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3.6. TONAL TEST
GENERAL CONSIDERATIONS
Tonal audiometry is the basic test for the diagnosis of hearing loss; it consists of determining hearing threshold levels via air and/
or bone conduction, with or without masking.
There are different procedures for conducting the test; the health professional must determine which procedure is most appropriate
for each patient. It is recommended to explore, at least, 4 frequencies through air conduction (500, 1000, 2000 and 3000 or
4000 Hz) for both ears.
Tests should be carried out by a technician trained on how to perform audiometric tests, since they need to decide which ear is
to be tested first (usually, the one with better hearing), whether or not masking is required, if the patient is producing coherent
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responses
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Preferably, tests should last less than 20 min, to prevent patient fatigue.
PREPARING AND INSTRUCTING THE PATIENT
Before performing the test, perform an otoscopic examination of the patient in order to identify possible obstructions in the external
auditory canal which would need extracting.
It is recommended that the patient arrives at the test site at least 5 minutes in advance, to avoid possible exposure to high-noise
levels, or previous physical activities which might alter the test results.
Before starting, the technician should give the patient instructions about the test procedure, indicating, amongst others, the following:
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Which ear will be examined first.
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The general tone presentation sequence.
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How to indicate a response using the patient's response button (or gestures).
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When the patient is expected to provide a response (when they hear the tone, not when they think they hear it).
Patients need to take off their glasses and/or accessories, and tie their hair back, whenever these may prevent the correct placement
of the headphones or the bone vibrator. When placing the air conduction headphones, make sure that the
patient's right ear, and the
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warns in case of discrepancies) and whether or not it is necessary to interrupt the test.
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one on the left ear.
EN 16
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headphone is on the