Diagnostic Services

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Diagnostic Services

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Audiometric and Speech Tests

Audiometric tests are used to diagnose hearing loss and diseases of the ear.An audiometer is used to determine your thresholds for tones and speech. These tests can reveal your ability to discriminate between different sound intensities, recognize pitch, or distinguish speech from background noise. Pacific Northwest Audiology uses the most advanced audiometer on the market. An audiogram graphically illustrates data collected during audiometric tests.The audiogram allows the doctor to visualize your hearing ability compared to a “normal” range of hearing.

Acoustic Immittance Tests

Tympanometry is used to detect fluid in the middle ear, perforation of the eardrum, and wax blockage in the ear canal. This test measures the energy transmitted through the middle ear and allows Dr. Li-Korotky to determine whether you have sensorineural or conductive hearing loss. Acoustic immittance tests are also used to evaluate Eustachian tube function. Abnormal or impaired Eustachian tube functions (impaired opening or closing, reduced drainage of secretions) may cause pathological changes in the middle ear. This can lead to hearing loss and other complications. Acoustic reflex and reflex decay offered by acoustic immittance tests may detect retro-cochlear pathologies such as acoustic neuroma, a benign growth on auditory nerves.

Speech in Noise Tests

A series of tests that reveal your ability to understand speech in an environment filled with background noise. Difficulty understanding speech in a noisy place is often an early indicator of hearing loss. Speech in Noise tests are also used to help evaluate Auditory Processing Disorders.

Otoacoustic Emissions (OAE) Evaluation

OAEs are sounds produced by the inner ear. These sounds are measured in the ear canal with a special microphone. OAEs indicate the responsiveness of outer hair cells in the cochlea, which are very sensitive to noise over-exposure. People with normal hearing produce a standard range of OAEs, but people with hearing loss produce smaller OAEs, or none at all, due to their damaged outer hair cells and the surrounding cochlear structures. Dr. Li-Korotky administers OAE tests:

  • To screen patients that are bad candidates for traditional hearing evaluation tests, such as infants or individuals with developmental disabilities.
  • To partially estimate hearing sensitivity within specific ranges.
  • To differentiate between the sensory and neural components of sensorineural hearing loss.
  • To reveal “faked” hearing loss.

Auditory-Evoked Potential (AEP) Testing

Dr. Li-Korotky will use AEP tests to evaluate the health of your hair cells, and the peripheral and central auditory functions.

The Auditory Brainstem Response test (ABR) evaluates how well sounds travel along the auditory pathways to a part of the brain called the brainstem.

An ABR may be used to estimate the sensitivity of the ear to sound, especially in newborns or in a child or adult who is unable to accurately complete a traditional hearing evaluation. The most common reason to give an ABR test to an adult is to help eliminate the possibility of a disorder (tumor) along the hearing nerve or in the brain itself.

An Otoacoustic Emissions (OAE) test is used to record and analyze echoes generated by the inner ear hair cells in response to acoustic stimulation.

The Auditory Steady State Response (ASSR) test is used to evaluate the degree of hearing loss in children too young for traditional audiometric testing. Results are obtained by measuring brain activity while the child listens to tones of varying frequency (pitch) and intensity (loudness). Studies indicate the ASSR may provide a reasonable alternative to the ABR for estimating audiometric thresholds in very young children.

Electrocochleography (ECochG) test measures the electrical potentials generated in the inner ear as a result of sound stimulation. This test is most often used to determine if the inner ear (cochlea) has an excessive amount of fluid pressure. Excessive fluid pressure in the cochlea can cause hearing loss, ear fullness, dizziness, and/or tinnitus.

Assessment and Management Options for Tinnitus



Dr. Li-Korotky will conduct a thorough assessment and advise you of the most effective management options to alleviate the symptoms of your tinnitus. A full tinnitus assessment takes 1.5-2 hours and includes:


  • A detailed case history to determine how tinnitus is affecting you as a person.
  • A Full hearing assessment to determine the characteristics and possible causes of your tinnitus.
  • Tinnitus pitch-, intensity-, and loudness matching tests will help the doctor counsel you effectively during the treatment phase.
  • Measurement of your sensitivity to loud sounds.
  • Recommendations for managing your tinnitus.

See a more thorough discussion of Tinnitus here

Evaluation of Auditory Processing Disorders (APD)

APD refers to how effectively we process and understand what we hear. Adults and children with APD suffer from a distortion of signals at the brain level, resulting in confused messages. APD is identified with auditory processing problems, but it can also be associated with a deficit  in the language or higher reasoning functions of the brain, and there is no clear line to distinguish between these two areas of initiation. This underscores the importance of finding a professional with the specialized knowledge and experience necessary to diagnose and effectively treat APD. Dr. Li-Korotky’s background is well grounded in auditory neuroscience, and she studied APD with one of the leaders in the field.

Functions that rely on auditory processing skills include:

  • Understanding speech in quiet as well as in noise
  • Dichotic listening (ability to differentiate whether sounds originate from the left or right side)
  • Short-term auditory memory (ability to remember words and sounds)
  • Sequencing (ability to remember the details of what is heard and the order in which they were communicated)
  • Sound localization (ability to identify the location of a sound).

