlea - as vibrations pass through this organ, the fluid inside the cochlea moves, causing thousands of "hair cells" to set in motion so they can translate the sound waves into electrical impulses
    • Auditory Nerve - sends the electrical impulses to the brain to be processed as sound
    What is a Diagnostic Hearing Evaluation?

    A diagnostic hearing evaluation is the first step in determining your hearing capability. If you have a hearing loss, it will detail the extent, type, and specifics of your particular hearing loss. The diagnostic hearing evaluation will be performed by a certified licensed audiologist, using equipment called an audiometer.

    The diagnostic hearing evaluation consists of a variety of tests to determine the unique aspects of your hearing loss, as well as the level at which you can detect and understand speech.

    It is recommended that you bring a family member with you to the evaluation appointment. Hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations.

    A diagnostic hearing evaluation at Carteret Physical Therapy includes the following tests:

    • Otoscopy
    • Air conduction testing
    • Bone conduction testing
    • Speech testing
    • Tympanometry or acoustic immittance testing

    The diagnostic hearing evaluation is covered by most health insurance policies, though you may need a referral from your primary care physician to qualify for coverage.

    What Can I Expect During a Diagnostic Hearing Evaluation?

    You will want to arrive 15 minutes before your scheduled appointment to fill out paperwork, including a complete case history. The case history is an important starting point of any audiologic evaluation. An effective case history is used to guide the audiologist in a number of ways. It provides important information about any complaints you have about your hearing. This includes:

    • Difficulty hearing in one ear or both ears
    • Experiencing ringing or buzzing (tinnitus)
    • Exposure to excessive or loud noise
    • Balance problems.

    Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.

    The audiologist will go over your case history with you prior to beginning the hearing evaluation

    The evaluation will probably last about 30 minutes in length. You should also allow for time for discussion with the audiologist to review test results, and ask questions.

    The results of your hearing test will determine if your hearing loss is conductive (relating to the outer and/or middle ear, sensorineural (relating to the inner ear hair cells and nerves) or a combination of the two. The results of the evaluation will also rate your hearing loss as mild, moderate, severe, or profound. The speech discrimination results will provide a practical look at the level of speech understanding with hearing instruments.

    If the determination is made that you need hearing aids, allow for sufficient time to discuss your options. With the results of the complete hearing test, a hearing instrument solution can be developed that best meets your specific and unique hearing needs now and for the foreseeable future.

    The diagnostic hearing evaluation is a good chance to establish a relationship with your audiologist. Above all, don't be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.

    How do I know if I have hearing loss?

    Most hearing loss occurs when people age. However, it can result from over-exposure to noise, infections, trauma, congenital or hereditary factors, medications or other causes. About 90% of all cases of hearing loss can be corrected with hearing instruments.

    There are over 30 million Americans with some type of hearing loss. Hearing is an integral part of the human experience and when it is diminished, it affects all aspects of that experience. If you are uncertain whether or not you may have a hearing loss, we invite you to take our 5-Minute Speech Understanding Test. It may help you decide whether or not you need to take additional steps necessary for amplification.

    Warning Signs of Hearing Loss

    • Difficulty understanding conversation, especially in background noise
    • Finding that people are mumbling or slurring their words
    • Trouble comprehending certain sounds or pitches
    • Continually asking people to repeat themselves
    • Mistaking sounds of words such as: "dime", "time", "make", "take"
    • Preferring the TV or radio louder than others
    • Straining to hear on the telephone
    • Reading people's lips
    • Avoiding conversations or interactions with others because it is too difficult to hear and understand
    • Nodding or agreeing with others during conversations while uncertain of the topic
    What are the most common types of hearing loss?

    Although there are many types of hearing loss, the most common type is sensorineural loss, and the second most common type of loss is conductive loss.

