Hearing tests 


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How the ear works

The ear is made up of the outer ear, the middle ear and the inner ear.

Sound enters the outer ear and passes down the ear canal to the eardrum (a thin layer of tissue that separates the outer ear from the middle ear). Sound makes the eardrum vibrate as it travels into the middle ear.

The middle ear is an air-filled cavity between the eardrum and the inner ear. It contains three tiny bones that pick up and carry the sound vibrations from the eardrum to the inner ear.

The inner ear contains the cochlea (a fluid-filled chamber that is responsible for hearing) and the vestibular system (the balance organ). Vibrations travel in the fluid of the inner ear and stimulate tiny nerve endings in the cochlea, which turn the vibrations into electrical signals that are fed along the auditory nerve to the brain.

Any problem with this process can result in hearing impairment, which may require a hearing test to diagnose the extent and type of deafness.

Hearing tests are used to assess your ability to hear different sounds and to determine if there are any problems.

Why are hearing tests needed?

Hearing tests are carried out for two main reasons:

  • as a routine part of a baby’s or young child’s developmental checks
  • to check the hearing of someone who is experiencing hearing problems or has a hearing impairment

It is important that hearing tests are carried out so that the right support and treatment can be provided.

Read more about why hearing tests are needed.

Hearing tests are carried out at regular intervals during childhood, starting with the new born hearing screening programme (NHSP) within a few weeks of birth.

Your child's hearing may also be checked during a general health review when they are a few years old and before they start school for the first time.

If at any point you are worried about your or your child's hearing, you can ask your GP for a hearing test.

Read more about when hearing tests are needed.

What happens during a hearing test?

Although your GP or practice nurse can examine your ears, you will usually be referred to a specialist for a hearing test.

A number of different tests are used to check how well the ears are functioning and their ability to detect different levels of sound.

Common hearing tests include:

  • automated otoacoustic emissions (AOAE) tests – a computer attached to an earpiece plays clicking noises and measures the response from the ear
  • automated auditory brainstem response (AABR) tests – sensors are placed on the head and neck to check the response of the nerves to sound played through headphones
  • pure tone audiometry tests – sounds of different volumes and frequencies are played and a button is pressed when they are heard
  • bone conduction tests – a vibrating sensor is placed behind the ear to test how well sound travels through the bones in the ear

The tests used generally differ between children and adults, but they are all completely painless.

The results of some of these tests are recorded on a graph called an audiogram, so that the type of hearing loss can be identified.

Read more about how hearing tests are carried out and hearing and vision tests for children.

Hearing problems

Your hearing may be affected if sounds don't reach the inner ear efficiently. This is known as conductive hearing loss. Conductive hearing loss can be caused by problems such as a blockage in your ear canal (such as from ear wax) or in the middle ear (for example, glue ear). An infection of your outer ear (otitis externa) or middle ear (otitis media) may also be responsible. Hearing loss of this type is often temporary and reversible.

If sounds reach the inner ear but are still not heard, the fault lies in the inner ear or, rarely, in the hearing nerve. This is called sensori-neural hearing loss. Inner ear hearing loss may occur for a number of reasons, most commonly as a result of age-related change. Inner ear hearing loss is nearly always permanent.

Hearing tests are used to determine the type of hearing loss that you have.

Page last reviewed: 23/10/2012

Next review due: 23/10/2014


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The 4 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Granthamroy said on 25 June 2014

About 18 months ago I was fitted with a CROS Aid because I am totally deaf in my left ear, and quite deaf in my right. This aid is a tremendous help as now I hear sounds from my left side through my aid in my right ear.
I must admit it takes a while to get used to because you have no perception of direction of sound, but at least you hear all round.
Now I want to make an appointment to have the balance adjusted, so that the output from both sides is about the same. That will make it even more comfortable.
Than you for a better life.

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skj1 said on 15 April 2013

5 days ago i had a hearing test ive got tinnitus.

im new to this
even though i have a result which im happy with .
im still struggling to hear its worse since my test

tonght result
so i did test on the rnid it recommends hearing test
so do 4 other apps my lowest mark is 8k hz in high range at under the 40 db for left a a little higner about a with of tracing paper for the right

friday result
after my test it was off the chart very steep drop

when talking it feels like there a bag over my right ear
and listening to music is like its mono

when using my iPhone it was on volume 8 out of 16
im having a lot of trouble yet im suppose have ok hearing
what do i do

also there was no test to see how loud my tinnitus was


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ttolga said on 10 March 2013

i had a ear operation when i was in turkey and operation was not successfull about 14 years ago, and i got ear calcification that might reason drop down my hearing is there a any possible solution is there a any risk if i had a operation ,

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HCheck said on 12 August 2009

If you have concerns about your or any of your family members hearing, you can get them to do a free, quick, online hearing check via the charity RNID here:


This will let you know if their hearing is within the 'normal' range or not.

Hope it is helpful for some of you out there.

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