Hearing Tests for Adults

What are hearing tests?

Hearing tests measure how well you hear. When a person has normal hearing, sound waves travel through the ear and cause the eardrum to vibrate. This vibration sends sound waves into the ear so that nerve cells send sound information to the brain. This information becomes the sound we hear.

Hearing loss (hypoacusis) occurs when there is a problem with one or more parts of the ear, with the nerves inside the ear, or with the part of the brain that controls hearing. There are three main types of hearing loss:

Sensorineural: (also called nerve deafness): This type of hearing loss is caused by a problem with the structure of the ear or with the nerves that control hearing. It can be present at birth (congenital) or appear later in life (acquired). Sensorineural hearing loss is usually permanent. This type of hearing loss ranges from mild (inability to hear certain sounds) to profound (inability to hear any sound).
Conductive: This type of hearing loss is caused by a blockage in the transmission of sound in the ear. It can occur at any age, but is more common in infants and young children and is usually caused by ear infections or fluid buildup in the ears. Conductive hearing losses are usually mild, temporary, and treatable.
Combined: It is a combination of conductive and sensorineural hearing loss.

Hearing loss is common in older adults. About a third of people over the age of 65 have some kind of hearing loss, usually of the sensorineural type. If you are diagnosed with hearing loss, there may be steps you can take to treat or manage it.

Alternative names: audiometry, audiography, audiogram, hearing test, sound test.

What are they used for?

In order to know if you have a hearing loss or any kind of hearing problem, a test for hearing loss will be necessary, which will also reveal how simple or severe the problem is.

Why do I need a hearing test?

You may need one of these tests if you have symptoms of hearing loss, such as:

Difficulty understanding what other people are saying, especially in noisy environments
You need to ask them to repeat what you have been told
Trouble hearing high-pitched sounds
Need to turn up the volume on the TV or music player
Ringing in the ears

What happens during a hearing test?

Hearing tests can be done by your primary care doctor or one of the following health professionals:

Audiologist: A health professional who specializes in the diagnosis, treatment, and management of hearing loss.
Otorhinolaryngologist: A doctor who specializes in the treatment of diseases of the ears, nose, and throat.

There are several types of hearing tests. Most tests look at response to words or sounds at different pitches, volumes, and levels of ambient noise. They are known as sound checks. Some of the common sound tests are:

Acoustic reflex testing: Also called middle ear muscle reflex (MEMR) testing; evaluates the ear’s response to loud sounds. In people with normal hearing, a very small muscle inside the ear contracts when hearing loud sounds. This is known as the acoustic reflex. It happens automatically, without noticing it. During the test:

An audiologist or other health professional places a soft rubber device in the ear.
Through it, it sends out a series of loud sounds that are recorded on a machine.
The machine shows whether or not the sound triggered the acoustic reflex.
If the hearing loss is severe, the sound has to be very loud to activate the reflex and sometimes it does not activate it at all.

Pure tone test: Also known as audiometry. During the test:

You put on headphones
Through the headphones, a series of sounds is played
At different times during the test, the audiologist or health care professional changes the pitch and volume of the sounds. Sometimes the sound is very soft and can hardly be heard
The health professional asks you to indicate each time you hear a sound. You can do this by raising your hand or pressing a button.
The test allows you to determine the softest volumes of sounds of different pitches (frequencies) that you are able to hear

Tuning fork test: A tuning fork is a U-shaped metal bar that produces a certain pitch when it vibrates. During the test:

An audiologist or health professional strikes the tuning fork to make it sound, then places it behind one ear or on top of the head
You are asked to indicate when you hear sounds of different volumes, or whether you heard the sound in your left ear, right ear, or both ears equally
Depending on where the tuning fork is placed and your responses, the test lets you know if the hearing loss is in one or both ears. It also allows you to find out if your hearing loss is conductive or sensorineural.

Phrase and word recognition tests indicate how well you hear speech. During the test:

You put on headphones
The audiologist reads a series of simple words at different volumes. You hear them through the headphones and are asked to repeat them
The audiologist records the lowest volume of speech you are able to hear
Some tests are done with background noise because many people with hearing loss have trouble understanding conversations in noisy environments.

Another type of test, called tympanometry, measures the mobility of the eardrum.

During tympanometry:

An audiologist or other health professional places a small device in the ear canal
The device sends air to the eardrum and causes it to move
A machine records this movement on graphs called tympanograms.
The test lets you know if there is an ear infection or other problems, such as a buildup of fluid or wax, or a hole in the eardrum

Do I need to do anything to prepare for the audition tests?

Hearing tests do not require any special preparation.

Are hearing tests risky?

Hearing tests have no known risk.

What do the results mean?

The results show whether you have a hearing loss and whether it is conductive or sensorineural.

If you are diagnosed with a sensorineural hearing loss, the results may indicate whether it is:

Mild: You cannot hear certain sounds, for example, very high-pitched or very low-pitched sounds
Moderate: You cannot hear many sounds, for example, conversations in noisy environments
Severe: Can’t hear most sounds
Deep: You cannot hear any sound.

Treatment and management of sensorineural hearing loss depend on its severity.

If you are diagnosed with conductive hearing loss, your health care professional may recommend medication or surgery, depending on the cause.

If you have questions about your results, ask your doctor or health care professional.

Is there anything else I need to know about hearing tests?

Even mild hearing loss can make it difficult to understand conversations. For this reason, many older adults avoid social situations, leading to isolation and depression. A hearing loss treatment can prevent these problems. Although hearing loss in older adults is often permanent, there are ways to manage it. Some treatment options are:

Hearing aids: A hearing aid is a device that is placed behind or inside the ear. The hearing aid amplifies the sound (makes it sound louder). Some hearing aids have more advanced features. Your audiologist can recommend the most appropriate option for you
Cochlear implant: A device that is placed in the ear in an operation. It is usually indicated for people with severe hearing loss who do not benefit much from the use of hearing aids. Cochlear implants transmit sound directly to the auditory nerve
Surgery: Some types of hearing loss can be treated with surgery. These include problems with the eardrum or the ossicles of the middle ear