    There are three types of hearing loss we encounter most frequently:

    1. Conductive Loss - is caused by damage to the outer or middle ear. Sound waves are blocked as they move through the outer or middle ear. Since the sound cannot travel effectively, the sound energy reaching the inner ear is weakened or muffled. Conductive loss may result from infection, earwax buildup, fluid in the middle ear, damage to the middle ear bones, a perforation in the eardrum or an obstruction in the ear canal. This type of loss is usually treated with earwax removal, medicine or surgery.

      Signs & Symptoms of Conductive Loss:

      • Perceiving speech and other sounds as stifled or distant
      • Ear discomfort or discharge from ear - Swelling or redness of the outer ear
      • Pressure or fullness in the ear
    2. Sensorineural Loss - (also known as "nerve deafness") is caused by damage to the hair cells in the inner ear. The inner ear is unable to transfer the sound vibrations to the brain and it usually occurs in both ears. It is the most common type of loss and it can result from aging, noise exposure, disease, birth defects and nerve damage. This type of loss is usually treated with amplification (hearing devices).

      Signs & Symptoms of Sensorineural Loss:

      • Difficulty understanding speech in background noise
      • Speech and other sounds seem unclear
      • Trouble hearing high pitched sounds
      • Persistent or episodic ringing or buzzing sound in ears
    3. Mixed Loss - is caused by damage to the outer or middle ear and the inner ear. It is the combination of conductive and sensorineural hearing losses.

      Signs & Symptoms of Mixed Loss:

      • See "Signs & Symptoms of Conductive and Sensorineural Losses"
    Things to Know about Hearing Loss
    • Hearing loss is a major public health issue that is the third most common physical condition after arthritis and heart disease.
    • Gradual hearing loss can affect people of all ages -- varying from mild to profound. Hearing loss is a sudden or gradual decrease in how well you can hear. Depending on the cause, it can be mild or severe, temporary or permanent.
    • Degrees of hearing loss: mild, moderate, severe, profound.
    • Congenital hearing loss means you are born without hearing, while gradual hearing loss happens over time.
    • Hearing loss is an invisible condition; we cannot see hearing loss, only its effects. Because the presence of a hearing loss is not visible, these effects may be attributed to aloofness, confusion, or personality changes.
    • In adults, the most common causes of hearing loss are noise and aging. There is a strong relationship between age and reported hearing loss.
    • With age-related hearing loss, known as presbycusis, changes in the inner ear that happen as you get older cause a slow but steady hearing loss. The loss may be mild or severe, and it is always permanent.
    • In older people, a hearing loss is often confused with, or complicates, such conditions as dementia.
    • Noise-induced hearing loss may happen slowly over time or suddenly. Being exposed to everyday noises, such as listening to very loud music, being in a noisy work environment, or using a lawnmower, can lead to hearing loss over many years.
    • Sudden, noise-induced hearing loss from gunfire and explosions is the number one disability caused by combat in current wars.
    • More often than not severe tinnitus (or ringing in the ears) will accompany the hearing loss and could be just as debilitating as the hearing loss itself.
    • Other causes of hearing loss include earwax buildup, an object in the ear, injury to the ear or head, ear infection, a ruptured eardrum, and other conditions that affect the middle or inner ear.
    • For more questions and answers read An Overview of Hearing Loss – Its Signs, Implications and Solutions.
  • Hearing Aids

    Jaime Taylor is a Doctor of Audiology and holds a separate New Jersey hearing aid dispensing license. Hearing Aid services include:

    • A complete hearing aid evaluation
    • Chosing between a wide selection of top-quality digital hearing instruments to find the best hearing aid for you
    • We work with all major hearing aid manufacturers; including Oticon, Starkey, Unitron, ReSound, & Phonak
    • A variety of styles available (behind the ear, custom hearing aids, & invisible completely in the canal options)
    • A thirty day trial period
    • Regular maintenance checks and repairs
    • Custom earmolds for hearing aids
    • Custom swim molds
    • Recreational or professional hearing protection available
    • Hearing aid prices vary depending on the level of technology

    Stay connected.

    Our revolutionary Hearing Aid product lines allow you to be immersed in the world around you like never before. We offer you only the most advanced technology with supreme sound quality and premium features customized to your unique hearing needs so you stay connected to the people and things you love most.



