What to expect during your upcoming hearing test.
What is a hearing test?
A hearing test is designed to measure how well a person can hear. Hearing tests help doctors diagnose hearing loss and assess the degree of the patient’s hearing loss.
The testing process usually begins when a primary health provider examines your ears for possible causes of hearing loss, including infection, ear wax buildup, and structural abnormalities.
If your provider notices anything unusual in the screening, they may refer you to an audiologist who specializes in ears and hearing for further consultation.
The audiologist will run hearing examination tests, or audiometry tests, by having you put on a special pair of headphones inside a soundproof chamber. Once you’re inside, the doctor will play different tones at different volumes to measure your hearing ability.
The results of these tests are plotted on a graph called an audiogram.
Who needs a hearing test?
The simple answer? Everyone.
Hearing tests are recommended once every 3 to 5 years for healthy adults, and even more frequently for newborn babies, children, older adults, and anyone experiencing symptoms of hearing loss.
- Newborn babies. Newborns should have their hearing checked before they’re one month old. This procedure is safe, painless, and typically only lasts a few minutes. Some hospitals may even conduct an initial screening while the baby is still in the hospital. Take your newborn to see an audiologist if they don’t pass their initial hearing screening.
- School-age children. Kids should have regular hearing check-ups as their bodies develop. Screening tests are commonly performed at ages 4, 5, 6, 8, 10, and later again in the preteen and teenage years.
Adults experiencing hearing loss. Get your hearing checked as soon as you suspect you might be suffering from hearing loss.
Symptoms include difficulty understanding what others are saying, especially in noisy environments; frequently asking others to repeat themselves; trouble hearing high pitched sounds; a ringing in your ears known as tinnitus; and regularly playing the TV or music louder than others find comfortable.
The different types of hearing tests, explained
Most hearing tests are considered sound tests, designed to assess your response to tones or words delivered at different pitches and volumes, or in different noise environments. The tests will help you understand if you need hearing aids or other types of treatment options.
Common types of hearing tests include:
Pure-tone hearing test
Also known as pure tone audiometry, a pure-tone test is one of the first types of hearing tests audiologists will run on patients. After you put on a pair of headphones and sit in a specially designed booth, the doctor will play a series of different sounds at different volumes and pitches to assess how well they travel through your outer and middle ear and into your brain.
Every time you hear a tone, you’ll be asked to raise your hand or press a button. This test helps identify the quietest sounds you can hear at different frequencies, and the results are mapped out on an audiogram.
Bone Conduction Testing
Bone conduction testing is similar to pure-tone testing but focuses more on the cochlea in the inner ear. The audiologist places a tiny conductor behind your ear that sends tiny vibrations through the bone directly into the inner ear.
That’s why we call this type of testing “bone conduction” as opposed to the traditional air conduction.
Bone conduction testing can also be more accurate in determining the type of hearing loss than traditional air conduction because it bypasses the outer and middle ear, thereby eliminating the effects of obstructions like fluid or wax build-up.
Speech audiometry involves two different hearing tests: one that measures how loud speech needs to be for you to hear it, and another that measures your ability to distinguish different words when you hear them spoken.
During the tests, you sit in a sound booth and wear headphones. The doctor plays a recording of several common words spoken at different volumes and asks you to repeat them back to determine your speech reception threshold (SRT), or the minimum hearing level needed for you to be able to understand 50% of the speech you hear.
After this, the audiologist will test your speech discrimination, or word recognition ability.
This test is administered in either a quiet or noisy environment and measures your ability to separate speech from background noise. Both tests take a combined 10 to 15 minutes.
Auditory brainstem response (ABR)
This test helps diagnose any abnormalities of the 8th cranial nerve, which contains the nerves that control hearing, balance, and eye movements. To run an ABR test, your audiologist will attach a set of electrodes to your head, scalp, or earlobes.
