Accessibility Tools

Types of Hearing Loss

Sensorineural Hearing Loss

Sensorineural hearing loss is when the hearing loss is caused by damage relating to the inner ear.

Causes of sensorineural hearing loss include:

  • Aging (presbycusis)
  • Autoimmune inner ear disease
  • Exposure to loud sound
  • Genetics
  • Malformation of the inner ear
  • Meniere’s Disease
  • Trauma
  • Ototoxic drugs
  • Tumors
  • Virus or disease

Conductive Hearing Loss

Conductive hearing loss occurs when sound is not transmitting efficiently through the outer and/or middle ear.

Causes of conductive hearing loss include:

  • Allergies
  • Cholesteatoma
  • Ear infections
  • Fluid in the middle ear
  • Infection in the ear canal
  • Malformation of outer ear, ear canal, or middle ear structures
  • Ossicular chain discontinuity
  • Ossicular chain fixation
  • Otosclerosis
  • Poor Eustachian tube function
  • Perforated ear drum
  • Presence of a foreign body
  • Scared ear drum(s)
  • Surfer’s Ear
  • Swimmer’s Ear
  • Wax build up

Mixed Hearing Loss

Mixed hearing loss occurs when there is damage to the inner ear and sound is not transmitting efficiently through the outer and/or middle ear.

Infant Hearing Screening and Evaluations

Hearing loss is a fairly common birth defect, affecting two to three out of 1,000 babies. But even if your baby fails the initial hearing test, it doesn’t necessarily mean that a hearing loss exists. A failed hearing test can be the result of crying and fussing during the exam or a buildup of fluid or debris in the ears. If your baby refers on his or her newborn hearing screening, he or she will be referred for a diagnostic auditory brainstem evaluation (ABR) .

Pediatric Hearing Evaluations

Your child’s hearing is a crucial component of the development process. It affects their social, emotional and cognitive skills and plays a major role in language and speech development. A hearing loss can have a big impact on your child’s learning ability, but if the problem is caught early, it may be able to be treated.

There are several different hearing tests that an audiologist can administer, based on your child’s age, development and health. These include:

  • Tympanometry: Soft sounds and air pressure are introduced in the ear canal to measure the status of the middle ear.
  • Middle ear muscle reflex (MEMR): A rubber tip is inserted in the ear canal, and a series of sounds that may trigger an acoustic reflex are delivered through the tips.
  • Otoacoustic emissions (OAE) test: Sounds are delivered through a probe in the ear canal, and the responses from the cochlear sensory (outer hair cells) in the inner ear are recorded.
  • Standard behavioral audiometry: Standard behavioral audiometry is typically utilized on older children (typically >5 years old). Patients are asked to repeat a series of words and respond by raising a hand, pushing a button, or a using a verbal response when the patient hears a beeping sound.
  • Conditioned Play Audiometry (CPA): Conditioned play audiometry (CPA), sometimes called play audiometry, is a method of testing the hearing ability of a child, toddler, or preschool age child.CPA is a fun and interactive game. It involves conditioning the child to listen to sounds and indicate a response when the sound is heard through a playful activitysuch as throwing a ball in a bucket or building a tower with blocks.
  • Visual Reinforcement Audiometry (VRA): Visual Reinforcement Audiometry (VRA) is a way that audiologists use to test hearing on young children, typically in the age range of 6 months to 3 years old. It can also be used on individuals with developmental delays. While the child sits in a chair in the center of the room or on a parent/guardian’s lap, the audiologist speaks or plays sound through speakers. The audiologist will then teach the individual to look towards the sound by showing the patient a toy that lights up or is animated as a reinforcement for looking toward the source where the sound is played. Once the patient is trained on this task, the audiologist then finds the softest sound the patient will respond to when played through the speakers.
  • Auditory Brainstem Response (ABR) Test: Sounds are transmitted through earphones, and electrodes measure the hearingnerve’s response to sound. This test is typically performed on infants or individuals whose behavioral hearing evaluation produced poor reliability.

If your child refers on any of these evaluations, solutions are available to help them.

Call for more information or to schedule an appointment.

Auditory Brainstem Evaluations

Auditory Brainstem Response (ABR) tests measure reactions of the auditory nerve in response to sound. An ABR test takes approximately three hours. During the test, an infant must be asleep.

When conducting the test, an audiologist places cleans the patient’s skin with rubbing alcohol and some exfoliating gel. Four small stickers, called electrodes are then placed on the child’s forehead and ears. The electrodes are connected to a computer and measures how your child’s hearing nerve responds to them. The child will wear a set of earphones and the audiologist will play sounds through them.