    With our Hearing Aids you can:

    • Stream phone calls, music and more to your hearing aids
    • Experience more natural hearing and effortless transitions as you go about your day
    • Enjoy pristine audio and exceptional listening clarity
    • Preserve peace and quiet while amplifying the important things
    • Better understand conversations and hear comfortably in noisy places
    • Choose the style right for you – including invisible and custom fit

    Wireless Hearing Aids

    • advanced noise reduction technology and precise directional microphones to help make speech sound more natural and easier to hear in today’s complex listening environments.
    • allows one to be present in a moment or situation that involves a sense of immersion, enabling you to feel connected to the sounds you miss during the moments that matter most.
    • smartphone (iPhone/Android) compatible hearing aids available

    Invisible Hearing Solution

    • The world’s smallest, most comfortable custom-fit invisible-in-the-canal hearing aids
    • loaded with advanced features for immersive listening and pristine sound.

    Rechargeable Hearing Solutions

    We Offer Two Rechargeable* Hearing Solutions To Keep You Connected To The People And Things You Love.

    Lithium ion batteries last 20 percent longer than other systems, are 30 percent smaller and are 100 percent easy to use. Plus, with the industry’s longest lasting charge, your hearing aids will always be ready to go. 

    • Smallest rechargeable hearing aid available today!
    • No more hassle of disposable batteries.
    • Longest lasting charge delivers over 30 hours of superior hearing.
    • All-in-one charger lets you grab your hearing aids and go.

    ZPower Rechargeable Batteries

    • Now you can enjoy continuous and stable use throughout your day, and avoid the hassle of disposable batteries. 
    • Simply set your ZPower® micro RIC 312t hearing aids on the charger overnight, instead of replacing your batteries every few days. 
    • A pair of ZPower® batteries can take the place of an estimated 200 disposable batteries. Your hearing care professional can replace your ZPower batteries for you each year.

    Balance Evaluation

    A balance disorder is a condition that makes you feel unsteady or dizzy. If you are standing, sitting, or lying down, you might feel as if you are moving, spinning, or floating. Your sense of balance relies on several components, known as the vestibular system: the inner ear, the eyes, proprioceptors, and how the brain processes information it receives from the other components.

    In order to diagnose a balance disorder, your physician may request a hearing evaluation along with a videonystagmography (VNG) test. VNG testing is used to determine which part of the vestibular system may be causing a balance or dizziness problem.

  • Millburn Physical Therapy | Audiology | Balance Evaluation | Millburn NJ

    balance Evaluation

    A balance disorder is a condition that makes you feel unsteady or dizzy. If you are standing, sitting, or lying down, you might feel as if you are moving, spinning, or floating. Your sense of balance relies on several components, known as the vestibular system: the inner ear, the eyes, proprioceptors, and how the brain processes information it receives from the other components.

    In order to diagnose a balance disorder, your physician may request a hearing evaluation along with a videonystagmography (VNG) test. VNG testing is used to determine which part of the vestibular system may be causing a balance or dizziness problem.

    How do you diagnose the causes of dizziness or poor balance?

    To understand the causes of dizziness or poor balance, you need to understand how our human balance system works. The three systems responsible for our equilibrium are the inner ear, eye movement, and proprioception. The vestibular portion of the inner ear sends information to the brain about how our head is moving. In response, the brain sends commands to move the eyeballs accordingly. Proprioceptors are nerve endings throughout the body that inform the brain about our body's interaction with the environment. If we walk barefoot from a tiled floor onto a thick carpet, the proprioceptors in our feet will give the brain this information so that we don't trip or fall. All three of these systems must work perfectly in order for us to achieve good balance. If one system is off, it will cause dizziness and/or imbalance and also affect the remaining systems. Although there are numerous causes for dizziness and imbalance, research has shown that 85% of persons with these problems have an underlying inner ear disorder.

