NHS Borders Audiology team conduct hearing assessments for adult patients who have been referred by their GP or other health professional with concerns about their hearing. We also provide hearing assessments for the Ear, Nose & Throat department.

What to expect from your appointment

Hearing assessments generally last around 45 minutes. Upon arrival into the department you should check in at our reception desk and you will then by asked to take a seat in the waiting area. At your appointment time your audiologist will collect you from the waiting area and guide you to one of our 5 purpose-built sound-proof testing rooms. All our rooms are wheelchair accessible and you are welcome to bring a friend or family member with you.

Once in the testing room your audiologist will introduce themselves and explain the purpose and structure of the appointment to you. Hearing assessments generally begin with some questions about your medical history and specific hearing difficulties.

Your audiologist will then ask your permission to examine your ears. We will be looking for wax blockages or signs of infection. We do advise you to have your ears checked for wax prior to attending the department because wax blockage can prevent us from conducting a full hearing assessment. If your ears are clear your audiologist will then continue on to the hearing test itself.

Pure Tone Audiometry

The hearing test is quite simple and will be explained to you fully during your appointment. You will be given a handheld button and headphones will be placed over your ears. You will be played a series of beeps through the headphones and asked to press your response button whenever you hear a sound. The test is designed to find out the quietest pure tone sounds you can hear at a range of pitches across both ears. Your audiologist may then change the headphones for a headband that sits behind your ears. They will again ask you to press your button if you hear a sound. If we need further information about your hearing levels in a particular ear or about the type of hearing loss you may be suffering with, your audiologist may play an additional 'hissing' white noise sound through the headphones and ask you to ignore this while concentrating on pressing for the beeps.

Tympanometry

If we need further information about the type of hearing problem you have we may perform an additional test to check the function of your middle ear. This is an objective test which involves us placing a small plug into your ears and measuring your middle ear pressure.

Types and Severity of Hearing Loss

Once we have completed all the necessary hearing tests your audiologist will explain your results to you and discuss next steps. Your audiologist will explain the degree of your hearing loss and the potential impacts this may have on your ability to hear in certain situations. They will also explain where in your hearing system the problem originates.

Your hearing loss may be:

Conductive This is a loss that affects the structures that conduct sound to your inner ear. This includes your outer and middle ear. Common causes of conductive hearing losses include: wax blockage; fluid or infection of the middle ear; perforated eardrum; or damage to the middle ear bones. If your tests indicate a conductive hearing loss you will generally be referred onto an Ear, Nose & Throat specialist for medical treatment.
Sensorineural This is a loss caused by damage to the pathway that conducts sound impulses from the sensory (hair) cells in your inner ear up to the brain. Most commonly this is due to age-related wear and tear (presbyacusis) but sensorineural hearing loss can result from noise damage, bacterial or viral infections, ototoxic medications, diseases such as Meniere's disease, and also head injuries or stroke. Unlike conductive hearing losses, sensorineural hearing loss are generally permanent and are managed through the wearing of hearing aids.
Mixed As the name implies, a mixed hearing loss is a combination of conductive and sensorineural loss or, in other words, it affects the outer/middle and inner ear structures.

Are you ready for hearing aids?

If your hearing loss is sensorineural or cannot be treated by our ENT colleagues with surgery or medication the best way to improve your hearing during the day is to wear hearing aids. Our audiologists understand that while for many a diagnosis of hearing loss is expected, for others it can be a worry. We will take the time to discuss how your hearing loss impacts on your day to day life and help you to come to a conclusion about whether to proceed with hearing aids. In many cases it is not the test results that guide whether a hearing aid is necessary - instead it is how those test results impact on your quality of life.

When thinking about whether you are ready for hearing aids consider:

  • In order to get the most benefit from hearing aids they need to be worn regularly every day. It takes time for your brain to get used to hearing with a hearing aid and to put meaning back to sound you have not heard for a while. Hearing aids can therefore sound a little tinny for the first few weeks and you may find that you hear your own voice differently. These sounds do become normal but only through consistent wear.
  • What situations do you feel you have difficulties in? Hearing aids work well for improving clarity of voices on the TV, in one to one conversations and small groups, but they are less effective in situations with a lot of background noise.
  • Have you stopped taking part in activities you previously enjoyed because of concerns about your ability to hear?
  • Do you feel your hearing loss is impacting on your quality of life?

Our Audiologists are happy to support you in your decision making. If you are unsure about proceeding at the time of your assessment we are happy for you to go away and consider your options and get back in touch with us when you feel ready.