These electrodes measure your brainwave activity to see how your brain responds to sounds of varying intensities. ABR tests are commonly used to diagnose hearing loss, acoustic tumors, and cerebellopontine angle (CPA) tumors.
They’re also commonly used to screen newborns for hearing problems.
Otoacoustic emissions test
Otoacoustic emissions, or OAEs, are nearly inaudible sounds generated by the vibrating hair cells in the cochlea when they’re stimulated by soft clicking sounds.
This test is run to assess how well the inner ear works. It’s run by inserting a foam or rubber-tipped earphone into the ear, which plays sounds into the canal and measures the sounds that come back.
The results of the test are produced on a monitor, so you do not need to say or do anything during the test.
The gentle sounds used in OAE tests make them an especially good option for anyone who’s uncomfortable with, or unable to complete, conventional hearing tests.
Tympanometry is used to assess how well the eardrum moves inside a person’s middle ear. The audiologist places a small probe into the ear with an attachment that pushes air in. A graph on the device called a tympanogram measures your eardrum’s responses to the air and tells the doctor how well it’s working.
Tympanometry tests can determine if your eardrum moves correctly, if it’s too stiff, if it moves too much, or if it’s ruptured.
They’re commonly used to identify cases of conductive hearing loss caused by a buildup of fluid, wax, eardrum injuries, or tumors.
Getting your results and next steps
Once the appropriate hearing tests have been run, your audiologist will use the test results to diagnose the type of hearing loss you have (if any) and provide you with treatment options.
Types of hearing loss
Just like hearing loss can be caused by different factors, there are also different types of hearing loss. These include:
- Sensorineural hearing loss. Also referred to as “nerve deafness,” this type of hearing loss occurs when the tiny hair cells inside the inner ear are damaged. Sensorineural hearing loss is the most common type of hearing loss. It’s a permanent condition in most cases, with symptoms ranging from mild to profound.
- Conductive hearing loss. This type of hearing loss occurs when sounds cannot get through the outer and middle ear. These are commonly caused by obstructions like fluid build-ups from colds or allergies, ear wax, or benign growths in the ear. People with conductive hearing loss may have difficulty hearing soft sounds, or hear louder sounds as muffled.
- Mixed hearing loss. As its name suggests, conductive hearing loss is used to describe cases in which a person suffers from both sensorineural and conductive hearing loss.
- Auditory Neuropathy Spectrum Disorder (ANSD). A rare disorder in which the ear can still pick up sounds and send signals to the brain, but sometimes scrambles the signals in a way that prevents the brain from properly interpreting them. ANSD is usually caused by damage to the auditory nerve, which connects the cochlea in the inner ear to the brain. Many people with ANSD are also born with it.
Treatment will vary depending on the type of hearing loss. Cases of sensorineural hearing loss are commonly treated with a hearing aids, electronic devices worn in or behind the ear to amplify sounds and make speech more understandable. Learn more about the different types of hearing aids.
People with mild to moderate hearing loss can also benefit from assistive listening devices like personal amplifiers, amplified telephones, and TV listening sets.
Severe cases of sensorineural hearing loss may require a cochlear implant, a device that bypasses a heavily-damaged inner ear and sends electrical impulses to the auditory nerve in its place.
Because cochlear implants are surgically implanted, you must undergo a thorough evaluation by an audiologist to make sure you’re a suitable candidate.
Cases of conductive hearing loss can usually be treated by removing the obstruction causing the problem. This can be as simple as removing an earwax impaction or foreign body, though sometimes medical intervention is required in the form of surgery or pressure equalization (PE) tubes.
Hearing aids and assistive listening devices can also benefit people suffering from conductive and mixed hearing loss.
👉 See an audiologist for a comprehensive treatment plan that accounts for the specifics of your hearing loss.
Going in for a hearing test can be an uncomfortable experience, but understanding how and why they’re conducted can help ease your concerns. Regular check-ups are the best way to ensure healthy hearing and prevent any serious problems from developing in the future.