    Dizziness and balance difficulties often result from problems in the vestibular system, which is linked with the hearing system in the ear. Testing, along with taking an extensive case history, can help determine the source of a person's dizziness by identifying any components of the hearing or vestibular systems that are not functioning normally.

    What inner ear problems can cause dizziness or poor balance?

    There are a variety of causes for dizziness, vertigo or balance problems, however research has shown that 85% of persons with these problems have an underlying inner ear disorder. The two most common inner ear problems contributing to dizziness and balance issues are BPPV and vestibulopathy.

    BPPV
    The leading cause of dizziness is a condition known as Benign Paroxysmal Positional Vertigo (BPPV). In the vestibular portion of the inner ear, there are salt-like crystals called otoliths. With BPPV, these crystals break loose and gather with debris that can float into or attach itself to the semicircular canals.

    The symptoms of BPPV can include dizziness or vertigo, lightheadedness, imbalance and nausea. Typically, the symptoms are brought about due to a change in head position. Common complaints are dizziness when rolling over or getting out of bed, looking up or bending down. The symptoms of BPPV may be present for a few weeks, then stop, and then come back again.

    The most common cause of BPPV in people under age 50 is head injury or whiplash. It is also common to experience BPPV following a sinus infection or severe head congestion. In older persons. the condition may be contributed to the degeneration of the vestibular system of the inner ear. In most cases, BPPV is said to be idiopathic, or for no known reason.

    Vestibulopathy
    Each inner ear has two main parts, one that controls hearing (the cochlea) and one that is responsible for balance (the vestibular portion). Vestibulopathy refers to a difference (usually a reduction) in the output of one or both of the vestibular portions of the inner ears. Vestibulopathy may be caused by infection, illness, trauma or simply the natural aging process. Many times, the onset of vestibulopathy starts with a severe attack of vertigo (spinning) accompanied by nausea that lasts for several days. Although the subsequent dizziness is not as severe, it can become a chronic situation if left untreated.

    The symptoms of vestibulopathy can include dizziness with head or body movement, motion sickness or uneasiness with certain visual stimuli (i.e., rows in a supermarket, flickering lights or down escalators).

    How does testing help diagnose & treat dizziness and poor balance?

    Behavioral hearing testing and tympanometry will be performed as part of a full evaluation for dizziness. Dizziness and balance difficulties often result from problems in the vestibular system, which is linked with the hearing system in the ear. These tests can help determine the source of a person's dizziness by identifying any components of the hearing or vestibular systems that are not functioning normally.

    At Carteret Physical Therapy a complete comprehensive diagnostic test for vestibular disorders, including taking an extensive case history, Videonystagmography (VNG) with infrared goggles, Vestibular-Ocular Reflex (VOR) Testing, Audiological Evaluation, Tympanometry, and Acoustic ReflexesTesting.

    The vital information obtained from each test is as follows:

    • VNG – When a person is dizzy, the eyes generally move uncontrollably. VNG helps isolate the source of a person's dizziness by measuring eye movements, both those that are voluntary and those that result from intentionally inducing dizziness. Analyzing the eye movements helps the audiologist isolate possible causes for dizziness. There are three main groups of sub-tests included in ENG testing: ocular mobility testing, positional and positioning testing, and caloric testing.
    • VOR – Through the use of active head rotation we measure gain, the amount of eye movement relative to head movement: phase, the reaction time of the eyes in response to head movement: and symmetry, the gain to rightward movement vs. the gain to leftward movement during sinusoidal head movement. Active head rotation tests more real-life frequencies of head movement than does rotational chair testing.
    • Audiometry – Measures hearing acuity and speech discrimination.
    • Tympanometry – Measures the status of the middle ear.
    • Acoustic Reflexes – Measures the status of the reflex arc and uses this information to determine possible site of lesion.

    The results from all of these tests are examined together to help determine a possible cause of the person's problem, as well as to design a customized treatment plan.

    What can I expect from balance testing and treatment?

    If a complete audiogram has been done recently, and you can bring a copy of the results to your appointment, there will be no need to repeat the testing. However, the hearing testing done during a vestibular assessment is a very important aspect of the evaluation and must be accurate and recent. Testing is completed in one office visit.

