Otolaryngology (ENT)

Audiology Services

Carilion Clinic's audiology services offer comprehensive hearing evaluations, using both conventional and highly sophisticated testing techniques. Our ear, nose and throat specialists will use the appropriated test(s) to most accurately determine your hearing levels.

Hearing loss tests include:


The part of the inner ear called the cochlea is what allows us to hear. It consists of two rows of tiny hair cells. The outer hairs move in response to sound and make a noise of their own. OEA testing allows the physician to gather information about the outer hair cells by placing a small probe in each ear canal.

The test is quick – taking about 30 seconds in each ear – and does not require cooperation from the person being tested, unlike the traditional earphones used in hearing tests. This makes it especially helpful in testing infants and young children. It also provides ear-specific data.

OEA testing is also useful in checking for ototoxicity – a high-frequency hearing loss caused by ototoxic drugs like the chemotherapy treatment Cisplatin. Ototoxicity is often difficult to test in small children.

While OEA testing cannot estimate the actual degree of hearing loss, it is a useful tool in estimating hearing sensitivity.


Auditory brainstem response is an electrical response to sound that travels from the cochlea in the inner ear, along the auditory nerve, to the brain. In ABR testing, electrodes are placed on the head and ears to monitor auditory brainstem response. Clicks or tone bursts are made into each ear, and a computer averages the responses.

ABR testing is especially helpful in measuring hearing sensitivity in infants and toddlers because it provides frequency-specific information. A test called "Bone Conduction ABR" helps determine the type of hearing loss a patient may have.

Because it is important that the patient be very still during ABR testing, infants should be brought to Carilion Clinic around naptime when they are more likely to sleep. Older infants and toddlers may need to be sedated with a "conscious" sedation such as Chloral Hydrate.

While ABR testing is not an actual test of hearing, it does provide important information about hearing sensitivity and brainstem function.


It is never too early to test a baby's hearing! Research shows that hearing-impaired children whose disability is discovered by six months of age can progress normally in their speech and language development.

Carilion Clinic uses state-of-the-art technology to identify babies with hearing loss, and thanks to improved hearing aid technology, children have the chance to keep up with their peers rate of learning, thus avoiding constant remediation.

The State of Virginia requires that all hospitals with newborn nurseries and neonatal intensive care units (NICUs) screen newborns prior to discharge. Babies are then referred to audiologists for further testing. For infants less than 6 months old, Auditory Brainstem Response (ABR) or Otoacoustic Emissions (OAE) testing is recommended. In addition to these tests, older infants are also encouraged to have conditioned behavioral audiometry and tympanometry tests.

Periodic monitoring may be necessary for some infants, even if they pass their initial screening tests. Infants with a family history of hearing loss, congenital infections, degenerative disorders, chronic lung disease, pulmonary hypertension, and/or ototoxic medications are at risk for delayed hearing loss. These infants should be monitored every 3 – 6 months until age 3.


For patients having difficulties with dizziness, vertigo or impaired hearing, Carilion Clinic’s audiologists may choose to perform an electronystagmography (ENG) test. An ENG test allows a doctor to evaluate the acoustic nerve, which aids in hearing and balance. This is done by observing a patient’s voluntary and involuntary eye movements. Your physician will place small electrodes above, below, and on the side of each eye, as well as on the forehead. The electrodes record eye movements as the inner ear and nearby nerves are stimulated with warm and cold water. When cold water enters the ear, the eyes should move away from the cold water and then slowly back. When warm water is placed in the ear, the opposite should happen.

During the test, patients may be asked to use their eyes to track objects, such as flashing lights, while a computer records the results of the length and speed of eye movements. The test lasts approximately 90 minutes, and there is relatively little discomfort.

Contact one of Carilion Clinic’s audiologists at (540) 224-5170 to learn more or to set up an appointment.