There are certain steps you can take to ensure a successful ABR test.

  • Babies: Bring babies to the appointment tired and hungry. Try to disrupt their sleep schedule so they’re ready to nap during the appointment, and hold off on feedings until just before the appointment.
  • Young Children: Anesthesia may be necessary to get the child to sleep through the test. Due to the likely necessity of anesthesia, young children tend to be referred to an outside facility for this test to be completed.
  • Older Children and Adults: Older children and adults are tested while awake if they relax and remain still during the test. If the patient is unable to relax, anesthesia maybe necessary and a referral will be made to an outside facility for the test to be completed.

Call for more information.

Balance Testing

Balance Testing Patient Instructions

The balance test you will be completing is called a Videonystagmography (VNG) examination. During this test, you will be wearing goggles that record your eye movements. There are three sections of a VNG: 1) watching images on a screen 2) moving your body in different positions 3) testing part of the balance portion of your ears. Please bring your questionnaire completely filled out to your appointment.

Please allow approximately 90 minutes for this test to be completed.

Patients cannot drive themselves home after testing as they may feel particularly off balance after testing.


  • Please do not wear eye makeup of any kind to the test. Eye makeup interferes with the camera’s ability to track your eye movements. If you have eye makeup on when you arrive, we will need you to remove it. Please also note that tattoos near or around the eyes may affect testing. If you have permanent tattoos near or around the eye, please use concealer or white eyeliner to cover the area.
  • Do NOT take any of the following at least 48 hours prior to testing:
    • Anti-nausea or Anti-vertigo medications (i.e., ondansetron, promethazine, metoclopramide, prochlorperazine, meclizine, lorazepam, Zofran, Reglan, Antivert, Dramamine, etc.)
    • Anti-depressants and anti-anxiety medications (i.e., citalopram, escitalopram, fluoxetine, paroxetine, sertraline, duloxetine, venlafaxine, imipramine, Ativan, Xanax, Valium, Celexa, Prozac, Paxil, Zoloft, Lexapro, Cymbalta, Effexor, etc.)
    • Cold or allergy medications (i.e., Benadryl, Claritin, Allegra, Zyrtec, levocetirizine, hydroxyzine, loratadine, doxylamine, etc.)
    • Narcotics (opioids) and Barbiturates (i.e., secobarbital, mephobarbital, pentobarbital, butabarbital, amobarbital, codeine, dilaudid, roxanol, vicoprofen, combunox, hycet, tylox, endocet, morphine, oxycodone, Demerol, Seconal, Mebaral, Butisol Sodium, etc.)
    • Alcohol
    • Sleeping pills (i.e., doxepine, eszopiclone, ramelteon, trazedone, Ambien, Lunesta, Rozerem)
  • Continue taking essential medications such as: blood pressure medications, heart medications, cholesterol medications, seizure medications, thyroid medications, and diabetic medications.
  • No eating, drinking, or smoking 4 hours prior to testing. If you are diabetic and must eat, confine yourself to light, simple foods such as toast and yogurt that are consumed as early before testing as possible (preferably 2+ hours before).
  • Do not consume caffeine (i.e., coffee, tea, cola, chocolate, etc.…) after midnight on the day of the test.
  • Wear comfortable clothing
  • If you wear contact lenses, please wear them to testing.

If you have any questions regarding this instruction sheet of the VNG exam, please call our Salinas office location.

ECochG or ECOG (Electrocochleography) Testing

Electrocochleography is a way the electrical potentials in the inner ear can be measured when stimulated by sound. This test is used to determine if the inner ear has an excessive amount of fluid pressure. An individual who has an excessive amount of fluid pressure may experience symptoms such as hearing loss, aural pressure, tinnitus, and/or dizziness.

Patients who are having this test completed can expect have some surface electrodes placed on their head and a small electrode placed in their ear canal. Sounds will be played into the patient’s ear and electrical activity will be recorded.

Hearing Aids

Hearing aid technology has improved time with advancements coming to the marketplace on an regular basis. They can be discrete for the patient to wear and provide the most natural hearing experience possible for the patient’s auditory system.

Discrete Sizes

Many styles of hearing aids are quite discrete making is difficult for others to see the hearing aid when worn. Many individuals can wear a very discrete hearing aid. The audiologist will make his/her recommendation as to the style and size of your hearing aid based on your hearing loss and your personal preferences.

