Man taking a hearing test in a booth.

If you haven’t had a hearing exam since you were in grade school, you’re not the only one, it’s usually not part of a routine adult physical, and, unfortunately, we tend to treat hearing reactively rather than proactively. The good news: Hearing exams are simple, painless, and supply a wealth of insight to professional hearing specialists, both for diagnosing hearing issues and determining whether treatments like hearing aids are working.

You may not get a lollipop after your full audiometry test, which is more involved than you probably remember from your childhood, but you will get a greater understanding of your hearing health. There are three common types of hearing tests, each of which will provide different perspectives about your hearing.

Pure tone testing

One component that we utilize to measure sound is the intensity or loudness which is calculated in decibels (dB). Tone, what we conversationally refer to as pitch, is another key factor. It’s measured in Hertz (no relation to the car rental company), with a low bass sound measuring about 50-60 Hz, and general speech ranging from 500 to 3,000 Hz. Healthy human hearing ranges from 20 to 20,000 Hz.

With a pure tone hearing test, your hearing specialist will have you don a set of headphones which are hooked up to an audiometer. You might also use a device called a bone oscillator which seems alarming but just measures how well your bones conduct sound. Pure tones are directed to one ear at a time, and you signal (by pushing a button or raising a hand) when you hear a sound.

The lowest volume that you can hear the tones will then be tracked. In other words, this test gauges how well your ears are working: What range of sound you have difficulty hearing (which can be an essential indicator of whether you’d benefit from hearing aids), and whether you are experiencing hearing loss in both ears equally or if one ear is worse than the other.

Speech audiometry

This test also makes use of headphones, but instead tracks your ability to hear words being spoken. Your hearing specialist will sometimes ask you to repeat recorded words that you hear while there is background noise. Your hearing specialist will, in other circumstances, have you repeat words they are saying, but their mouths will be hidden from view.

Because you are unable to see the speaker’s mouth, you won’t have any visual cues to help you, and because they are only speaking single words, you won’t have any context to help you. Words that rhyme, let’s say crime, time, dime, and climb, can be challenging for people suffering from high-frequency hearing loss to differentiate.

Instead of just looking at the volume or threshold required for hearing, as tone testing does, speech audiometry evaluates your ability to make sense of the sounds you hear. Whether hearing aids will be helpful is another thing that word recognition testing can help determine.

Immittance audiometry

Alright, these can be a little uncomfortable, but shouldn’t cause pain. In tympanometry, a small probe is inserted in your ear, and air flows through it to artificially alter your ear’s pressure. A graph readout will allow your hearing specialist to identify if there’s an issue with your eardrum such as earwax impaction or a perforation, and how well your eardrum is functioning.

A related test uses a similar probe as an auditory tap on the knee, yes, your ears have reflexes! Muscles in your ear involuntarily contract when you are exposed to loud sound. It will be easier for your hearing specialist to determine the severity of your hearing loss when they know the level of noise needed to trigger this reflex. There’s no reflex response in individuals who have profound hearing loss.

It’s important to include immittance testing because it helps diagnose conductive hearing loss, which is when issues happen in the small bones inside of the ears and can occur at the same time as age-related or noise-related hearing loss.

Are you having trouble hearing? Get it tested! We can help you better comprehend your hearing health, inform you on what you can do to maintain healthy hearing, and let you know what your treatment options are if you have hearing loss or tinnitus.

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The site information is for educational and informational purposes only and does not constitute medical advice. To receive personalized advice or treatment, schedule an appointment.

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