APD is complex so no single test can diagnose the presence and characteristics of the disorder. Dr. Li-Korotky will use a highly specialized test battery to evaluate different aspects of your central auditory processing. The results from these tests can reveal the presence and characteristics of APD, and point the way to effective treatment strategies:

  • Auditory discrimination tests: measure the ability to differentiate similar acoustic stimuli that differ in frequency, intensity, and/or temporal characteristics.
  • Auditory temporal processing and patterning tests: assess the ability to analyze acoustic events over time.
  • Dichotic speech tests: assess the ability to differentiate whether sounds originate from the left or right side. These tests can suggest sound processing weaknesses in the left or right ear.
  • Monaural low-redundancy speech tests: evaluate recognition of degraded speech stimuli presented to one ear at a time.
  • Binaural interaction tests: measure binaural processes dependent on intensity or time differences of acoustic stimuli.
  • Electroacoustic measures: recordings of acoustic signals from within the ear canal that are generated spontaneously or in response to acoustic stimuli.
  • Electrophysiological measures: measure the brain’s response to sounds.

The bottom line: Pacific Northwest Audiology has the professional expertise necessary to diagnose and effectively treat APD.

Hearing Tests Can Reveal Medical Conditions

Audiometric tests by a certified Audiologist can reveal serious underlying medical problems such as cardiovascular disease or tumors along the nerve that connects the ear to the brain. In some cases, patients may not be aware of the trouble ahead, and a comprehensive hearing evaluation can be a life-enhancing event.

Hearing tests may uncover tumors…even if you have no symptoms!

It is not uncommon for Audiologists to refer patients to ENT specialists  for further medical or surgical intervention. Dr.Li-Korotky recently referred a patient to an ENT specialist when she suspected the possibility of a tumor. An MRI indicated a slow growing tumor near the base of the patient’s scull, and he is currently under medical care for treatment.

Hearing problems may signal cardiovascular disease.

Trouble hearing low-frequency sounds could be a sign of cardiovascular disease. Low frequency hearing loss can be revealed by audiological testing.

This is Why You See a Doctor of Audiology

Emergency Help

I woke up with a major hearing problem on Monday morning. I called and got in first thing in the morning and then had help getting in touch with other doctors to help me. Thanks so much for you calm caring help.

Excellent Care!

Rarely write reviews but NW Audio deserves a glowing one. I have mild hearing loss tried 3 devices and none worked to my satisfaction – Dr Li and Dr Ian were so patient and accepting and “hearing my concerns” with hours of trying to get the perfect one. While we all concluded that maybe I just wasn’t ready for one – I never felt pressured or directed – they wanted the best for me. I’m certain I’ll be back when I’m ready. Both doctors, their office staff were fabulous!

My experiences are always wonderful

Dr. Li is caring, competent, thorough and a pleasure to be working with. There is no one like her in Audiology, in my opinion.

Help and support when needed

I made an after hours trip to see Dr Li for issue. She was so helpful took care of my issue and I felt confident I was in good hands because of her advanced training. I followed up with her 3 days later again treated with care and received with a smile and warm greeting from Kat and Dr. Li. I always feel confident that the staff are up on the latest information and freely check if they need more information. Love the new office so beautiful and peaceful!

Speech mapping

Another great experience at Pacific Northwest Audiology, . The speech mapping was a fantastic process. It once again showed me how much I had been missing before my hearing aids. Thank you Dr. Li and your staff.

Very professional

My experience with PNA was excellent. The tests were fairly standard, but still comprehensive. Dr. Li was VERY knowledgeable, friendly and professional. We discussed my condition, among other things, for over an hour. I highly recommend her and PNA

My favorite Doctor of Audiology!

Dr. Li is by far the most caring, knowledgeable doctor I’ve ever seen. I’ve been a patient since she first opened PNWA, and she has consistently been interested in figuring out and helping me with my unusual hearing problem. A local ENT office told me I’d just have to live with it, and offered no help at all. Not Dr. Li – love her!

Life changing!

For the first time in 20 years, someone listened to what I needed. They confirmed that I needed my ears cleaned out, and didn’t send me home with some crazy product to do it my self!! Dr.Li spent several hours with me over 2 days to care for my ears, the moment she finished on the second ear I was in tears of Joy, hearing sounds I thought I never would hear again in my life!! I am continuing to work with her to compensate for the damage of having impacted ears for so long. She gets a 10!!

…and more than 400 other 5-Star Reviews!

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Click below for the previous or next topic

Evaluation and Treatment of TinnitusEvaluation and Treatment of Tinnitus

Tinnitus treatments are highly personalized. They generally focus on counseling to manage the negative reactions associated with tinnitus, utilizing sound therapy, relaxation, and stress-reduction techniques. Learn more, here

Clinical ProcessThe Clinical Process

We will work with you to find the final piece of the puzzle on your road to better hearing…from  testing, to planning, to hearing aid fitting and programming, to post-fitting counseling and rehabilitation. Learn more, here

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