Color Options

Hearing aids come in a wide range of colors including options that coordinate with hair color and a user’s personal preferences.


Many hearing aids have wireless connectivity to smartphones allowing the user to stream phone calls and audio to his/her hearing aid(s). These connectivity options can allow a user to pair the hearing aid(s) to his/her computer, or tablet. Manufacturers also create mobile applications which allow users to perform many functions including: find their hearing aid(s) if lost, control volume, and make subtle sound quality changes.

Your audiologist at Central Coast Head and Neck Surgeons can help you figure out which technology and features are best fit for your hearing loss and your personal needs

Call for more information or to schedule an appointment.

Hearing Aid Styles

Receiver-in-the-Canal (RIC) Hearing Aids

Receiver-in-the-canal hearing aids known to be discrete and comfortable. The hearing aid fits behind the user’s ear with a thin wire connecting the hearing aid to the ear piece. Most styles come with features such as volume control options and wireless connectivity to devices such as smartphones and tablets. They can also be paired with hearing aid accessories.

Behind-the-Ear (BTE)

A behind-the-ear style is a hearing aid that fits behind the ear where an earmold is connected to the hearing aid via a clear tube. Styles come with features such as volume control options and wireless connectivity to devices such as smartphones and tablets. They can also be paired with hearing aid accessories.

Invisible-in-the-Canal (IIC)

Invisible-in-the-canal hearing aids are the most discrete hearing aids on the market. They sit deep inside the ear canal where it is extremely difficult to see. Due to their small size, user controls are typically not available on these devices. They work best for individuals with mild to moderately severe hearing loss and good manual dexterity. They do not work for all types and severity of hearing loss.

Completely-in-the-Canal (CIC)

CIC hearing aids fit inside the ear canal and are very discrete when wearing.They work best for individuals with mild to moderately severe hearing loss and good manual dexterity. They do not work for all types and severity of hearing loss.

In-the-Canal (ITC)

In-the-canal hearing aids are slightly larger and more visible than invisible- or completely-in-the-canal hearing aids. Styles may come with features such as volume control options and wireless connectivity to devices such as smartphones and tablets. They may also be able to be paired with hearing aid accessories.

In-the-Ear (ITE)

In-the-ear custom hearing aids are the largest of the custom hearing aid family. They provide on-ear user controls and are sometimes best for use with individuals with challenges with dexterity. Styles may come with features such as volume control options and wireless connectivity to devices such as smartphones and tablets. They may also be able to be paired with hearing aid accessories.

Hearing Aid Accessories

Assistive Listening Devices

Assistive listening devices (ALDs) are a type of hearing aid accessory designed to help individuals hear with or without a hearing aid.

Remote Microphones

Remote Microphones are very discrete and are often placed near or on the speaker who the listener is trying to hear. The remote microphone picks up the sound from the speaker and wirelessly sends what the speaker is saying directly to the hearing aids. These devices are particularly helpful in noisy situations, when in lectures, meetings, or in classroom settings.

Remote Controls

Remote controls are small handheld devices that users can use to adjust the settings in the hearing aids. These devices are particularly helpful for individuals with dexterity challenges.

Connectivity Devices

Connectivity accessories devices that allow you to stream from devices such as television, smartphones, computers, or tablets.

Hearing Aid Warranties

New hearing aids purchased at Central Coast Head and Neck Surgeons come with multiple warranties. The choice of level of technology will determine the length of the hearing aid warranty.

Loss and Damage Warranties

For the length of the warranty period, if a hearing aid user loses or damages his/her hearing aid(s), the hearing aid(s) will be able to be replaced after a deductible has been met. This is a one-time use warranty and each hearing aid holds its own warranty.

Repair Warranties

For the length of the warranty. if a hearing aid malfunctions, the manufacturer will fix the hearing aid at no cost to the hearing aid user.

Bone Anchored Hearing Devices

Bone anchored hearing devices are devices are made for individuals with conductive and some mixed hearing losses. They work through bypassing the individuals outer and middle ear and accessing the individual’s inner ear to allow them to hear. A small device is worn behind the individual’s ear. This device picks up the environmental sound and helps transmit the sound to the inner ear.

Custom Earmolds

Custom molds can be used in a variety of products including:

  • Swim-Plugs
  • Occupational earpieces
  • Industrial hearing protection
  • Recreational hearing protection
  • Stethoscopes
  • Use with headphones
  • In-Ear monitors
  • Musician and personal-listening earpieces

If you are interested in obtaining custom earmolds, call to schedule an appointment.