Diagnostic hearing evaluations are performed for a number of reasons. You may be referred by your physician to rule out hearing loss or to investigate the nature of a hearing loss. You may also be seen at the encouragement of a friend or family member who has concerns about your hearing. Or maybe you have noticed changes in your own hearing and have decided it is time to have it checked. Regardless of the reason for your visit, your evaluation may include the following:
 

1. A discussion about your health history, your concerns, and the reason for your visit

2. Otoscopy

   • Your ear canal will be examined for wax, foreign bodies, or any abnormalities that may need to be addressed prior to the hearing test to ensure test results are accurate.

3. Tympanometry

   • This test measures the mobility of the eardrum and the air pressure behind the eardrum in the middle ear space. If this test is abnormal, a referral to an ENT or primary care physician may be necessary.

4. Pure tone air and bone conduction testing.

   • You will be asked to respond by pressing a button or raising your hand when you hear sounds presented through headphones, ear inserts, or a headband. These tests measure the degree of hearing loss and determine whether the loss originates in the outer, middle, or inner ear.

5. Speech testing

   • You will be asked to repeat words presented at varying volume levels. A speech reception threshold is the softest level at which speech can be recognized. It is another means by which to measure the degree of hearing loss. Speech intelligibility, or discrimination testing, measures how well you can understand speech clearly when it is heard at a comfortable loudness level. Speech in noise testing is sometimes performed on those patients who have particular difficulty discriminating speech in the presence of background noise.
      

Depending on the patient’s age and physical or cognitive ability, testing techniques may vary. Other techniques include conditioning a patient (usually a small child) to drop a block in a bucket when a sound is heard or showing awareness of sound by turning toward the sound source when that sound is presented through speakers rather than through headphones. Otoacoustic emissions (OAEs) testing is an objective measure of hearing often used to test newborns.

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   6. Finally, test results are discussed and treatment recommendations are made.