See your GP if you are having problems with your hearing. If you are unsure whether you have hearing problems, answering the following questions can be a guide:
- Do you have difficulty hearing over the telephone?
- Do you have difficulty listening when more than one person in the room is talking?
- Do other people complain about the volume of your music or television?
- Do you have to concentrate quite hard to understand the other person when you are having a conversation?
- Do you often miss the sound of the doorbell or the phone ringing?
- Do you often get confused about the direction a sound is coming from?
- Do you regularly have to ask people to repeat themselves?
- Do the voices of women and children seem harder to understand?
- Do you work in a noisy environment?
- Does it seem as though everyone is mumbling?
- Do you often misunderstand what people are saying?
- Can you sometimes hear a hissing, rushing or ringing sound?
- Has someone close to you suggested that you may have a hearing impairment?
You should visit your GP if you answer yes to most of these questions. Your GP will examine your ears and carry out some simple hearing tests.
You might also wish to visit the Action for Hearing Loss website for an online hearing test.
Ear examination
During an ear examination, an instrument with a light at the end called an auriscope (or otoscope) is used to look for anything abnormal including:
Your GP will ask you if you have any pain in your ear and when you first noticed the hearing loss.
Referral to a specialist
Your GP may refer you to an ear, nose and throat (ENT) specialist or an audiologist (a hearing specialist). The specialist will carry out further tests to help determine what is causing your hearing loss and recommend the best course of treatment.
Some of the hearing tests that you may have include:
- a tuning fork test (may be performed by your GP)
- a pure tone audiogram, which tests air conduction hearing and bone conduction hearing
- a speech audiogram
These tests are described below.
Tuning fork test
A tuning fork is a Y-shaped, metallic object. When tapped, it produces sound waves at a fixed pitch. It is usually used for tuning instruments. The hearing specialist will tap the tuning fork on their elbow or knee to make it vibrate and they will then hold it next to your ear. This will indicate whether you can hear sounds that are transmitted through air vibrations.
The specialist may also hold the tuning fork against the bone behind your ear (mastoid). This will help to determine your level of hearing when the sound waves are transmitted to your inner ear through the bone.
Audiometry test
This is sometimes known as Pure Tone Audiometry and includes testing both air conduction and bone conduction.
Air conduction
During the air conduction part of the test you will wear earphones that are attached to a machine. Sounds of different tones and volumes will be played through the earphones. You will be asked to indicate whether you have heard them by raising your hand or pressing a button.
The audiologist may also check how well you are able to hear words that are spoken at different volumes. After listening to the words, you will be asked to repeat what you have heard.
Bone conduction
The bone oscillator test determines how well you are able to hear sounds that are transmitted through the bone rather than the air. It is similar to the tuning fork test but instead of a tuning fork, an instrument called a bone oscillator is placed against the bone behind your ear (mastoid) to determine your level of hearing through the bone. This is testing how well the nerve part of your hearing works.
Newborn Hearing Screening Programme (NHSP)
It is not easy to identify hearing loss in young babies because they are too young to know that something is wrong. Screening a baby’s hearing soon after they are born means that any hearing loss can be identified early.
After your baby is born, they will be given a number of routine health checks, including a hearing test. The test is part of the NHS Newborn Hearing Screening Programme (NHSP), and it will be carried out within the first few weeks of your baby's birth.
A test that is commonly used to check a baby’s hearing is the otoacoustic emissions (OAE) test. The test involves inserting a tiny probe just into the outer ear. If possible, it will be carried out while your baby is asleep.
The probe emits small sounds and checks for a corresponding "echo" from the ear, which is known as an otoacoustic emission. If there is no response, it does not necessarily mean that your child has a hearing impairment, although further tests will be needed to determine the cause.
About 15% of newborn babies will need further testing and one to two babies in every thousand will have some level of hearing loss in one or both ears.
