Types of Hearing Tests

Hearing Test
Hearing testing are helpful when you have hearing problems. Your hearing is vital to your health in more ways than you may realize. A delay in hearing testing can cause permanent damage to your hearing. It can also affect your mental and physical health.
Everyone should have hearing testing performed, especially all newborns and children. Adults of all ages, regardless of if you have hearing loss, should have routine hearing tests. This helps to determine a baseline of their hearing ability. This baseline becomes part of your health history. Your doctor uses this to check if hearing loss occurs over time. It is also used to measure the amount of hearing loss, and to see if the loss progresses, stabilizes, or gets better.
Hearing testing may start with your primary care provider. Audiometry is the term for the different hearing examination tests. Results of the audiometry tests are often shown on an audiogram. This is a graph that shows the softest sounds you can hear at different pitches and frequencies.

What should I expect during a hearing test?

Your provider will look at your ears’ structure and test your hearing health. From there, they can establish your baseline. They may examine you for possible causes of hearing loss or damage. This may include an infection or ear wax buildup and structural abnormalities.
Your provider will perform simple screening tests. These should include a health history and questionnaire. Your doctor may also use voice recognition testing or a tuning fork test. Your provider may refer you to a hearing specialist. They will perform more thorough testing to more exactly measure your hearing.
Hearing specialists test, diagnose, treat, and manage hearing loss. They can help both adults and children. Hearing specialists can determine your type of hearing loss and the degree. You may also schedule a hearing exam with a hearing specialist. Call your insurance company first to see if you need a referral and if they will cover your audiology visit.

What do hearing tests measure?

Audiometry tests your ability to hear sounds based on their intensity and tone. You hear when sound waves stimulate the nerves in the inner ear. These then travel along the nerve pathways to the brain to interpret.
This type of testing helps determine if there is hearing loss. If there is, it will determine the type and degree of hearing loss. Hearing loss may be sensorineural, conductive, or mixed.

What are the types of hearing tests?

Tuning fork tests

A tuning fork is a two-pronged, metal instrument that produces sound when struck. This test shows if there is damage to the vibrating parts of your middle ear and eardrum. It will also show if there is damage to inner ear nerves or damage to both. Rinne and Weber are the two main types of tuning fork tests.
The Rinne test involves striking then placing the tuning fork on the bone behind the ear. Then, it will go next to your ear canal. You will tell the doctor when you no longer hear the sound in both places and they will record the length of time.
In the Weber test, the doctor strikes the tuning fork then places it in the middle of your head. You will tell the doctor where the sound is best heard – left ear, right ear, or both.

Auditory brainstem response (ABR) test

The ABR test measures the hearing nerve’s response to sound. It indicates how well the inner ear (cochlea) and the brain pathways for hearing are working. The test is often used with newborns and young children. It can also be helpful for people with a brain malfunction or those who cannot do a typical hearing test. Auditory evoked potential (AEP) is another name for this test.
Doctors place electrodes enclosed in stickers on the head and in front of the ears. These are then connected to a computer. These electrodes measure how the nerves respond to sounds coming through earphones.

Pure tone test

You’ll wear earphones and go into a sound booth. Each time you hear a beep or tone at different pitches, you’ll need to raise your hand, press a button or say “yes.” You will need to respond even if the tone is very soft, so you will need to pay very close attention. Most people have had this test done as a health screening at some point in their lives.

Speech test

The speech test is often used instead of a pure-tone test. They measure your ability to hear and repeat spoken words in a speech audiometry test. This test determines your speech reception threshold. These are softest sounds you are able to hear, understand, and repeat. Your doctor may perform this in quiet or loud environments.
They will ask you to repeat the words spoken above your threshold to see if you can understand them. This test is sometimes used to determine your most comfortable listening level.

Bone conduction test

In cases where you may have fluid or wax blockage in the ear, your doctor may use a bone conduction test. They place a bone conductor or oscillator behind the ear and do not use headphones. The bone conductor causes the skull bones to vibrate in response to different tones. The results are also shown on an audiogram.

Otoacoustic emission (OAE) test

Your ear’s hair cell function is often measured with an OAE test. The ear contains small hairs that vibrate when sound enters the ear. They conduct the sound to the ear’s nerve pathway to the brain to interpret.
Your doctor will insert a small probe into the ear. With normal hearing, your inner ear will produce tones or clicking in response to the probe. If you have hearing loss, your inner ear may not produce these sounds.

Middle ear testing/immittance testing

Immittance testing assesses the middle ear’s function. They examine how the eardrum reacts to varying pressure in the ear canal. Your ability to hear correlates with eardrum sensitivity. A probe pumps air into the ear. This probe changes the pressure within the ear at different tones. The three types of middle ear tests are:
  • Tympanometry: a probe tests how well the eardrum moves.
  • Acoustic reflex measures: records the strength of the middle ear’s response to a loud sound.
  • Static acoustic impedance measures the volume of air in the ear canal. This can detect fluid behind the eardrum or a perforated or ruptured eardrum.

A microphone monitors how well the ear conducts sounds in different air pressures. This requires no response from patients. This type of testing works very well with children.

What are my next steps?

Your provider or hearing specialist will share your test results with you. Audiometry test results are often shown on an audiogram. This is a graph that shows the softest sounds you can hear at different pitches or frequencies. Your audiogram will also show the intensity of the sounds you hear.
If you have hearing loss, your hearing specialist may recommend further testing. They will discuss treatment options with you. They may recommend hearing aids. Your treatment center will be able to help you choose the right option for your lifestyle.
If you have healthy hearing, you’ve done a great job protecting your hearing! Your hearing team will give you more information on ways to protect your hearing. They may recommend follow up at a certain time to keep monitoring your hearing health.