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How Is Hearing Loss Tested?

By Jon McKenna
Reviewed by Jordan Glicksman, MD, FRCSC, MPH on January 13, 2021
Specialists can use a number of different tests to identify whether you are experiencing hearing loss, and if so what type and how severe it is.

If you wonder whether your hearing ability is declining, your uncertainty can quickly be put to rest. Specialists can perform several types of tests to indicate the presence of conductive (affecting the outer or middle ear), sensorineural (affecting nerves in the inner ear), or mixed hearing loss (affecting both), or show whether your hearing is normal. The following are the most commonly used hearing loss tests.

Weber Hearing Loss Test

This test is performed by an otolaryngologist or audiologist by striking tuning forks of different frequencies and placing them at the midline of your skull (typically the forehead). If sound “lateralizes” (you hear it more loudly on one side), then that is the ear with potential hearing loss.

StatPearls publishing notes that a Weber test is a quick and straightforward evaluation that can detect unilateral conductive and sensorineural hearing loss.

Rinne Hearing Loss Test

With this hearing loss test, the tuning forks are placed against the mastoid bones behind your ears until you can no longer hear sound, at which point they are shifted to just outside the ear canal opening.

Like the Weber test, the Rinne test is simple and straightforward—in fact, they are often used together—“but it cannot precisely tell you how much hearing loss you experience,” Wafaa af, MD, an audiologist at Missouri State University tells WebMD Connect to Care.

Audiogram Hearing Loss Test

With this test, also known as pure-tone audiometry, a device lets the audiologist test each of your ears and generates a graph showing how well you hear based both on frequencies measured in Hertz (Hz) and loudness measured in decibels (dB).

According to the 2015 Handbook of Clincal Neurology, this graph helps establish if your hearing loss is conductive, sensorineural, or mixedand pure-tone audiometry is the gold standard hearing test. The test should always take place in a soundproof booth with properly-calibrated equipment. 

Tympanometry Hearing Loss Test

The specialist uses the same device that measures acoustic reflex testing to measure the stiffness of the eardrum, and thus evaluate middle ear function. 

“A tympanometry test is quick and easy to perform on patients of all ages and gives objective measurements of the middle ear function. However, it can be hard to use if your ear canal has oil or wax build-up, and it yields information about only conductive, not sensorineural, hearing loss,” Kaf says.

Otoacoustic Emissions (OAE) Hearing Loss Test

In this test, a probe containing a tiny speaker and microphone is inserted into the ear canal. Quiet tones are sent from the speaker to stimulate the cochlea hairs. If the hairs do not send out their own minute sounds, hearing loss is likely present.

An OAE test is used routinely for both screening hearing in infants and children and for diagnostic purposes, according to Kaf. “It is not useful in identifying the type of hearing loss, though, and excessive ear wax, noise, or movement can interfere with the test,” Kaf says.

Auditory Brainstem Response (ABR) Hearing Loss Test

Here, electrodes are placed on your head to measure how well the brain pathways for hearing and inner ear (cochlea) are working together.

The American Speech-Language-Hearing Assocation notes that this test, also known as an auditory evoked potential (AEP) test, is often used by children, those who are unable to complete a standard hearing test, and those whose symptoms indicate brain-related hearing loss. 

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