Doctors may diagnose hearing loss using a range of techniques, such as audiometry tests, brainstem auditory evoked response tests, and otoacoustic emissions tests.

Hearing loss can affect one or both ears, and it is a relatively common condition that people are more likely to experience as they age.

Keep reading to learn more about the different tests and techniques that healthcare professionals use to diagnose hearing loss, as well as when you may want to consider speaking with a doctor.

If you’re experiencing symptoms of hearing loss, your doctor may first ask questions about:

  • when your symptoms started
  • the types of symptoms you’ve been experiencing
  • whether your symptoms have increased in severity since you first noticed them

They may then conduct a general screening test to assess your hearing, which may involve a tuning fork test.

To begin a tuning fork test, a healthcare professional will place a tuning fork behind your ear or on your head. They will then tap the tuning fork so that it vibrates, causing your skull bones to vibrate gently.

If you experience any difficulty hearing the sound in either ear, the healthcare professional may suggest that you have further diagnostic tests for hearing loss.

Audiometry tests involve playing sounds and tones of different pitches and volumes through headphones or other devices to measure your hearing ability. A healthcare professional then interprets the results of the test using an audiogram or another type of graph.

Below are some common audiometry tests that a doctor may recommend.

Pure-tone tests

Pure-tone tests assess the quietest sounds you can hear at different pitches.

A healthcare professional will give you headphones to put on and play a variety of high and low tones, some of which will be loud and others of which will be very soft. They’ll ask you to raise your hand, speak, or push a button whenever you hear a sound.

Speech tests

Speech tests check how well you’re able to hear and understand spoken words. They may indicate how beneficial hearing aids could be for you.

During the test, you’ll hear words at different levels of loudness. Some of the words will be spoken over noise. You’ll then repeat the words that you hear.

Tympanometry

Tympanometry assesses the function of your eardrum and bones in your middle ear.

At the start of the test, a healthcare professional will place a small device in your ear. This device will send air and sound into your ear, causing your eardrum to move. You’ll also feel the air pressure inside your ear.

While the test is ongoing, a machine documents the movements of your eardrum on a type of graph known as a tympanogram. If the tympanogram shows that your eardrum doesn’t move in a typical way, you may have:

Bone conduction tests

Doctors use these tests to work out if one of your ears has better hearing ability than the other, and differentiate between conductive hearing loss and sensorineural hearing loss.

To begin the test, a healthcare professional will place a device on your head that may look like a headband with a small box on one side that sits behind one ear. They will then activate the device, causing the small box to vibrate, which in turn gently vibrates your skull bones.

The vibrations travel through your bones and straight into your inner ear, meaning the outer and middle ear aren’t involved in hearing the sound.

If you experience any difficulty hearing the sound in either ear, a problem in your inner ear may be causing hearing loss.

If the healthcare professional is using a tuning fork, they may recommend that you do another test to compare how well you hear the tuning fork through vibrations in the air that travel through your outer ear and vibrations through your bones that travel directly into your inner ear.

Typically, people can hear better through the air. If you hear better through bone vibrations, something may be blocking sound from reaching your inner ear.

Audiometry tests for children

The United Kingdom’s National Health Service (NHS) notes that, in addition to some of the other audiometry tests in this section, doctors may also recommend play audiometry and visual reinforcement audiometry to help diagnose hearing loss in children.

Play audiometry involves a child listening to sounds and being asked to follow simple instructions, such as completing a puzzle or putting a toy in a bucket, when they hear a certain sound.

Visual reinforcement audiometry involves a child listening to sounds and linking the sound to a visual reward, such as a toy lighting up, by turning their head towards it.

Sometimes, a doctor may recommend that you have additional diagnostic tests, which may include some of the examples below.

Otoacoustic emissions tests

These tests assess damage in the hair cells of the cochlea, which is part of your inner ear.

A healthcare professional will begin the test by placing a small device in your ear that makes and measures sound. When the device makes a sound, the fluid in your cochlea ripples, which moves the hair cells. The hairs make vibrations when they move that have their own sound called otoacoustic emissions (OAEs).

The small device measures OAEs to test the function of the hair cells. If the test results indicate that there are little or no OAEs, you may have sensorineural hearing loss.

Brainstem auditory evoked response tests

Brainstem auditory evoked response tests measure how your vestibulocochlear nerve and your brain respond to sounds. The vestibulocochlear nerve helps with detecting sound and maintaining balance.

At the start of the test, a healthcare professional will place small earphones in your ears and soft electrodes, which look like small sensor stickers, near your ears and on your forehead. The earphones will emit clicking sounds and tones, and the electrodes will measure how your vestibulocochlear nerve and your brain are responding.

Imaging tests

Imaging tests that help healthcare professionals see inside your ear to look for structural problems, such as tumors or bone damage, include MRI and CT scans.

You will not need these scans if a healthcare professional has already identified that nonstructural problems are leading to hearing difficulty.

You may want to consider speaking with a doctor if you are experiencing the following symptoms:

  • increased need to turn up the volume during activities like watching television or listening to music
  • difficulty hearing or understanding speech, including following conversations
  • needing people to repeat themselves when talking
  • increased tiredness due to concentrating on hearing sounds
  • tinnitus, which refers to sounds like ringing and buzzing in the ears

A healthcare professional can work out the underlying cause of your symptoms and recommend appropriate treatment.

Diagnostic tests for hearing loss include audiometry tests, brainstem auditory evoked response tests, and otoacoustic emissions tests.

You may want to consider contacting your doctor if you are experiencing symptoms of hearing loss or changes in the way you hear sounds. A healthcare professional can work with you to diagnose any underlying problems and recommend appropriate treatment, if necessary.