    If vestibular therapy is recommended, the type of therapy will determine the duration. Some therapies can be completed in as little as 2-3 office visits. However, some balance retraining may take 12-14 visits.

    If you need to see a doctor, in most cases you can return to your primary care provider. However, if another referral is recommended, our staff works closely with your doctor to assure that you get the proper care.

    All testing is done by licensed, certified audiologists. These specialists have had specific training in vestibular assessment and therapy.

    How do I know if I should get a balance test?

    If you notice any of these symptoms, you should have your balance evaluated. Do You...

    • Experience a feeling of motion with certain movements such as quick head turns or getting out of bed?
    • Have difficulty getting around in the dark?
    • Feel uneasy walking down an aisle in the store or walking in a shopping mall?
    • Sometimes feel like you have no control of your feet?
    • Feel unsteady or need to touch something while walking?
    • Have a fear of falling?
    • Feel uneasy looking out of the window of a moving car?
    • Have trouble walking from one surface to another, such as tile to carpet?
    • Feel as though your are swaying or leaning toward one direction while you are walking?
    • Feel like no one understands how upsetting this is?
    Balance & Aging Fall Prevention
  • Frequently Asked Questions

    Click On A Question To View The Answer

    What happens on my first visit?

    During your first visit you can expect the following:

    • Arrive at your appointment with your paperwork completed (you can download it from our website – see the paperwork link).
    • You will provide us with your prescription for physical therapy.
    • We will copy your insurance card.
    • You will be seen for the initial evaluation by the therapist.
    • The therapist will discuss thwing:
      • Your medical history.
      • Your current problems/complaints.
      • What aggravates and eases the problem.
      • How this is impacting your daily activities or your functional limitations.
      • Your goals for the visit.
      • Medications, tests, and procedures related to your health.

    The audiologist will then perform the comprehensive audiological evaluation, which may include some of the following:

    • VNG – When a person is dizzy, the eyes generally move uncontrollably. VNG helps isolate the source of a person's dizziness by measuring eye movements, both those that are voluntary and those that result from intentionally inducing dizziness. Analyzing the eye movements helps the audiologist isolate possible causes for dizziness. There are three main groups of sub-tests included in ENG testing: ocular mobility testing, positional and positioning testing, and caloric testing.
    • VOR – Through use of active head rotation we measure gain, the amount of eye movement relative to head movement: phase, the reaction time of the eyes in response to head movement: and symmetry, the gain to rightward movement vs. the gain to leftward movement during sinusoidal head movement. Active head rotation tests more real-life frequencies of head movement than does rotational chair testing.
    • Audiometry – Measures hearing acuity and speech discrimination.
    • Tympanometry – Measures the status of the middle ear.
    • Acoustic Reflexes – Measures the status of the reflex arc and uses this information to determine possible site of lesion.

    The results from all of these tests are examined together to help determine a possible cause of the person's problem, as well as to design a customized treatment plan.

    What do I need to bring with me?

    Make sure you bring your referral (provided to you by your doctor) and your payment information. If your insurance is covering the cost of your visit, bring your insurance card.

    If you are covered by Workers' Compensation, bring your claim number and your case manager's contact information. If you are covered by auto insurance or an attorney lien, make sure you bring this information.

    If your are coming in for a hearing evaluation it is recommended that you bring a family member with you to the evaluation appointment. Hearing loss is a family issue. It helps to have another supportive person at the appointment to help you understand the information and recommendations.

    How should I dress?

    If you are coming in for a balance evaluation or balance therapy you should wear loose fitting clothing so you can perform the tasks comfortably.

    What Can I Expect During a Diagnostic Hearing Evaluation?

    You will want to arrive 15 minutes before your scheduled appointment to fill out paperwork, including a complete case history. The case history is an important starting point of any audiologic evaluation. An effective case history is used to guide the audiologist in a number of ways. It provides important information about any complaints you have about your hearing. This includes:

    • Difficulty hearing in one ear or both ears
    • Experiencing ringing or buzzing (tinnitus)
    • Exposure to excessive or loud noise
    • Balance problems.

