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Finding the Silent Gaps: Understanding the TEN Test - By Acoustik Hearing And Speech Clinic

Sometimes a standard hearing test shows a person "hears" a pitch, when really that part of the inner ear isn't functioning — a neighbouring, healthier region is picking up the slack. This is off-frequency listening, caused by a cochlear dead region, and it's exactly what the TEN (Threshold Equalizing Noise) Test detects.

What Is the TEN Test?

Developed by Brian Moore, the TEN test measures pure tone thresholds against a specially designed masking noise (TEN), presented to the same ear as the test tone — unlike standard masking, which uses noise in the opposite ear. This distinguishes a true threshold from a false one caused by a neighbouring, still-functioning part of the cochlea responding instead.

Test Specifications

Duration: 15–20 min
Equipment: Calibrated audiometer with TEN test capability, TDH39/DD45 or insert earphones
Preparation: Clear ear canal; pure tone audiogram completed first
Setting: Sound-treated room at the clinic
Age Group: Cooperative older children through seniors
Typically Considered For: Severe high-frequency loss, steeply sloping loss, or low-frequency loss with better hearing at higher pitches

Procedure of the Test

Otoscopy check, then standard pure tone audiometry to identify suspected dead regions.
TEN noise level selected based on the degree of hearing loss at that frequency.
A precise unmasked threshold is re-established at the suspected frequency using 2 dB steps.
TEN noise introduced to the same ear; tonal threshold re-measured in its presence.
Masked and unmasked thresholds compared to determine if a dead region is present.
Process repeated at other suspected frequencies.

Why Is the Test Done?

Confirms whether a threshold reflects a true dead region or off-frequency listening
Guides hearing aid programming to avoid ineffective amplification at those frequencies
Informs realistic counselling on expected hearing aid benefit and speech clarity
Supports cochlear implant candidacy decisions when dead regions are extensive

What Will the Result Show?

A comparison between the masked (TEN) threshold and the unmasked threshold at each tested frequency, along with the TEN noise level used.

Interpretation

Dead Region Present (Positive): "Masked threshold at least 10 dB above both the TEN noise level and unmasked threshold — consistent with a cochlear dead region at this frequency."
No Dead Region Detected (Negative): "Masked threshold does not meet these criteria — a dead region is not detected here, though this does not entirely rule one out."

Where confirmed, amplification is generally avoided at that exact frequency and targeted at neighbouring functioning regions instead, with settings and counselling adjusted accordingly.TEN testing needs specialized software and a controlled setting, so it's performed at our clinic. Acoustik Hearing and Speech Clinic brings pure tone audiometry and hearing aid trials to your home across @Mumbai, @Navi Mumbai, and @Thane.

Book your pure tone audiometry and hearing aid trial at home, or schedule your TEN test at our clinic.

#TENTest #ThresholdEqualizingNoise #CochlearDeadRegions #OffFrequencyListening #HearingAidCounselling #HearingDiagnostics #PureToneAudiometry #HearingAidTrial #AcoustikHearingAndSpeechClinic #HomeVisitAudiometry #HearingAidsMumbai #NaviMumbaiHealthcare #ThaneHealthcare #AudiologyIndia #SeniorCareAtHome #HearYourBest #MumbaiHearingClinic

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