Audiometry assessment: what it involves

Pure tones at different pitches are presented to each ear, commonly through headphones or insert earphones. Bone-conduction testing may bypass the outer and middle ear to assess the inner-ear pathway more directly. Speech tasks and middle-ear measurements can be added when they help answer the clinical question.

The assessment describes hearing by pitch, sound level, side, and route of sound delivery. A gap between headphone and bone-conduction responses may indicate that sound is being reduced in the ear canal or middle ear. Similar changes by both routes may reflect the inner ear or hearing nerve. Some results contain elements of both patterns.

Reliability matters: responses should agree when tones are repeated in different ways. The clinician weighs the chart against speech understanding, examination findings, tinnitus or dizziness, recent infection, noise exposure, family history, and medicine use before recommending next steps.

Bring earlier results so changes can be compared, along with your hearing aids and a current medicine list. Describe which listening situations cause difficulty and whether the problem began suddenly, varies, or affects one ear more. Mention wax, pressure, pain, discharge, ringing, imbalance, and recent exposure to loud sound.

Respond whenever a tone may be present; you do not need to wait until it is clear. If you lose concentration, feel uncomfortable, or do not understand the task, say so because the tester can pause and clarify. Request an explanation of the final chart and a written follow-up plan.

Hearing that becomes suddenly poorer should be assessed urgently and should not wait for a standard appointment. The need is especially pressing for a one-sided change, new tinnitus with hearing loss, or severe vertigo. Obtain prompt medical care after head injury or when symptoms include facial weakness, trouble speaking, limb weakness, severe ear pain, blood, or fluid from the ear.

Ask whether the result is symmetrical, which sound pitches are most affected, and whether the findings point to conductive, sensorineural, or mixed hearing loss. Check whether wax removal, medical evaluation, repeat audiometry, hearing protection, communication support, or a hearing-device discussion fits the result.