    Make sure that you take a full list of any medications and supplements you are taking with you to your appointment.

    The audiologist will go over your case history with you prior to beginning the hearing evaluation

    The evaluation will probably last about 30 minutes in length. You should also allow for time for discussion with the audiologist to review test results, and ask questions.

    The results of your hearing test will determine if your hearing loss is conductive (relating to the outer and/or middle ear, sensorineural (relating to the inner ear hair cells and nerves) or a combination of the two. The results of the evaluation will also rate your hearing loss as mild, moderate, severe, or profound. The speech discrimination results will provide a practical look at the level of speech understanding with hearing instruments.

    If the determination is made that you need hearing aids, allow for sufficient time to discuss your options. With the results of the complete hearing test, a hearing instrument solution can be developed that best meets your specific and unique hearing needs now and for the foreseeable future.

    The diagnostic hearing evaluation is a good chance to establish a relationship with your audiologist. Above all, don't be afraid to ask questions. You will want to be clear on any information you receive so that you can be an active participant in finding hearing solutions that work best for you and your lifestyle.

    How do I know if I have hearing loss?

    Most hearing loss occurs when people age. However, it can result from over-exposure to noise, infections, trauma, congenital or hereditary factors, medications or other causes. About 90% of all cases of hearing loss can be corrected with hearing instruments. There are over 30 million Americans with some type of hearing loss. Hearing is an integral part of the human experience and when it is diminished, it affects all aspects of that experience. If you are uncertain whether or not you may have a hearing loss, we invite you to take our 5-Minute Speech Understanding Test. It may help you decide whether or not you need to take additional steps necessary for amplification.

    Warning Signs of Hearing Loss

    • Difficulty understanding conversation, especially in background noise
    • Finding that people are mumbling or slurring their words
    • Trouble comprehending certain sounds or pitches
    • Continually asking people to repeat themselves
    • Mistaking sounds of words such as: "dime", "time", "make", "take"
    • Preferring the TV or radio louder than others
    • Straining to hear on the telephone
    • Reading people's lips
    • Avoiding conversations or interactions with others because it is too difficult to hear and understand
    • Nodding or agreeing with others during conversations while uncertain of the topic
    What can I expect from balance testing and treatment?

    If a complete audiogram has been done recently, and you can bring a copy of the results to your appointment, there will be no need to repeat the testing. However, the hearing testing done during a vestibular assessment is a very important aspect of the evaluation and must be accurate and recent. Testing is completed in one office visit.

    If vestibular therapy is recommended, the type of therapy will determine the duration. Some therapies can be completed in as little as 2-3 office visits. However, some balance retraining may take 12-14 visits.

    If you need to see a doctor, in most cases you can return to your primary care provider. However, if another referral is recommended, our staff works closely with your doctor to assure that you get the proper care.

    All testing is done by licensed, certified audiologists. These specialists have had specific training in vestibular assessment and therapy.

    How do I know if I should get a balance test?

    If you notice any of these symptoms, you should have your balance evaluated. Do You...

    • Experience a feeling of motion with certain movements such as quick head turns or getting out of bed?
    • Have difficulty getting around in the dark?
    • Feel uneasy walking down an aisle in the store or walking in a shopping mall?
    • Sometimes feel like you have no control of your feet?
    • Feel unsteady or need to touch something while walking?
    • Have a fear of falling?
    • Feel uneasy looking out of the window of a moving car?
    • Have trouble walking from one surface to another, such as tile to carpet?
    • Feel as though your are swaying or leaning toward one direction while you are walking?
    • Feel like no one understands how upsetting this is?

    Persistent dizziness and balance problems are more than a nuisance, they can lead to falls and other serious injuries. If you have signs of an inner ear problem, don't settle for medicating the symptoms. Schedule a dizziness and balance evaluation now. Contact Carteret Physical Therapy (732) 969-3480